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UMR presentation shows high-cost claimants drive a large share of Sunnyside plan spend
Summary
UMR analysts told trustees that 21 high-cost claimants account for roughly 32.6% of total medical cost, MSK and digestive diagnoses drove spending increases, and utilization measures show 81.9% of members used medical benefits during the period reviewed.
UMR’s data-analytics team presented the trust with a multi-slide review of enrollment, utilization and cost drivers for the plan’s experience period.
Heather Liglerhoppe introduced Carissa Daniels as the designated analyst. Carissa said enrollment rose about 4.3% versus the prior year and reported a paid PMPM of about $361.98 (up roughly 2%). "About 81.9% of your members…
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