Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Admin Fees topic
No spam. Unsubscribe anytime.
Board approves Aon recommendation to adjust UHC administrative fees and shared-savings split
Summary
The Health Service Board approved Aon's package recommending a 2.7% base ASO fee increase for UnitedHealthcare City Plan and a migration in shared-savings terms, with staff to build a $71.61 PSPM expense into 2019 rating; commissioners questioned projected savings and volatility.
The board voted to approve Aon's recommendation on administrative services fees for the UnitedHealthcare (UHC) City Plan after an Aon presentation explaining the components and projected trade-offs.
Aon—s Mike Clark recommended three actions for 2019: a 2.7% increase in the base administrative services-only fees quoted by UnitedHealthcare; a change in the allocation of shared-savings program proceeds (moving from the current SFHSS/UHC split to a proposed 70/30 split in SFHSS—s favor) combined with a $0.71 per-subscriber-per-month (PSPM) increase in the fixed fee to offset risk; and a total PSPM expense recommendation to be included in 2019 City Plan rating. Clark presented a slide estimating that the proposed trade-off could yield a projected net savings to SFHSS (Aon—s illustrative figure was about $47,408 for 2019 under the assumptions in the presentation).
Commissioners probed the statistical uncertainty around projected savings, the mechanical basis for PSPM calculations and how changes could affect enrollment mixes. Aon acknowledged a degree of variance and provided a +/- range (Clark suggested an estimate range of roughly $25,000$60,000 for that component). After discussion a motion to accept Aon—s three requests was moved, seconded and the board voted in favor.
The board also heard related information on UHC programs that generate savings for the system (shared-savings program, facility reasonable-and-customary program, and value-based contracting) and a projected additional annualized saving from migrating contracting approaches in California. The motion did not modify plan design; it directed staff to build the approved PSPM and fee structure into the upcoming 2019 rate calculations and to continue negotiating contracting details with carriers.
