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San Francisco health board reviews new risk-score analysis as input to 2019 rates
Summary
Health Service System staff presented third-year risk-score results showing a modest decline in aggregate commercial risk across plans but increases for Blue Shield; commissioners asked about model limits, Medicare retiree data, and how scores will influence 2019 rate negotiations.
Marina Coleridge, Enterprise Systems and Analytics Manager for the San Francisco Health Service System, presented the system—s third annual risk-score analysis to the Health Service Board, outlining how concurrent and prospective DXCG-based scores for the October 2016September 2017 period will inform the 2019 rates-and-benefits cycle.
Coleridge said the blended commercial population (actives and early retirees) showed a continued downward trend in both concurrent and prospective risk scores year over year, with Blue Shield the only plan to show an overall increase. She cautioned that the DXCG models are…
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