Future expenditure risk of silent members: a statistical analysis

Table 2 Review requiring 12 member months continuous enrollment per year

	Count	Retention Rate	Count who had claims	Count who were Silent	PMPY Mean for cohort^a and for claimants only	PMPY Median for cohort^a and for claimants only	% > Top 5 % PMPY of All Members with 12 MM	% > Top 1 % PMPY of All Members with 12 MM	% > $100,000
Silent-members in 2009	238,180		0
2010: 2009 Silent-members with 12 MM in 2010	198,632	83.40 %	89,475	109,157	Cohort^a $1,116	Cohort^a $0	1.22 %	0.26 %	0.10 %
2010: 2009 Silent-members with 12 MM in 2010					Claimants $2,477	Claimants $398	(n = 2432)	(n = 509)	(n = 205)
2011: 2009 Silent-members with 12 MM in 2010 and 2011	162,257	68.12 %	81,097	81,160	Cohort^a $1,481	Cohort^a $0	1.61 %	0.37 %	0.18 %
2011: 2009 Silent-members with 12 MM in 2010 and 2011					Claimants $2,963	Claimants $439	(n = 2619)	(n = 607)	(n = 284)
	Count	Retention Rate	Count who had claims	Count who became silent	PMPY Mean	PMPY Median	% > Top 5 % PMPY of All Members with 12 MM	% > Top 1 % PMPY of All Members with 12 MM	% > $100,000
Low-Expenditure Members in 2009	121,700		121,700		$94.01	$95.27
2009 Low-Expenditure Members with 12 MM in 2010	93,184	76.57 %	69,465	16,147	Cohort^a $1,462	Cohort^a $215	1.50 %	0.25 %	0.09 %
2009 Low-Expenditure Members with 12 MM in 2010					Claimants $1,962	Claimants $383	(n = 1401)	(n = 231)	(n = 85)
2009 Low-Expenditure Members with 12 MM in 2011	76,772	63.08 %	57,755	12,298	Cohort^a $1,590	Cohort^a $150	1.92 %	0.35 %	0.17 %
2009 Low-Expenditure Members with 12 MM in 2011	76,772	63.08 %	57,755	12,298	Claimants $2,466	Claimants $433	(n = 1472)	(n = 268)	(n = 129)

^aCohort refers to the group of members in the reported year who originated in 2009 and for whom PMPY means were estimated using all individuals originally assigned to the silent-member or low-expenditure member cohort in 2009, regardless of whether they had claims in that particular year. Persons for whom mean PMPY estimations were calculated using only those individuals from the cohort who had claims during the specific year are referred

ISSN: 1472-6963