Medicare

The ARC project team has extensive experience in the development of actuarial techniques, cost estimates, and data bases for the Medicare program. Examples of such work in development of actuarial cost estimation techniques for the Medicare program include:

• Estimates for providing limited dental care under part B of Medicare.
• Analyses of proposals to limit reimbursement to cost HMOs to the AAPCC.
• Estimate cost and potential offsetting savings related to prevention and health screening initiatives.
• Actuarial consultants for a major evaluation research project examining HMO at risk capitation contracts for services to Medicare beneficiaries.
• Advice to the Office of the Actuary, CMS, concerning the impact of the Prospective Payment System (DRG-based payments to  hospitals).

ARC personnel also have considerable experience through GRTCA in the private sector, advising HMOs and other insurers concerning strategies to offer at risk Medicare contracts and concerning the benefit structure, premium rate and likely costs and profits to the plans. ARC has also advised a leading consumer advocate organization concerning the relative value of Medicare supplemental policies, HMO cost contracts and PHP at-risk contracts, and concerning ways to improve consumer information.