| Revenue Recognition | Diagnosis | Count | Claim Budget | OverUnder | Budget RM | Budgeted | Required |
|---|---|---|---|---|---|---|---|
| MC-Acute | ABI | 26 | 17,307,651 | 435,025 | 609,071 | 4% | -3% |
| MC-Acute | Amputation | 2 | 726,919 | -49,741 | 45,241 | 6% | 7% |
| MC-Acute | Multiple Trauma | 27 | 14,990,332 | -534,822 | 515,539 | 3% | 4% |
| MC-Acute | Other | 4 | 1,208,286 | 164,686 | 62,336 | 5% | -14% |
| MC-Acute | SCI | 16 | 11,666,231 | 444,151 | 550,252 | 5% | -4% |
| MC-Chronic | ABI | 18 | 5,689,193 | -126,151.8 | 117,378 | 2% | 2% |
| MC-Chronic | Amputation | 2 | 931,827 | 2,953.8 | 15,402 | 2% | 0% |
| MC-Chronic | Burn Injury | 2 | 639,402 | 282,165.8 | 11,334 | 2% | -44% |
| MC-Chronic | Multiple Trauma | 9 | 3,894,247 | 1,344,508.8 | 209,196 | 5% | -35% |
| MC-Chronic | Other | 2 | 471,716 | -167,461.6 | 38,646 | 8% | 36% |
| MC-Chronic | SCI | 20 | 7,509,093 | -270,080.3 | 237,216 | 3% | 4% |
CLL Risk Margin
CLL Risk Margin Summary
by Diagnosis
Data is for CLL contracts with effective dates between 2015 and 2022, as of 4/30/2025
Comparing the budgeted risk margin to the retrospective required risk margin, chronic SCI and ABI were generally close to where they needed to be. Acute ABI and SCI had a negative requirement as they were overbudgeted. In additon multiple trauma was close to budget and no risk margin was required, though 4% was budgeted. Other categories were too small to draw conclusions
by Revenue Recognition
Overall, both acute and chronic were overbudgeted as the required margin was negative. Though with only 133 contracts in total to evaluate, its not clear that a risk margin would not be theoretically required.
| Revenue Recognition | Count | Claim Budget | OverUnder | Budget RM | Budgeted | Required |
|---|---|---|---|---|---|---|
| MC-Acute | 75 | 45,899,420 | 459,299 | 1,782,439 | 4% | -1% |
| MC-Chronic | 53 | 19,135,477 | 1,065,935 | 629,172 | 3% | -6% |
by Effective Year
| Effective Year | Count | Claim Budget | OverUnder | Budget RM | Budgeted | Required |
|---|---|---|---|---|---|---|
| 2015 | 22 | 5,414,762 | 396,431 | 199,322 | 4% | -7% |
| 2016 | 23 | 7,633,480 | 863,669 | 278,261 | 4% | -11% |
| 2017 | 10 | 4,001,185 | -51,153 | 223,632 | 6% | 1% |
| 2018 | 13 | 3,227,831 | -519,937 | 111,354 | 3% | 16% |
| 2019 | 15 | 8,328,152 | -23,741 | 335,371 | 4% | 0% |
| 2020 | 13 | 11,442,349 | -636,433 | 502,086 | 4% | 6% |
| 2021 | 22 | 17,075,166 | -395,724 | 448,732 | 3% | 2% |
| 2022 | 10 | 7,911,972 | 1,892,122 | 312,853 | 4% | -24% |
| Revenue Recognition | Effective Year | Count | Claim Budget | OverUnder | Budget RM | Budgeted | Required |
|---|---|---|---|---|---|---|---|
| MC-Acute | 2015 | 9 | 2,131,277 | 300,663 | 96,136 | 5% | -14% |
| MC-Acute | 2016 | 12 | 4,052,154 | 861,998 | 188,227 | 5% | -21% |
| MC-Acute | 2017 | 5 | 2,783,955 | 16,535 | 188,051 | 7% | -1% |
| MC-Acute | 2018 | 6 | 1,969,787 | -542,315 | 98,251 | 5% | 28% |
| MC-Acute | 2019 | 11 | 7,219,985 | 294,400 | 271,927 | 4% | -4% |
| MC-Acute | 2020 | 11 | 10,513,964 | -391,757 | 445,788 | 4% | 4% |
| MC-Acute | 2021 | 15 | 13,000,095 | -260,811 | 329,899 | 3% | 2% |
| MC-Acute | 2022 | 6 | 4,228,202 | 180,586 | 164,160 | 4% | -4% |
| MC-Chronic | 2015 | 13 | 3,283,486 | 95,768.2 | 103,186 | 3% | -3% |
| MC-Chronic | 2016 | 11 | 3,581,326 | 1,670.6 | 90,034 | 3% | 0% |
| MC-Chronic | 2017 | 5 | 1,217,230 | -67,688.0 | 35,581 | 3% | 6% |
| MC-Chronic | 2018 | 7 | 1,258,044 | 22,377.8 | 13,103 | 1% | -2% |
| MC-Chronic | 2019 | 4 | 1,108,167 | -318,141.0 | 63,444 | 6% | 29% |
| MC-Chronic | 2020 | 2 | 928,385 | -244,675.9 | 56,298 | 6% | 26% |
| MC-Chronic | 2021 | 7 | 4,075,071 | -134,912.3 | 118,833 | 3% | 3% |
| MC-Chronic | 2022 | 4 | 3,683,769 | 1,711,535.2 | 148,693 | 4% | -46% |