Health Reform Cost Guide (HRCG)

Overview

Walely's Health Reform Cost Guide (HRCG) provides key metrics including utilization, unit cost and PMPM costs for individual and small group ACA members. The metrics are provided for key demographic, condition and other characteristics at a member level including cost level, age, gender, condition category (asthma, diabetes, etc.), cost-sharing reduction (CSR) category, plan (metal level) enrollment, and on/off exchange, and national region (Northeast, South, Midwest, West). The tool can be customized to provide different or additional details.

Applications

HRCG can be used for many purposes, including:

  • Modeling the impact of health reform proposals
  • Calibrating econometric models exponentially better than dated and inaccurate survey data
  • Modeling the impact of medical and care management programs
  • Analyzing current market rules and changes in rules
  • Building models to estimate consumer behavior
  • Pricing health insurance products in new markets
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