High-Cost Claimants: Cost per Member, Top-Member Share & a Pareto Chart
This lesson is part of the course
In this lesson
You total each anonymised member's cost from claim lines with SUMIFS, measure how much of the group's cost the top 10 % of members drive, count members above a fictional high-cost level and chart the members from most to least expensive.
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Lessons in this course
- Member Months: Enrolment Dates, Months Covered per Member & the Plan's Exposure Locked
- Cost per Member per Month: Paid Claims by Category & by Month Locked
- Utilisation per 1,000 & Unit Cost: Splitting PMPM into How Often and How Much Locked
- High-Cost Claimants: Cost per Member, Top-Member Share & a Pareto Chart Locked
- Cost Trend: PMPM Year over Year, Utilisation Trend vs Unit-Cost Trend Locked
- Paid vs Incurred: Months of Development, Completion Factors & Claims Still to Come Locked
- Benefit Design Effects: Co-Pays, Deductibles, Out-of-Pocket Maximums & Plan PMPM Locked
- Plan Dashboard: Actual vs Budget PMPM, Traffic Lights & a Category Chart Locked