Description: According to the Actuarial Standards Board’s Actuarial Standard of Practice No. 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally accepted method for quantifying underwriting gain in managed Medicaid capitation rates. This article discusses a new model developed to address this void and calculate underwriting gain. The model was developed by researching existing financial literature and performing a statistical analysis of industry data to build out a framework that can be leveraged to estimate underwriting gain.

Description: This article is the first installment of a three-part series that aims to provide an overview of ESGs and will focus on the general motivation for stochastic modeling, its advantages and its limitations. Future articles will further break down the key factors of ESGs and the application of these factors to better understand the Academy Interest Rate Generator (AIRG).