Advanced Medicare Bid Simulator

Plan Inputs

Base Expected Claims PMPM ($): 400 ``` Utilization Trend (%): 5 Specialty Drug Trend (%): 5 Seasonality Amplitude (%): 5 Member Retention (%): 90 Target Profit Margin (%): 3 Star Rating: 4 Credibility Weight (% Plan vs Regional): 80 Future Claim Variance (% for CI): 10 Include Catastrophic Specialty Shock ```

CMS & Risk Parameters

CMS Benchmark PMPM ($): 500 ``` Average RAF Score: 1.0

Risk-Adjusted Benchmark: $

Formula: Risk-Adjusted Benchmark = CMS Benchmark × RAF Score

Plan Bid PMPM: $

Formula: Bid = (Credibility-Adjusted Claims × Retention Adjustment + Catastrophic Shock) × (1 + Profit Margin)

Rebate: $

Formula: Rebate = max(0, Risk-Adjusted Benchmark − Bid)

Expected PMPM Range (Confidence Interval): $ - $

Formula: CI = Bid ± z × √(Variance × Bid² × (1−Credibility))

Explanation: Higher variance widens CI, higher credibility narrows it; seasonal and trend adjustments affect base bid.

```

Advanced Medicare Advantage Bid Simulator

Trend, Seasonality, Credibility, Variance, Catastrophic Event

Plan Inputs

CMS & Risk Parameters