Exhibit_15_New_Supp_Aggregate_Utilization_Exp_.xlsx
XLSX spreadsheet 14 KB Posted
- Attached to
- OEIBA Program Commercial HMO, MSP, and MAPD Plans State and local contract opportunity
- Solicitation number
- EV00000681
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This document is an Excel exhibit (Exhibit 15) for a healthcare services contract involving the state of Oklahoma, specifically detailing aggregate utilization and experience data for active and early retiree health plan participants for Plan Year 2026. The exhibit provides a comprehensive template for vendors to report detailed healthcare metrics across two distinct experience segments: one for Non-Value Based Networks and another for Value Based Networks, covering the period from April 2024 through March 2025. Vendors are instructed to provide statewide data covering 14 key performance indicators, including total premiums received, medical and prescription paid claims, subscriber and member coverage, age/sex factors, clinical utilization metrics, and provider network details.
The exhibit appears designed to collect standardized healthcare performance data to support procurement or contract evaluation processes, with a focus on capturing granular insights into network performance, claims experience, and healthcare utilization across different network models. By requesting anticipated or actual data, the state seems to be establishing a framework for comparing vendor capabilities, network effectiveness, and potential cost structures. The document is marked as confidential, suggesting it is part of a competitive solicitation or contract renewal process for Oklahoma's health benefits program, with an emphasis on gathering comprehensive, comparable data from potential healthcare service providers.
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Text version
Exhibit 15
| Exhibit 15 |
| New Vendor Only- Aggregate Utilization/Experience Data- Actives & Early Retirees |
| Plan Year 2026 |
| Instructions on providing the experience segments: |
- Experience Segment 1: Provide requested information for the Oklahoma Book of Business on Non-Value Based Networks
- Experience Segment 2: Provide requested information for the Oklahoma Book of Business on Value Based Networks Note: In absence of actual data, please provide anticipated/expected information
| Experience Segment 1 - April 2024 through March 2025 | Statewide | |
| 1. | Total Premium Received (In Dollars) | |
| 2. | Total Medical Paid Claims non-capitated (In Dollars) | |
| 3. | Total Rx Paid Claims (In Dollars) | |
| 4. | Total Capitated Paid Claims (In Dollars) | |
| 5. | Total Rx Rebates (Client Specific in Dollars) | |
| 6. | Total Subscribers Covered | |
| 7. | Total Members Covered | |
| 8. | Age/Sex Factor | |
| 9. | Total Admissions | |
| 10. | Total Inpatient Days | |
| 11. | Total Prescriptions | |
| 12. | Total Primary Care Providers | |
| 13. | Total Specialists | |
| 14. | Total Hospitals | |
| Experience Segment 2 - April 2024 through March 2025 | Statewide | |
| 1. | Total Premium Received (In Dollars) | |
| 2. | Total Medical Paid Claims non-capitated (In Dollars) | |
| 3. | Total Rx Paid Claims (In Dollars) | |
| 4. | Total Capitated Paid Claims (In Dollars) | |
| 5. | Total Rx Rebates (Client Specific in Dollars) | |
| 6. | Total Subscribers Covered | |
| 7. | Total Members Covered | |
| 8. | Age/Sex Factor | |
| 9. | Total Admissions | |
| 10. | Total Inpatient Days | |
| 11. | Total Prescriptions | |
| 12. | Total Primary Care Providers | |
| 13. | Total Specialists | |
| 14. | Total Hospitals | |
| CONFIDENTIAL |
File details come from the government source that posted it. Updated .