Health Care Business Plan

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THE NEW JERSEY MEDICAID ACO BUSINESS PLANNING TOOLKIT Appendix B: Page 20 of 34 Applied Health Strategies APPENDIX B: BUSINESS PLAN TEMPLATE Applied Health Strategies, LLC Step 1 2008 Baseline Population Total Costs of Care by Medicaid Program Type Jerseytown Next Coalition TANF Designated Area Mbr Mths Avg Mbrs 12345 3,664 305.3 12346 5,880 12347 6,094 12348 2,202 12349 PMPM SSI Non-Dual TCC Mbr Mths Avg Mbrs PMPM CHIP TCC Mbr Mths Avg Mbrs Combined Population PMPM 96.69 354,286 321 26.8 320.97 103,030 480 40.0 57.08 490.0 77.53 455,862 574 47.8 449.90 258,240 664 55.3 507.8 105.73 644,295 754 62.8 249.81 188,359 621 51.8 183.5 98.01 215,817 200 16.7 232.06 46,413 268 22.3 45.91 TCC Mbr Mths Avg Mbrs PMPM TCC 27,396 4,465 372.1 108.56 484,713 36.70 24,366 7,118 593.2 103.75 738,468 581.04 360,825 7,469 622.4 159.79 1,193,479 12,303 2,670 222.5 102.82 274,533 3,640 303.3 68.47 249,226 340 28.3 308.02 104,725 270 22.5 44.26 11,951 4,250 354.2 86.09 365,903 NC Totals 21,480 1,790.0 89.36 1,919,487 2,189 182.4 320.13 700,767 2,303 191.9 189.68 436,842 25,972 2,164.3 117.71 3,057,096 Other Central 10,805 900.4 84.17 909,494 1,134 94.5 374.26 424,410 3,647 303.9 49.84 181,766 15,586 1,298.8 97.25 1,515,670 One Zip Code yielded insufficient activity to model: 12340 THE NEW JERSEY MEDICAID ACO BUSINESS PLANNING TOOLKIT Appendix B: Page 21 of 34 Applied Health Strategies APPENDIX B: BUSINESS PLAN TEMPLATE Applied Health Strategies, LLC Step 2 2008 Baseline Population Total Costs of Care Trended to 2015 Medical Trend alone - Holding Membership constant Jerseytown Next Coalition Trend Factors: 2009 Combined Population Designated Area 12345 Mbr Mths 4,465 Avg Mbrs 372.1 PMPM 108.56 TCC 484,713 PMPM 111.82 3 3 3 2010 TCC PMPM 499,254 115.17 3 2011 TCC PMPM 514,232 118.62 3 2012 TCC PMPM 529,659 122.18 3 2013 TCC PMPM 545,549 125.85 3 2014 TCC 2015 PMPM TCC PMPM 561,915 129.62 578,773 133.51 TCC 596,136 12346 7,118 593.2 103.75 738,468 106.86 760,622 110.06 783,441 113.37 806

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