actuarial consulting
The Department of Health Services Division of Health Care Access and Accountability (DHCAA) along with the Division of
Long Term Care (DLTC) seek a vendor to provide actuarial services. The actuarial consulting firm (contractor) selected will be
responsible for providing a variety of services including, but not limited to, evidence based scenario modeling, cost effectiveness
analyses, cost containment analysis of quality data as well as setting capitation for various provider assessments.
The Department seeks a qualified actuarial services entity to develop actuarially derived capitation rates utilizing a variety of
parameters such as recipients age, gender, eligibility category, disease burden, and geographic location. This requires that the
contractor have experience in long-term health care issues and health-based risk adjustment payment techniques.
The contractor will be expected to perform within a dynamic regulatory and legislative environment which can produce swift
and significant impacts on rates. Therefore, the actuarial entity may be directed to develop multiple models and actuarial
scenarios to assist the Department in determining the impact of the proposed regulation or legislation. The contractor must
have the capabilities to review, understand and advise the Department on expected solvency of healthcare plans and other
issues that affect the Departments health and long term care programs.
