Payor Financial Models

Payor Financial Database (PFD)

The PFD aggregates and verifies information from SNL Financial, the National Association of Insurance Commissioners, and other public sources to create a consolidated set of P&L data by carrier, by state, by line of business. At present, data is available for the individual, small-group, and large-group-risk markets; breakdowns for Medicaid, Medicare Advantage, and Medicare Supplemental will be available soon. The PFD includes granular data for the most recent three years (2010 – 2012). The data is validated and adjusted to account for reporting and other errors, as well as to ensure comparability. Outputs include covered lives, premiums, claims, expenses, and profits. Claims are subcategorized to allow detailed comparison of granular expense categories (e.g., five separate components of expenses incurred for improving healthcare quality). Thus, the PFD can give clients an immediate ability to benchmark market performance.