NorthSTAR Dashboard Utilization, Enrollment, and Expenditure Trending.
Medical Loss Ratio (MLR) Trends
Table 1a: Medical Loss Ratio: Previous Contract: Contract Beginning 11/07 through 8/09 Run from the NorthSTAR Data Warehouse and NorthSTAR payment system on 2/18/2010
Total Direct Service DSHS Payment State Fiscal Expenditures, including civil including civil state Medical Loss Ratio Year Month state hospital allocation hospital allocation (MLR) 2008 Nov-07 $ 8,749,710.46 $ 10,615,868.54 82.42% 2008 Dec-07 $ 8,536,706.68 $ 10,315,013.14 82.76% 2008 Jan-08 $ 9,391,877.93 $ 10,437,455.11 89.98% 2008 Feb-08 $ 9,088,235.22 $ 10,199,670.25 89.10% 2008 Mar-08 $ 9,391,575.88 $ 10,009,982.01 93.82% 2008 Apr-08 $ 9,473,920.36 $ 10,402,888.31 91.07% 2008 May-08 $ 9,445,156.20 $ 10,388,244.44 90.92% 2008 Jun-08 $ 9,453,010.79 $ 10,419,079.51 90.73% 2008 Jul-08 $ 9,822,505.96 $ 10,293,988.12 95.42% 2008 Aug-08 $ 9,403,169.38 $ 11,742,897.88 80.08% 2009 Sep-08 $ 9,610,111.29 $ 10,649,808.69 90.24% 2009 Oct-08 $ 10,160,851.26 $ 10,378,138.22 97.91% 2009 Nov-08 $ 9,478,252.63 $ 10,622,690.79 89.23% 2009 Dec-08 $ 9,929,004.16 $ 11,088,659.65 89.54% 2009 Jan-09 $ 10,446,214.99 $ 10,788,684.07 96.83% 2009 Feb-09 $ 9,941,818.99 $ 11,004,342.79 90.34% 2009 Mar-09 $ 10,845,625.92 $ 10,880,642.82 99.68% 2009 Apr-09 $ 11,023,236.14 $ 11,885,350.97 92.75% 2009 May-09 $ 10,506,407.39 $ 11,204,758.00 93.77% 2009 Jun-09 $ 10,701,391.45 $ 10,982,933.53 97.44% 2009 Jul-09 $ 10,859,748.22 $ 13,736,837.13 79.06% 2009 Aug-09 $ 10,461,568.38 $ 14,478,697.18 72.25%
TOTAL $ 216,720,099.73 $ 242,526,631.15 89.36%
88% Level $ 213,423,435.41 88.0%
Over/(under) spend of 88% $ 3,296,664.31
Notes: Dallas county funding for June July and August are not included Includes $2, 5000,000 for July and $2, 5000,000 for August (supplemental) Includes extra $400,000 in incentive dollars Does not include $1,529,353.19 in “freed up GR for FY09, as a result of ARRA (distributed in 9/09)
1 Table 1b: PRELIMINARY Medical Loss Ratio Trends: Current Contract Beginning 9/1/09 through 11/09: The data below should be consider preliminary, as all encounter data and cost data is not yet factored in the calculation of MLR Total Direct Service DSHS Payment State Fiscal Expenditures, including civil including civil state Medical Loss Ratio Year Month ID state hospital allocation hospital allocation (MLR)
2010 Sep-09 $ 10,540,140.65 $ 12,989,229.83 81.15%
2010 Oct-09 $ 10,534,619.82 $ 12,195,430.33 86.38% 2010 Nov-09 $ 9,581,494.38 $ 11,725,373.64 81.72% $ 30,656,254.86 $ 36,910,033.80 83.06%
88% Level $ 32,480,829.74 88.0%
Over/(under) spend of 88% $ (1,824,574.88)
NOTES includes $1,529,353.19 in “freed up GR for FY09, as a result of ARRA (distributed in 9/09) includes $400,000 in incentive payments
Table 2: Funding Levels and Persons Served in NorthSTAR FY00 Compared to FY09
FY00 FY09 Percent Change Number of Enrollees Served (MH and SA/CD) 30,742 61,993 101.7%
Cash Payments $78,787,143.71 $111,181,502.43 41.5%
FY00 FY09 Percent Change Cash Funding per Cash Funding per enrollee Served enrollee Served
$2,562.85 $1,793.45 -30.0%
Note: The NorthSTAR budget consists of Cash Funding and State Hospital Allocation. The top table represents the change in cash funding and persons served from Fiscal Year 2000 (beginning 9/1/99 and ending 8/31/00) to Fiscal year 2009 (beginning 9/1/08 and ending 8/31/09. The bottom table represents the cash funding per person served for the same periods.
2 Revenue Trends
Table 3a: Revenue, FY08 to FY09 $ 100,496,696.14 Annual Cash to ValueOptions FY08 $ 111,465,178.58 Annual Cash to ValueOptions FY09 $ 10,968,482.44 Increase from FY08 to FY09** **Note: This includes $5,000,000 in supplemental funding, and $400,000 incentive payments for FY09.
Table 3b: Projected Revenue, FY09 to FY10 $ 111,465,178.58 Annual Cash to ValueOptions FY09 $ 116,556,016.03 Projected Annual Cash to ValueOptions FY10** $ 5,100,837.45 Projected Increase from FY09 to FY10** **Note: This includes additional FY09 GR ($1,529,353.19 as a result FMAP increases associated with ARRA, and additional $400,000 in incentive payments. Projections were done using average 9/09-11/09 payment amounts multiplied by 12 months. Actual amounts may ultimately be more or less.
Utilization Trends
Table 4: Medicaid and non Medicaid Served Trends, 11/07-11/09
30000 Non Medicaid Enrollees Served Medicaid Enrollees Served
25000
20000
15000
10000
5000
0 8 9 7 8 9 8 9 8 9 8 9 8 9 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l l r r y y v v v n n p p u u a a a a o o o a a e e J J J J M M N S N S N M M
3 Table 5: Outpatient MH Trends-Claims Dollars
Allowed_Amount- Outpatient MH (ACT, Rehab, CM, Med Mgt, Counseling)
$4,500,000.00 $4,000,000.00 $3,500,000.00 $3,000,000.00 $2,500,000.00 $2,000,000.00 $1,500,000.00 $1,000,000.00 $500,000.00 $- 7 7 8 8 8 8 8 8 8 8 8 9 9 9 9 9 9 9 9 8 9 8 8 9 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l - - l - t t r r n n n n v c b r y v c b r y v p p u g u g c c a a o a u a a u e e p a o e e p o e e J u J u J J O J J O F M A F M A N D S N D S N M A M A
Table 6: Outpatient MH Trends-Persons Served
Un_Duplicated_Count_of_Claimants-Outpatient MH (ACT, Rehab, CM, Med Mgt, Counseling)
25000 20000 15000 10000 5000 0 7 7 8 8 8 8 8 8 8 8 8 9 9 9 9 9 9 9 9 8 9 8 8 9 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l - - l - t t r r v c n b r y n v c n b r y n v p p u g u g c c a a o e a e p a u o e a e p a u o e e J u J u J J O J J O F M A F M A N D S N D S N M A M A
Table 7: SA/CD Trends-Claims Dollars
CD Residential CD Non Residential
$1,200,000.00
$1,000,000.00
$800,000.00
$600,000.00
$400,000.00
$200,000.00
$- 7 8 9 8 8 9 9 8 9 7 8 8 8 8 8 9 9 9 9 9 9 8 8 8 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l l r r r r t t v v v n n n n c b y g p c b y g p u u p p a c a c o o o u u a a e e a u e e e a u e J J J A J J A J N O N O N F M F M D A S D A S M M
4 Table 8: SA/CD Trends-Persons Served
CD Residential CD Non Residential 3000
2500
2000
1500
1000
500
0 7 8 9 8 9 9 8 8 9 8 9 7 8 8 8 8 8 8 9 9 9 9 9 8 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l l r r t r t r v v v n n n n c g p c b g p b y y u u a p c c a p o o o a u a u e e e e a u e a u e J J J A J J A J N O N O N F M F M D A S D A S M M
Table 10 Community Inpatient vs ER/23 hour Observation Trends-Dollars Expended
$2,500,000.00 Community Inpatient ER/23 Hour Observation
$2,000,000.00
$1,500,000.00
$1,000,000.00
$500,000.00
$- 8 7 7 8 8 8 8 8 8 8 9 9 9 9 9 8 9 9 9 9 8 8 9 9 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l - - l - - t t r r v c y v c n b r y n n b r n v p p u g u g c c a a o e a e a u o e p a o p a e u e e J u J u J J O J J O F M A F M A N D S N D S N M A M A
Table 9 Community Inpatient vs ER/23 hour Observation Trends—Persons Served
1800
1600
1400
1200
1000
800
600 Community Inpatient 400 ER/23 Hour Observation
200
0 7 7 8 8 8 8 8 9 9 9 9 9 8 8 8 8 9 9 9 8 9 8 8 9 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------l - l t t r r v c n b r y v c n y v n b r n p p g u u g c c a a e a e p a o e a a o o u e p u e e u J J u J J O J J O F M A F M A N D S N D S N M A M A
5 Table 11 Medication Data Trends
Persons Who Received a Month Prescription Number of Claims Amount Paid Nov-07 8,302 23,571 $ 533,040 Dec-07 8,047 22,468 $ 546,876 Jan-08 8,504 24,474 $ 569,083 Feb-08 8,392 23,609 $ 571,181 Mar-08 8,258 23,228 $ 569,769 Apr-08 8,494 24,771 $ 600,579 May-08 8,297 23,969 $ 596,911 Jun-08 8,462 24,271 $ 614,386 Jul-08 8,919 26,680 $ 697,853 Aug-08 8,710 24,796 $ 667,655 Sep-08 8,996 26,229 $ 728,681 Oct-08 9,501 28,792 $ 850,894 Nov-08 9,060 25,634 $ 754,157 Dec-08 9,946 30,783 $ 863,360 Jan-09 10,002 29,975 $ 833,846 Feb-09 9,869 28,441 $ 789,494 Mar-09 10,572 32,042 $ 868,325 Apr-09 10,822 32,782 $ 928,589 May-09 10,632 31,549 $ 833,738 Jun-09 10,975 34,052 $ 890,988 Jul-09 11,366 35,725 $ 905,747 Aug-09 11,161 33,962 $ 876,644 Sept 09 11,171 34,675 $ 881,408 Oct 09 11,495 35,753 $ 919,569 Nov 09 11,052 33,548 $ 767,321 *Feb 09 Medication expenditures excludes jail drug expenditures ($184,000). Later months are incomplete due to claims lag
6 Table 12a State Hospital Trends- Allocation Compared to Bed Utilization - 9/1/08-8/09 FY09 Allocation End Of Year Expenditure End Of Year Over/Under
$34,968,007 $35,159,759 $191,752
Table 12b State Hospital Trends- Allocation Compared to Bed Utilization – 9/1/09-1/31/10 FY09 Allocation Projected Annual Expenditure Projected Over/(Under)
$39,450,379 $38,354,641 $ (1,095,738)
Note: NorthSTAR has a slightly increased % of the overall statewide allocation, but the beds day costs have also risen, and whether NorthSTAR experiences increased access depends on their usage of the various bed days, as well as other LMHA usages
Table 13 Non Medicaid Enrollment Trends
Non Medicaid Enrollment Trends
2000
1500
1000
500
0 8 9 8 8 8 8 9 9 7 8 9 9 9 7 8 9 9 9 8 8 8 8 8 9 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
l l t t r t t y y v y v y v i i c h g c g n b b e e n l l c r c r p a p a a c o o o e u u e a e e n n a u u r p p e e O O J J M N F M J A N F M u J A N u D D a A A S S J J M
Note: Most Recent Months may show Medicaid retroactive enrollment, and thus the latest months could decrease.
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