title: How to outsmart biases in health plan claims data.
abstract: Before negotiating your next contract, heed this expert advice for reducing risk when setting PMPM rates and case rates using frequently biased and incomplete HMO historical data. Here are 8 tips for using HMO-provided data, plus some benchmark utilization projections for commercial and Medicare populations.
mesh_terms: D019985:Benchmarking; D015982:Bias; D002204:Capitation Fee; D003284:Contract Services / Q000191:economics; D019468:Disease Management; D005544:Forecasting; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007344:Insurance Claim Reporting; D011907:Rate Setting and Review / Q000379:methods; D012308:Risk Management; D014481:United States