*Disclaimer: Results may vary. Any examples, estimates, or performance metrics are provided for illustrative purposes only

This calculator will allow you to input three key variables to determine an estimate for annual savings in cost avoidance and return on investment.

• For the Enter Number of Medicaid Members field, simply enter your current Medicaid population.
• For the Enter Average Drug Expense/Medicaid Utilizer field, enter your plan’s average Rx cost per medicaid utilizer. In a recent case study with a MCO with 1.4 million Medicaid lives, we determined an average Rx savings of $69/Medicaid utilizer.
• For the Enter Average Medical Expense/Medicaid Utilizer field, enter your plan’s average medical cost per utilizer. In the same case study as above, we determined an average medical savings of $1011/Medicaid utilizer.

Assumptions:

• The Medicaid Plan will fully utilize ProTPL for eligible OHI discovery opportunities.

• This calculator has been developed based on actual case studies, but an eligibility OHI discovery test file is the only way to empirically evaluate value to your Medicaid plan.