Although Utilization Reviews (URs) and Independent Medical Reviews (IMRs) have been used in state jurisdictions for years, insurers have only recently focused on how the Centers for Medicare and Medicaid Services (CMS) treats URs and IMRs when evaluating Medicare Set-Asides (MSAs).
This article outlines some ways in which users of AIR’s Touchstone platform can gain new insights into the uncertainty in their modeled loss estimates, create a framework for testing the sensitivity of results, and make better informed business decisions.