RenewalMUGs (RMUGs) is a convenient and flexible evidence-based medical underwriting tool that can accurately identify the medical conditions and relative health status of health plan members.
Based on the Milliman Small Group Medical Underwriting Guidelines™ (MUGs™), which use underwriting questionnaires to assess the health status of new plan members, RenewalMUGs instead uses administrative data such as claims, capitation, pharmacy, premium, and enrollment data to estimate members' health status.
A customized system that gives you a competitive edge
The RenewalMUGs risk adjuster was developed in 2000 specifically for the small group medical underwriting market. The Milliman MUGs that support the tool include rating data for approximately 700 conditions and more than 3,000 rating levels. The MUGs, available since 1990, have a consistent track record of success and are used by approximately 100 clients.
RenewalMUGs is calibrated for each client so that health status load factors are consistent with manual rating variables, such as family size categories and age/gender factors. The software's setting features enable clients to comply with all applicable state regulatory limits on health status factors.
RenewalMUGs provides an automatic coverage duration adjustment, as well. Using three years of data, the software calculates each member's months of coverage, then adjusts the member's debit score if the claims data is not fully complete.
A flexible, easy-to-use software solution
With RenewalMUGs software, underwriters can easily review member-specific conditions and debits. Underwriters can also track member-specific conditions from the time of application to renewal, which allows for better first-year renewal rating.
Input data is accepted in three different formats (text, Microsoft Access, or SQL) making it easy to map source data to standard structures. Standard reports are produced in Excel, and a datamart of output files can be increased for detailed reporting. Contact Will.Fox@milliman.com for a demonstration.
