Value

The Value section of the Utilization Folder imports the Title, Unit, and Per items are from the Specifications section of the Parameters Folder and ask you to fill in data shaded in blue if you checked in the Specifications section that the data was known.

In the Value section of the Utilization Folder, if the Per is not PMPM, then the calculated data described in Value must be restated * 12 for PMPM and * 1,000 for Per 1,000 members.

The Value field displays either data or the text “Enter Value”. There are three possibilities:

  1. Value displays data if in the Specifications section of the Parameters Folder, the Utilization Data Known box is not checked and the Capitation Rate Known and Cost Per Unit Known boxes are checked.

  2. Otherwise “Enter Value” text is displayed and Value must be entered to proceed with Next, Previous or another folder. If Value is calculated and not entered, the formula is: Capitation Rate/Cost Per Unit for corresponding item; or for Sub Totals of Line Items.

  3. If the Enter as Utilization Value is checked, the value is copied to the value in the Utilization Folder.

The Utilization value is calculated as follows:


Per Member
Per 1,000 Members
Per Month
Per Year





Member Months
Units/Member Months
Per Member/1,000

  • 2
    • Members

    		Units/(Members * Months)
    		Per Member/1,000

  • 2