Systems And Methods For Projecting Sample Store Activities That Are Restricted In Non-Sample Stores
Systems and methods are provided for estimating non-sampled store activities by applying projection factors to sampled store activities taking into account restrictions on non-sampled store activities. The systems and methods adjust data projection factors for managed healthcare plans that have restrictions in non-sampled stores to prevent unrestricted activity under these plans at sample stores from being projected into non-sample stores where such projected activity would be restricted. Conventional sampled-to-non-sampled store projection factors leading to restricted plan activities are reallocated to non-restricted plan activities in the non-sample store based on the historical ratio of such activities observed in sample stores.
1 . A method for projecting sample store activities that are restricted in non-sample stores, comprising:
identifying restricted activities data within a projection, the restricted activities data indicating activities disallowed at nonsample stores;
removing the restricted activities data from the projection;
generating replacement activities data for the nonsample stores; and
reassigning the replacement activities data to non-restricted plans based at least in part on factors applied to nonrestricted activities at nonsample stores.
2 . The method of claim 1 , wherein the activities include scripts purchases.
3 . The method of claim 1 , wherein the estimated total activities remains constant.
4 . The method of claim 1 , wherein reassigning the replacement activities data is based at least in part on historical ratios of sampled, restricted activities to sampled, non-restricted activities.
5 . A method for projecting sample store activities that are restricted in non-sample stores, comprising:
determining restricted outlet-plan combinations applicable in a market region;
generating exclusion lists of nonsample stores;
generating restricted plan allocation data;
generating restricted plan adjustments (RPA) factors data;
selecting, from a current week sample TRxs data file, a first group including scripts associated with a restricted plan and a second group including scripts not associated with a restricted plan;
appending RPA factors to one or more scripts in the first group; and
adjusting missing supplier records.
6 . The method of claim 5 , further comprising:
generating reverse roster data identifying which outlets a restricted plan is not allowed to fill prescriptions for.
7 . The method of claim 6 , further comprising:
generating the roster data by combining the current month next generation prescription services universe, current month plan rosters for restricted plans, and coverage area.
8 . The method of claim 5 , further comprising:
summing, at the outlet-product-plan level, non-missing supplier weights to create RPA factors
9 . a method for projecting sample store activities that are restricted in non-sample stores, comprising:
determining restricted outlet-plan combinations;
exploding an exclusion/inclusion parameter files;
creating a restricted plan allocation file;
appending allocations to weight files;
creating factor files from the weight files;
transforming factors;
splitting sample file;
applying factors to rxs;
splitting missing supplier weights; and
appending missing supplier weights to sample rxs.
10 . An article of manufacture comprising a computer readable medium having computer executable instructions embodied therein, the computer instructions for projecting sample store activities that are restricted in non-sample stores, the computer executable instructions causing a computer system to perform the steps comprising:
identifying restricted activities data within a projection, the restricted activities data indicating activities disallowed at nonsample stores;
removing the restricted activities data from the projection;
generating replacement activities data for the nonsample stores; and
reassigning the replacement activities data to non-restricted plans based at least in part on factors applied to nonrestricted activities at nonsample stores.
11 . The article of manufacture of claim 10 , wherein the activities include scripts purchases.
12 . The article of manufacture of claim 10 , wherein the estimated total activities remains constant.
13 . The article of manufacture of claim 10 , wherein reassigning the replacement activities data is based at least in part on historical ratios of sampled, restricted activities to sampled, non-restricted activities.