Cost Cap Research Articles

Moneyminder: An Expense Tracking Application

Abstract: In today’s fast-paced world, the ability to track regular expenses efficiently is more vital than ever to maintaining a budget. Moneyminder is a web application. This application allows user to maintain and keep a track of expenses on a daily basis. It enables individuals to categorize their spending, such as groceries, utilizes, entertainment. This method is used to split the daily expenditures. This program manages a user's daily costs based on their income, allowing them to save money. You will receive a notice if your daily spending limit is exceeded, encouraging you to limit your spending on that particular day. The money that remains after spending is added to the user's savings if they spend less than the daily cost cap. Every month at the conclusion, the program creates a report of the costs. By tracking your expense, you can understand your financial habits on a deeper level. It helps in setting realistic financial goals and provide a clear picture of financial health. Overall, this is a smart automated solution for tracking expense

Out-of-pocket cost modeling of adjuvant radiation therapy duration in standard-of-care treatment of glioblastoma across Medicaid and Medicare plans.

2045 Background: The optimal radiation treatment (RT) length (6 weeks of 60 Gy in 30 fractions versus 3 weeks of 40 Gy in 15 fractions) for older adults with glioblastoma is debatable, with Level 1 evidence (PMID 15051755) revealing no difference in survival between RT regimens. However, there remains a paucity of evidence describing the role of insurance on out-of-pocket (OOP) costs for patients undergoing varying lengths of RT. This project aims to quantify expenses by insurance plans, enhancing transparency in treatment cost understanding. Methods: We utilized the National Comprehensive Cancer Network guidelines to determine the standard treatment protocol, including 30-fraction or 15-fraction RT with concurrent and post-radiation temozolomide for 12 cycles. The model assumes a Medicare- and/or Medicaid-eligible patient ≥ 65 years of age with glioblastoma. The total aggregate out-of-pocket (OOP) costs were determined from the sum of treatment costs, deductibles, and copays/coinsurance based on Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D Rx plan over a two-year time horizon (not adjusted for inflation). All procedures were assumed to take place within the premises of an Ohio hospital. Results: Treatment charges include neurosurgery, neuro-oncology, and radiation oncology initial consultation, follow-up visits, diagnostic head CT, MRI, craniotomy with maximum safe resection, surveillance brain MRI, temozolomide, antiemetics, prophylactic TMP-SMX, weekly CBC, and tumor treating fields. RT-specific treatment charges include treatment planning, simulation and verification, RT delivery, and on-treatment visits. Original Medicare beneficiaries face an OOP cost of 20% for Medicare Part B claims with no cost cap for approved procedures after the deductible. Medications are covered under Medicare Part D with copays. This results in a total OOP treatment charge of $4,454.01 for 30 fractions and $3,913.86 for 15 fractions. Medigap Plan G beneficiaries face a total OOP charge of $2,387.22 for 30 fractions and $2,369.61 for 15 fractions. For Medicaid beneficiaries (assuming all treatments are approved by Medicaid), all expenses are covered without limit, resulting in no OOP expense for either treatment plan. Conclusions: Three-week versus six-week RT for GBM reduces OOP costs facing patients by 10%. By understanding the financial implications, healthcare providers, policymakers, and patients can make informed decisions about treatment options, and healthcare systems can develop strategies to mitigate the economic burden associated with GBM care.

Association of State Insulin Out-of-Pocket Caps With Insulin Cost-Sharing and Use Among Commercially Insured Patients With Diabetes : A Pre-Post Study With a Control Group.

Twenty-five states have implemented insulin out-of-pocket (OOP) cost caps, but their effectiveness is uncertain. To examine the effect of state insulin OOP caps on insulin use and OOP costs among commercially insured persons with diabetes. Pre-post study with control group. Eight states implementing insulin OOP caps of $25 to $30, $50, or $100 in January 2021, and 17 control states. Commercially insured persons with diabetes and insulin users younger than 65 years. Subgroups of particular interest included members from states with insulin OOP caps of $25 to $30, enrollees with health savings accounts (HSAs) that require high insulin OOP payments, and lower-income members. Mean monthly 30-day insulin fills and OOP costs. State insulin caps were not associated with changes in insulin use in the overall population (relative change in fills per month, 1.8% [95% CI, -3.2% to 6.9%]). Insulin users in intervention states saw a 17.4% (CI, -23.9% to -10.9%) relative reduction in insulin OOP costs, largely driven by reductions among HSA enrollees; there was no difference in OOP costs among nonaccount plan members. More generous ($25 to $30) state insulin OOP caps were associated with insulin OOP cost reductions of 40.0% (CI, -62.5% to -17.6%), again primarily driven by a larger reduction in the subgroup with HSA plans. Single national insurer; 9-month follow-up. Insulin OOP caps were associated with reduced insulin OOP costs but no overall increases in insulin use. A proposed national insulin cap of $35 for commercially insured persons might lead to meaningful insulin OOP savings but have a limited effect on insulin use. Centers for Disease Control and Prevention and National Institute of Diabetes and Digestive and Kidney Diseases.

Adoption of out-of-pocket cost caps: an Australian perspective.

Adoption of out-of-pocket cost caps: an Australian perspective.

Assessing out-of-pocket cost differences in treatment for Medicare-eligible patients with favorable prognosis early-stage Hodgkin lymphoma.

15 Background: In the treatment of favorable Hodgkin Lymphoma (HL), Level 1 evidence comparing combined modality therapy (CMT) with chemotherapy alone has persistently demonstrated that obviating radiation therapy (RT) worsens recurrence rates despite no significant overall survival difference. As there remains limited evidence on the granularity of the impact of insurance on HL treatment, this project disaggregates costs by insurance plans to enhance the transparency of out-of-pocket (OOP) cost estimations in Medicaid and/or Medicare-eligible (age 65+) patients. Methods: National Comprehensive Cancer Network guidelines were queried to assess the appropriate therapy for HL. Following initial adriamycin/bleomycin/vinblastine/dacarbazine (ABVD) chemotherapy x 2 cycles with Deauville 1-2 response on PET scan, CMT was defined as involved site RT (20 Gy / 10 fractions), while chemotherapy alone was defined as an additional ABVD x 2. Current Procedural Terminology and Healthcare Common Procedure Coding System codes identified treatments. OOP expenditures, deductibles, and copay/coinsurance were computed for Medicaid, Original Medicare, and Medigap Plan G plans via medicare.gov, medicaid.oh.gov, and cms.gov. Price estimates (from actual prices per insurance plan rather than claims data predictions) assume an Ohio hospital location (zip code = 44106) for all treatments. Total costs were calculated based on all treatments plus a 5-year follow-up (not adjusted for inflation). Treatment charges for chemotherapy alone include initial medical oncology office visit, cost of ABVD x 4, and infusion costs for 4 cycles. Additional treatment charges for CMT include initial radiation oncology consultation, treatment planning, dosimetry calculations, treatment device, simulation and verification, RT delivery, on-treatment visits, medical physics consultation, and annual TSH labs. Results: With Original Medicare plans, patients are faced with an OOP cost of 20% for Medicare Part B claims with no cost cap for approved procedures after the deductible. As such, patients are faced with a total 6-year charge of $1,928.95 for chemotherapy alone, and $2,385.28 for CMT. Under Medigap Plan G, patients encounter an OOP charge of $1,151.14 for chemotherapy alone and $1,176.34 for CMT. Medicaid beneficiaries (assuming all treatments are approved by Medicaid) face no OOP expenses for both treatment plans, as all expenses are covered without limit. Conclusions: By comparing OOP costs between Medicare and Medicaid plans, this model improves cost transparency in the treatment of favorable early-stage HL. Our findings indicate that omitting RT in favor of chemotherapy alone yields a cost savings of 2-24% at a 5-year follow-up. Further studies are required to assess whether these savings compensate for the inferior outcomes achieved by omitting RT in this patient population.

Insurance Plan Coverage Modeling of the Marginal Costs from One Week vs. Three Week Radiation Therapy in Standard-Of-Care Treatment of Post-Lumpectomy Early-Stage Breast Cancer Across Medicaid and Medicare Plans

For early-stage breast cancer (BC), the choice of radiation therapy (RT) duration (1- versus 3-weeks) is highly debated. Cost and financial toxicity are major concerns that BC patients face. Nonetheless, there remain limited discussions providing granular details of the role of insurance in the aggregate cost of 1 week versus 3 weeks of RT for patients. This project addresses this gap by disaggregating costs by insurance plan to increase transparency of out-of-pocket (OOP) cost estimates in RT. Surgical, medical, and radiation oncology treatment procedures were determined through the National Comprehensive Cancer Network guidelines; codes were identified using Current Procedural Terminology and Healthcare Common Procedure Coding System. OOP treatment costs, deductibles, and copay/coinsurance were calculated in accordance with insurance type, including Medicaid, Original Medicare, and Medigap Plan G. The medicare.gov, medicaid.oh.gov, and the physician fee schedule from cms.gov were used to determine pricing. Price estimates reflect actual costs per insurance plan rather than costs estimated from claims data. All procedures were considered to be performed in an Ohio hospital setting. One-week RT was defined as 5 fractions without boost, and 3-week RT was defined as 15 fractions without boost. Treatment charges for RT included initial radiation oncology office consultation and subsequent radiation oncology clinical treatment planning notes, complex 3D treatment plan, dosimetry calculations, complex treatment device design and construction, complex treatment planning simulation, simple verification treatment simulation, complex RT delivery, port verification films, on-treatment visits with radiation oncology, and continuing medical physics consultation. Original Medicare beneficiaries face an OOP cost of 20% for every Medicare Part B charge with no cost cap for all approved procedures after the deductible is met, resulting in a marginal OOP treatment charge of $649.24 for 1 week and $1006.20 for 3 weeks of RT. Assuming the deductible is met post-lumpectomy, Medigap Plan G beneficiaries are faced with no additional charges for both lengths of radiation treatment. Similarly, for Medicaid beneficiaries (assuming all treatments approved by Medicaid), all expenses are covered without limit, resulting in no OOP expense. Considerations of 1 week and 3 weeks of RT for post-lumpectomy early-stage BC are often dependent on cancer characteristic and patient preferences. This model (based on actual cost estimates per insurance plan rather than claims data) compares OOP costs across Medicaid and Medicare plans, which more holistically informs patients in their decision for choice of treatment.

The Increasing Adoption of Out-of-Pocket Cost Caps

This Viewpoint discusses potential benefits and unintended consequences of out-of-pocket cost caps in Medicare and the employer-sponsored health insurance market and provides suggested policy opportunities to address shortcomings.

Assessing the marginal costs of radiation therapy and antiestrogen therapy for post-lumpectomy, early-stage breast cancer across Medicaid and Medicare plans.

529 Background: With recent Level I evidence (FAST FORWARD) supporting radiation therapy (RT) duration as short as one week and Level I evidence (CALGB9343) supporting RT omission in favor of antiestrogen endocrine therapy (ET) alone in select patients, the necessity of both RT and ET, adjuvantly, in early-stage breast cancer (BC) has been questioned. Evidence providing granular details on the role of insurance in the aggregate cost of RT and ET is lacking. This project disaggregates costs by insurance plan to increase transparency of out-of-pocket (OOP) cost estimates. Methods: National Comprehensive Cancer Network guidelines were utilized to determine the proper treatments, with FAST FORWARD radiation dose/fractionation (26 Gy in 5 fractions) representing RT. Treatments were identified using Current Procedural Terminology and Healthcare Common Procedure Coding System codes. OOP costs, deductibles, and copay/coinsurance were calculated for Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D Rx. The medicare.gov, medicaid.oh.gov, aarpmedicareplans.com, and cms.gov were used to determine pricing. Price estimates reflect actual costs per insurance plan rather than costs estimated from claims data. All procedures were considered to be performed in an Ohio hospital setting, insurance coverages were based on the zip code 44106, and total expenses were based on all treatments plus a 5-year follow-up (not adjusted for inflation). Results: Treatment charges for ET include medical oncology initial consultation, biannual medical oncology follow-up, baseline bone density study, and Anastrozole cost (5-years). Treatment charges for RT include initial consultation, treatment planning, dosimetry calculations, treatment device, simulation and verification, RT delivery, on-treatment visits, and medical physics consultation. Original Medicare beneficiaries face an OOP cost of 20% for Medicare Part B claims with no cost cap for approved procedures after the deductible. Medications are covered under Medicare Part D with copays. This results in a marginal OOP treatment charge (after 5-year follow-up) of $767.54 for ET alone and $1,416.78 for ET + RT. Medigap Plan G beneficiaries face a marginal OOP charge of $1,225 for both ET alone and ET + RT, assuming the $226 Medicare Plan B deductible is met by the cost of lumpectomy during the year of RT. For Medicaid beneficiaries (assuming all treatments are approved by Medicaid), all expenses are covered without limit, resulting in no OOP expense for either treatment plan. Conclusions: Discussions of adding RT to ET for post-lumpectomy early-stage BC often involves considerations of treatment costs. This model (based on actual cost estimates per insurance plan rather than claims data) can help to enhance cost transparency by comparing expenses between Medicare and Medicaid plans.

Astrobiology eXploration at Enceladus (AXE): A New Frontiers Mission Concept Study

The Saturnian moon Enceladus presents a unique opportunity to sample the contents of a subsurface liquid water ocean in situ via the continuous plume formed over its south polar terrain using a multi-flyby mission architecture. Previous analyses of the plume’s composition by Cassini revealed an energy-rich system laden with salts and organic compounds, representing an environment containing most of the ingredients for life as we know it. Following in the footsteps of the Cassini-Huygens mission, we present Astrobiology eXploration at Enceladus (AXE), a New Frontiers class Enceladus mission concept study carried out during the 2021 NASA Planetary Science Summer School program at the Jet Propulsion Laboratory, California Institute of Technology. We demonstrate that a scientifically compelling geophysical and life-detection mission to Enceladus can be carried out within the constraints of a New Frontiers-5 cost cap using a modest instrument suite, requiring only a narrow angle, high-resolution telescopic imager, a mass spectrometer, and a high-gain antenna for radio communications and gravity science measurements. Using a multi-flyby mission architecture, AXE would evaluate the habitability and potential for life at Enceladus through a synergistic combination of in situ chemical analysis measurements aimed at directly detecting the presence of molecular biosignatures, along with geophysical and geomorphological investigations to contextualize chemical biosignatures and further evaluate the habitability of Enceladus over geologic time.

Multi-Objective Optimization of an Intelligent Soil-Moisture-Monitoring Satellite Constellation

In early satellite mission design, requirements are not yet fixed, cost is sometimes negotiable, and designs are relatively unconstrained. During this period of design freedom, multi-objective optimization can provide a useful lens into the design space by showing theoretical performance limits and illuminating design tradeoffs. This work optimizes a radar constellation for a potential soil moisture mission. Several different optimization cases with different variables are considered and contrasted. The optimization of the instrument and constellation parameters is considered jointly and separately to better understand the effect of coupling on the optimization performance. A science-driven optimization based on soil moisture retrieval error is compared with a performance-metric-driven optimization. Pareto analysis and association rule mining are performed on the generated designs to provide insight into driving features. Design recommendations are made for several cost caps. Results show that optimization that considers the instrument and constellation design together find superior revisit metrics than treating instrument and constellation separately. The use of the science value metric as an optimization objective shows that while cost may always be increased to improve instrument and constellation performance, the difference in science value may be negligible. These findings can inform tradespace exploration studies for similar problems.

European Union Cost Caps: One Step Forward Two Steps Sideways to Substantive Harmonisation of Consumer Credit Law

European Union Cost Caps: One Step Forward Two Steps Sideways to Substantive Harmonisation of Consumer Credit Law

VALENTInE: A Concept for a New Frontiers–Class Long-duration In Situ Balloon-based Aerobot Mission to Venus

Described here is a concept for a variable-altitude aerobot mission to Venus developed as part of the 2020 NASA Planetary Science Summer School in collaboration with NASA Jet Propulsion Laboratory. The Venus Air and Land Expedition: a Novel Trailblazer for in situ Exploration (VALENTInE) is a long-duration New Frontiers–class mission to Venus in alignment with the goals recommended by the 2013 Planetary Science Decadal Survey. VALENTInE would have five science objectives: (1) determine the driving force of atmospheric superrotation, (2) determine the source of D/H and noble gas inventory, (3) determine the properties that govern how light is reflected within the lower cloud later, (4) determine whether the tesserae are felsic, and (5) determine whether there is evidence of a recent dynamo preserved in the rock record. The proposed mission concept has a total duration of 15 Earth days and would float at an altitude of 55 km, along with five dips to a lower altitude of 45 km to study Venus’s lower atmosphere. The instrument payload allows for measurements of the atmosphere, surface, and interior of Venus and includes six instruments: an atmospheric weather suite, a mass spectrometer, a multispectral imager, a near-infrared spectrometer, light detection and ranging, and a magnetometer. Principle challenges included a limitation caused by battery lifetime and low technology readiness levels for aerobots that can survive the harsh conditions of Venus’s atmosphere. This preliminary mission was designed to fit within an assumed New Frontiers 5 (based on inflated New Frontiers 4) cost cap.

Customer lifetime value prediction for gaming industry: fuzzy clustering based approach

The use of fuzzy logic in machine learning is becoming widespread. In machine learning problems, the data, which have different characteristics, are trained and predicted together. Training the model consisting of data with different characteristics can increase the rate of error in prediction. In this study, we suggest a new approach to assembling prediction with fuzzy clustering. Our approach aims to cluster the data according to their fuzzy membership value and model it with similar characteristics. This approach allows for efficient clustering of objects with more than one cluster characteristic. On the other hand, our approach will enable us to combine boosting type ensemble algorithms, which are various forms of assemblies that are widely used in machine learning due to their excellent success in the literature. We used a mobile game’s customers’ marketing and gameplay data for predicting their customer lifetime value for testing our approach. Customer lifetime value prediction for users is crucial for determining the marketing cost cap for companies. The findings reveal that using a fuzzy method to ensemble the algorithms outperforms implementing the algorithms individually.

The case for a Themis asteroid family spacecraft mission

The last decade has highlighted the importance of icy asteroids as likely outer-solar-system planetesimals that brought organics and ices to the inner solar system. Better characterizing the relationship between these objects and other water-rich bodies throughout the solar system and their evolution as potential sources of organics has broad-ranging implications. Additionally, characterizing ice-rich bodies is important for understanding the evolution and diversity of Ocean Worlds. Observations and modeling have suggested that the Themis asteroid family likely represents the fragments of an icy protoplanet originally similar in size to (10) Hygeia (∼444 ​km), which was broken apart by a catastrophic collision and with (24) Themis possibly representing its core. While extensive observations have been made of the icy asteroid (1) Ceres, exploring the deep interior structure and processes is difficult when observing an intact planetary body. Thus, the many objects in the Themis family provide an opportunity to observe an interior cross-section of one of these protoplanetary objects. The Themis family contains a variety of members, including multiple Main Belt Comets (e.g., 133P/Elst-Pizarro) for which comet-like dust ejection (consistent with being driven by sublimation of volatile material) has been observed. In this paper, we present the science case for why the exploration of the Themis family is key to understanding icy objects in the solar system, and present three design-referenced mission architectures that would be plausible under the NASA Discovery mission cost cap that would address key science objectives pertaining to icy asteroids.

Evolvability analysis framework: Adding transition path and stakeholder diversity to infrastructure planning

AbstractThis paper presents the Evolvability Analysis Framework (EAF), a new perspective on evaluating complex infrastructure systems. EAF enables decision makers to explore alternative transition paths, thus providing several multi‐step options to achieve a desired end state. These multi‐step transition paths can be particularly valuable when they mitigate the impact of system degradation during the deployment of new capabilities. Additionally, EAF is formulated in a manner that empowers decision makers to apply decision variables, such as a cost cap or an equity metric, which are increasingly relevant to modern decision‐making. To demonstrate the method and its value, we apply the EAF to a case study inspired by Los Angeles’ Vision 2028. We identify 26 transition paths across different performance dimensions. We model the cost and performance of each transition pathway and compare them using multiple measures, including traditional benefit‐cost metrics and differential impacts on different stakeholder groups. Our results show that multi‐step paths outperform single‐step transitions to an end state (“big bang” approaches) in most scenarios. Multi‐step paths also provide valuable alternatives when particular stakeholders value non‐cost metrics.

In Situ Geochronology for the Next Decade: Mission Designs for the Moon, Mars, and Vesta

Abstract Geochronology is an indispensable tool for reconstructing the geologic history of planets, essential to understanding the formation and evolution of our solar system. Bombardment chronology bounds models of solar system dynamics, as well as the timing of volatile, organic, and siderophile element delivery. Absolute ages of magmatic products provide constraints on the dynamics of magma oceans and crustal formation, as well as the longevity and evolution of interior heat engines and distinct mantle/crustal source regions. Absolute dating also relates habitability markers to the timescale of evolution of life on Earth. However, the number of terrains important to date on worlds of the inner solar system far exceeds our ability to conduct sample return from all of them. In preparation for the upcoming Decadal Survey, our team formulated a set of medium-class (New Frontiers) mission concepts to three different locations (the Moon, Mars, and Vesta) where sites that record solar system bombardment, magmatism, and habitability are uniquely preserved and accessible. We developed a notional payload to directly date planetary surfaces, consisting of two instruments capable of measuring radiometric ages, an imaging spectrometer, optical cameras to provide site geologic context and sample characterization, a trace-element analyzer to augment sample contextualization, and a sample acquisition and handling system. Landers carrying this payload to the Moon, Mars, and Vesta would likely fit into the New Frontiers cost cap in our study (∼$1B). A mission of this type would provide crucial constraints on planetary history while also enabling a broad suite of complementary investigations.

Policy impact of cancellation of wind and photovoltaic subsidy on power generation companies in China

Renewable energy is environmentally friendly and with subsidies stimulating, global wind power and photovoltaic (PV) power generation industries are developing rapidly. As the biggest renewable energy generation country, China's wind power, and PV power generation industries have high growth and are suffering from the subsidy gap. Therefore, China's government gradually reduced and canceled the subsidies. The cancellation of subsidies brought challenges and opportunities to power generation companies.The purpose of this study is to explore the impact of subsidy cancellation on wind power, PV power and, coal-fired power generation companies. Firstly, we reviewed the subsidy policy history and then focused on the background of subsidy cancellation. Secondly, the impact of subsidy cancellation on wind power generation hours was proved using the difference-in-differences (DID) method. And the benefits of different trading methods of wind power and PV power existing units were calculated. The building cost caps of the future wind power and PV power unsubsidized units were calculated for different areas. The option of the existing units whether to waive subsidies and the investment advice in each area were proposed. Then, the impact on coal-fired power companies’ generation and revenues were analyzed. Finally, policy suggestions were discussed.

Cost Caps and Coverage for All: How to Make Health Care Universally Affordable

Cost Caps and Coverage for All is a comprehensive approach to health care. It protects everyone through two main parts: 1) Cost Caps: Caps premiums, deductibles, and other out-of-pocket costs for everyone based on income: 2) Universal Coverage: Ensures health care is a basic human right by automatically covering everyone not currently insured in an affordable plan. It would be paid for by protecting patients against high prices, realigning incentives to deliver better value for patients, reducing complexity for patients, and targeted tax increases on the wealthy.

Camilla: A centaur reconnaissance and impact mission concept

Centaurs, minor planets with a semi-major axis between the orbits of Jupiter and Neptune (5–30 AU), are thought to be among the most diverse small bodies in the solar system. These important targets for future missions may have recently been Kuiper Belt Objects (KBOs), which are thought to be chemically and physically primitive remnants of the early solar system. While the Kuiper Belt spans distances of 30–50 AU, making direct observations difficult, Centaurs' proximity to the Earth and Sun make them more accessible targets for robotic missions. Thus, we outline a mission concept designed to reconnoiter 10199 Chariklo, the largest Centaur and smallest ringed body yet discovered. Named for a legendary Centaur tamer, the conceptual Camilla mission is designed to fit under the cost cap of the National Aeronautics and Space Administration (NASA) New Frontiers program, leveraging a conservative payload to support a foundational scientific investigation to these primitive bodies. Specifically, the single flyby encounter utilizes a combined high-resolution camera/VIS-IR mapping spectrometer, a sub-mm point spectrometer, and a UV mapping spectrometer. In addition, the mission concept utilizes a kinetic impactor, which would provide the first opportunity to sample the composition of potentially primitive subsurface material beyond Saturn, thus providing key insights into solar system origins. Such a flyby of the Chariklo system would provide a linchpin in the understanding of small body composition, evolution, and transport of materials in the solar system.

Approaches to Reduce Conflict when Insuring the Environmental Cleanup of Closed Military Bases Intended for Redevelopment

ABSTRACTBase Realignment and Closure (“BRAC”) of military bases has occurred in waves over the last few decades. Many of these properties were operational through World War I, World War II, the Korean War, the Vietnam conflict, and into the modern Cold War. As part of the United States military's transfer of these properties to the local municipalities, which includes significant funds to cleanup remaining chemicals of concern, contract terms of the transfer typically require insurance policies that have the intention of mitigating the risk of additional future cleanup costs. As a result, numerous BRAC sites have established contracts with environmental consultants who have provided guaranteed fixed price contracts for cleanup of the site. To mitigate additional future cleanup costs, the environmental contractor is required to purchase a stop loss or cost cap insurance policy for their guaranteed fixed price contract to share the risk that there will be cost overruns in the cleanup of the known pollution. The redeveloper is required to purchase Premises Pollution or Environmental Liability insurance to share the risk that any newly discovered contamination will not result in additional cleanup costs for the redeveloper. This paper will discuss some of the recent lessons learned regarding (1) the terms of the initial cleanup transfer agreement, (2) efforts for project scoping/set-up, and (3) subsequent implementation dynamics of the relationships between the US Military, local municipality, redeveloper, and environmental contractor.