| 来源类型 | Publication
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| 来源ID | Technical Assistance Brief
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| Look Before You Leap: Risk Adjustment for Managed Care Plans Covering Long-Term Services and Supports |
| Debra Lipson
|
| 发表日期 | 2016-08-31
|
| 出版者 | Hamilton, NJ: Center for Health Care Strategies, Inc.
|
| 出版年 | 2016
|
| 语种 | 英语
|
| 概述 | This brief reviews risk-adjustment strategies in Medicaid managed long-term services and supports programs that account for enrollees’ functional and cognitive status to improve the accuracy of capitation rates, as well as technical challenges and state program features that may affect the need to use risk adjustment.", |
| 摘要 | Many states are creating or expanding Medicaid managed long-term services and supports (MLTSS) programs to improve quality and control costs. To accomplish these goals, capitation rates paid to managed care plans should reflect the expected costs of care for the LTSS beneficiaries enrolled in these plans. This brief, supported through the West Health Policy Center, explains the role of risk adjustment in setting accurate, actuarially sound capitation rates for MLTSS plans, and the challenges in developing risk adjustment models that are suited to MLTSS programs. Risk adjusting MLTSS capitation rates to account for enrollees’ functional and cognitive status may improve the accuracy of rates paid to each plan. However, risk adjustment is technically challenging, and the importance of using risk adjustment in MLTSS programs may vary based on state-specific program features, such as which population groups are enrolled, the benefits covered, whether enrollment is mandatory or voluntary, and the number and type of participating health plans. State officials should ensure they understand the benefits and challenges of adopting an MLTSS risk adjustment model for their programs. |
| URL | https://www.mathematica.org/our-publications-and-findings/publications/look-before-you-leap-risk-adjustment-for-managed-care-plans-covering-longterm-services-and-supports
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| 来源智库 | Mathematica Policy Research (United States)
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| 资源类型 | 智库出版物
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| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/488595
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推荐引用方式
GB/T 7714 |
Debra Lipson. Look Before You Leap: Risk Adjustment for Managed Care Plans Covering Long-Term Services and Supports. 2016.
|
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