Capitation

On Friday, July1, 2016, Mathematica Policy Research published a report summarizing the basic approach to rate-setting in Medicaid managed care and reviews the main options for structuring managed LTSS (MLTSS) rates. It presents examples from states with financial alignment demonstrations as well as long-standing MLTSS programs. The report concludes by highlighting the policy and operational considerations that should influence a state’s choice of strategy.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.