Setting Capitations for Medicaid: A Case Study

Abstract

This article examines the methodology New York State used to set capitation rates for a Medical health maintenance organization. By examining the methods used and the assumptions made in a particular case, some general lessons are drawn about the ratesetting process. Greater reliance on statewide data to assure fair and statistically stable estimates is needed. Although the article focuses on one State and its ratesetting for one particular plan (Health Care Plus), the issues raised have general interest for other plans for other States concerned with the setting of capitation rates for Medicaid enrollees in prepaid plans.

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Document Details

Document Type
Technical Report
Publication Date
Nov 01, 1990
Accession Number
ADA256866

Entities

People

  • Arleen Leibowitz
  • Joan L. Buchanan

Organizations

  • RAND Corporation

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Age Groups
  • Case Studies
  • Corporations
  • Cost Estimates
  • Costs
  • Data Processing
  • Governments
  • Health Care
  • Health Maintenance Organizations
  • Health Services
  • Information Systems
  • Management Information Systems
  • Medical Personnel
  • Medicare
  • New York
  • Patient Care
  • Therapy

Readers

  • Educational Psychology
  • Medical or Health Care Field.