Setting Capitations for Medicaid
A Case Study
ResearchPublished 1990
A Case Study
ResearchPublished 1990
This Note examines the methodology New York State used to set capitation rates for a Medicaid health maintenance organization. After examining the methods used and the assumptions made in a particular case, the authors are able to draw lessons about the ratesetting process. They suggest the need for greater reliance on statewide data to assure fair and statistically stable estimates. Although the Note focuses on one state and its ratesetting for one particular plan (Health Care Plus), the issues raised have general interest for other plans and for other states concerned with setting capitation rates for Medicaid enrollees in prepaid plans.
This publication is part of the RAND note series. The note was a product of RAND from 1979 to 1993 that reported miscellaneous outputs of sponsored research for general distribution.
This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions.
RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.