Skip to Main Content
Title
Setting health maintenance organization capitation rates for Medicaid in Wisconsin.
First Author
England, William L
Date of Pub
1986 Summer
Pages
67-73
Volume
7
Issue
4
Other Authors
N/A
Abstract
In late fall 1984, more than 110,000 Wisconsin Aid to Families with Dependent Children (AFDC) Medicaid recipients were enrolled in health maintenance organizations (HMO's). Capitation rates were set by competitive bidding, subject to a rate ceiling. Planners considered whether to adjust the rates to account for demographic changes in the AFDC population between the time that data for the rate ceilings were collected and when the rates went into effect. They also considered whether to pay a single rate or to adjust rates for the age and sex of each HMO's actual enrollees. This article is a report of the analysis that led to a decision to pay a single, countywide rate that was not demographically adjusted.
Abstract Continued
N/A
MeSH
Actuarial Analysis : Age Factors : Aid to Families with Dependent Children/economics : Capitation Fee/standards : Competitive Bidding : Fees and Charges/standards : Female : Health Maintenance Organizations/economics : Human : Male : Medicaid/economics : Rate Setting and Review/methods : Sex Factors : Wisconsin
NTIS Number
PB86-241262