Capitated payment approaches for Medicaid-financed long-term care services.
In the following analysis, the authors examine the capitated payment approaches for long-term care (LTC) services of five programs: the Program of All-Inclusive Care for the Elderly (PACE), the Arizona Long-Term Care System (ALTCS), the Texas STAR + PLUS, the Minnesota Senior Health Option (MSHO), and the Monroe County Continuing Care Networks (CCNs) in New York. The authors describe key aspects in the design of these programs, with an emphasis on Medicaid reimbursement, and discuss differences and commonalities in the approaches taken by the programs in setting capitation rates.
Rudolph
N V
NV
Health Care Financing Administration, Office of Strategic Planning, Baltimore, MD 21244-1850, USA. nrudolph@hcfa.gov
Lubitz
J
J
D000368:Aged; D002204:Capitation Fee / Q000458:organization & administration*; D014487:Centers for Medicare and Medicaid Services, U.S.; D004608:Eligibility Determination; D005260:Female; D006302:Health Services Research; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008134:Long-Term Care / Q000191:economics* / Q000458:organization & administration; D008297:Male; D008484:Medicaid / Q000458:organization & administration*; D017146:Models, Organizational; D011907:Rate Setting and Review; D013221:State Health Plans / Q000458:organization & administration*; D014481:United States