Base Experience. We used the projected claims data underlying the calendar year CY 2020 MyCare Opt-In capitation rates, as outlined in the Original certification, as base experience for developing the July 1, 2020 capitation rates. These projected claims costs are inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
Base Experience. We used the projected claims data underlying the calendar year CY 2016 MMC capitation rates, as outlined in the Original certification, as base experience for developing the July 1, 2016 capitation rates. These projected claims costs are inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
Base Experience. We used the projected claims data underlying the July 2021 MMC capitation rates, as outlined in the Original certification, as base experience for developing the amended capitation rates effective during the January through June 2022 period. These projected claims costs are inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
Base Experience. We used the projected July 2018 benefit expenses developed from the Opt-Out capitation rates (baseline Medicaid data), as base experience for developing the July 1, 2018 capitation rates, consistent with the Original certification. The baseline Medicaid data was published on June 6, 2018, titled “July 2018 MyCare Opt-Out Capitation Rate Amendment”. The baseline Medicaid data is inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
Base Experience. We used the projected claims data underlying the calendar year CY 2017 MMC capitation rates, as outlined in the Original certification, as base experience for developing the July 1, 2017 capitation rates. These projected claims costs are inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification, with minor exceptions as noted below. We replaced all adjustments included in the Original certification for Ohio’s conversion from the status of a 209(b) to a 1634 state. Applicable adjustments for Ohio’s 1634 conversion were developed from the ground up, and not applied incrementally to the adjustments included in the Original certification. Additionally, we modified the managed care efficiency adjustments included in the Original certification for the Adoption and Xxxxxx Kids (AFK) population.
Base Experience. We used the projected claims data underlying the CY 2021 MMC capitation rates, as outlined in the Original certification, as base experience for developing the amended capitation rates effective during 1H 2021 and 2H 2021. These projected claims costs are inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
Base Experience. We used the projected July 2019 benefit expenses developed from the Opt-Out capitation rates (baseline Medicaid data), as base experience for developing the July 1, 2019 capitation rates, consistent with the Original certification. The baseline Medicaid data was published on June 6, 2019, titled “July 2019 MyCare Ohio Capitation Rate Amendment - Opt-Out Capitation Rates”. The baseline Medicaid data is inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
Base Experience. We used the projected CY 2017 benefit expenses developed from the Opt-Out capitation rates (baseline Medicaid data), as base experience for developing the July 1, 2017 capitation rates, consistent with the Original certification. The baseline Medicaid data was published on June 6, 2017, titled “July 2017 MyCare Capitation Rate Amendment: Opt-Out Capitation Rates”. The baseline Medicaid data is inclusive of all retrospective, prospective, trend, managed care efficiency, and other claims cost adjustments made to the data as outlined in the Original certification.
