DESCRIPTION OF KEY ASSUMPTIONS i. Acuity or health status adjustments Over the course of CY 2018, we observed material enrollment decreases due to improvements in the economy along with changes in the eligibility redetermination process. While some of the morbidity impact is reflected as part of re- basing, we reviewed encounter data from CY 2018 for members that were present in the base period versus those that remain in the program as of July 2019 and determined the resulting morbidity impact of the enrollment decline. The resulting morbidity adjustments were greater for the EXT population relative to the CFC, ABD, and AFK populations due to both the magnitude of the EXT enrollment decreases along with the observed EXT acuity changes.
DESCRIPTION OF KEY ASSUMPTIONS i. Acuity or health status adjustments We have observed and continue to anticipate material enrollment increases in the Extension population during CY 2020 and 2021 due to ODM’s pause in redetermination as well as economic factors as a result of the COVID-19 pandemic. The CY 2021 capitation rates include adjustments to reflect the fact that the Extension population is anticipated to less acute in composite as a result. Our methodology for developing these adjustments is detailed further in preceding sections.
