Common use of Development of Weights Clause in Contracts

Development of Weights. ‌ The risk adjustment method utilizes two sets of weights, one for Medical Assistance only (non- Dual Eligible) Enrollees, and one for Dual Eligible Enrollees. These two models include disease categories and risk factor weights customized separately for non-Dual Eligible and Dual Eligible experience. The weights were developed using constrained linear regression and were based upon the Fiscal Years (FYs) 2016 and 2017 experience of individuals enrolled in the SNBC program. Risk factor weights were constrained to be non-negative. The model includes: 1) demographic information; 2) diagnoses from health care claims for services provided to individuals during FY 2016; 3) costs from health care claims for services provided to individuals during FY 2017; and 4) developmental disability (DD) waiver status.