Managed Care Adjustments. Utilization and cost per service adjustments were developed for each rate group, service category, and region.
Managed Care Adjustments. As the underlying claims costs for the Extension population are based on CFC and ABD Adults, this experience reflects a very mature managed care environment. Recognizing that managed care techniques may take time to integrate and achieve efficient and effective care delivery; adjustments were made to reflect the likely reduced managed care abilities of the MCPs during the first year of the Extension population.
Managed Care Adjustments. Utilization and cost per service adjustments were developed for each rate group, service category, and region. Milliman makes no representations or warranties regarding the contents of this letter to third parties. Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for ODJFS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this letter must rely upon their own experts in drawing conclusions about the information presented. Mx. Xxx Xxxxxx, Ph.D. December 12, 2007 Page 13 FINAL and CONFIDENTIAL Utilization Milliman adjusted the encounter utilization and cost per service to reflect changes anticipated in the managed care environment. After reviewing utilization benchmarks in the Milliman Medicaid Guidelines (Guidelines) as well as other sources, Milliman calculated percentage adjustments to reflect the utilization differential between an economic and efficiently managed plan and the encounter base experience.
