Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2017 through first half 2021 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2021 through first half 2023 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. Using a consistent approach with the administrative cost development, we increased care management costs for the Institutional, Community Waiver 18-44 and all Community Well populations for CY 2024. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs. Taxes, licensing and regulatory fees, and other assessments and fees Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. The HIC Franchise Fee consists of a PMPM amount that varies based on an entity’s Medicaid member months. The development of the actuarially sound capitation rates includes HIC Franchise Fee (collected by ODM) and HIC tax (collected by the Ohio Department of Insurance) components. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months for January through June 2024, and then weighted based on regional enrollment by MCOP. As the HIC Franchise Fee is assessed on a state fiscal year basis, we anticipate amending the CY 2024 capitation rates to reflect HIC Franchise Fee amounts applicable to July through December 2024. The HIC tax will remain at 1% of total capitation.
Other Populations. At present, common seal populations are reported to be declining in several areas of Europe, including some that are strongholds for this species, such as Scotland and Norway. In Scotland, strong declines have been seen since 2000; Shetland 30%, Orkney 75% and the Firth of Tay 85% (SCOS 2013). The number of seals declined In Norway by 10% between surveys carried out in the period 1996-1999 and in 2003-2005 (Xxxxxxx et al. 2010). Other areas have been surveyed less well, but available data indicate concerns for conservation, e.g. for the Xxxxxx coast of Russia (Zyryanov & Xxxxxx 2010), the Baltic (Xxxxxxxx & Xxxxxxx 2010), Iceland (Xxxxxxxx & Xxxxxxxxx 2010) and Greenland (Xxxxxx- Asvid 2010). In recent decades, there has been an increase in the number of common seals in the Wadden Sea and Southwest Delta (CBS et al. 2013). A similar increasing trend was found for common seals in Denmark and Southern Sweden (Regions Skagerrak, Kattegat, Limfjord and western Baltic; Xxxxx et al. 2010). There has been a different trend in England, in comparison to Scotland. Counts in the Wash and eastern England did not demonstrate any recovery from the 2002 epidemic until 2009, but numbers have increased in the past three years (SCOS 2013). Grey seal populations in Europe are increasing in many regions, including the mainland European coast, United Kingdom (Duck & Xxxxxxxx 2007), Norway (Xxxxxxx & Xxxx 2007), and the Baltic (Xxxxxxx et al. 2007). A decline was reported for Iceland (Hauksson 2007). No recent data were available for the Murmam coast of Russia (Ziryanov & Mishin 2007) and the Faroe islands (Xxxxxxxxx 2007). Generally, a reduction in recruitment seems to play a role in the areas with a declining abundance of common seals (Xxxxx et al. 2003; Xxxxxxxx et al. 2010). Declines were also observed in North American common seal populations. For Sable Island, Canada, food shortages arising from competition with grey seals were suggested to play a role, along with shark-inflicted mortality (Xxxxx et al. 2003). The decline in the western Gulf of Alaska was thought to be related to overfishing of shrimp and capelin which are important prey species for young common seals in this area (Xxxxxx 1996). Several possible causes were suggested for the decline in Scotland, namely competition with grey seals through dietary and foraging area overlap, disease, and in particular the ingestion of toxins from harmful algae and physical trauma (SCOS 2013). For Norway, increased hunting, h...
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Care management costs from the YTD June 2016 cost reports were used to develop expenditure estimates for these populations. Because large variances exist among MCOP care management costs on a population by population basis, the cost report care management data was composited and normalized for comparison to composite care management costs included in the current capitation rates. We determined that the 2.0% trend increase over the current PMPM care management values, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the YTD June 2016 cost report data. As a result, care management costs for the Institutional, Community Waiver 18 – 44 and all Community Well populations were increased by 2.0% over current levels. The resulting PMPMs were then averaged based upon August 2016 MyCare enrollment to develop plan management rates that are uniform across. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 18-44 and 65+ amounts.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2017 through first half 2020 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. We determined that a 50% distribution between care management expenses and other administrative expenses, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the CY 2019 cost report data. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. We determined that the 4.0% trend increase over the current PMPM care management values, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the YTD June 2017 cost report data. As a result, care management costs for the Institutional, Community Waiver 18 – 44 and all Community Well populations were increased by 4.0% over current levels. The resulting PMPMs were then averaged based upon July 2017 MyCare enrollment to develop plan management rates that are uniform across regions. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 18-44 and 65+ amounts.
