Common use of Plan Factor Clause in Contracts

Plan Factor. (Reform only) - A budget-neutral calculation using a Health Plan's available historical enrollee diagnosis data grouped by a health-based risk assessment model. A Health Plan's plan factor is developed from the aggregated individual risk scores of the Health Plan's prior month’s enrollment. The plan factor modifies a Health Plan's monthly capitation payment to reflect the health status of its enrollees.

Plan Factor. (Reform only) - — A budget-neutral calculation using a Health Plan's ’s available historical enrollee diagnosis data grouped by a health-based risk assessment model. A Health Plan's ’s plan factor is developed from the aggregated individual risk scores of the Health Plan's ’s prior month’s enrollment. The plan factor modifies a Health Plan's ’s monthly capitation payment to reflect the health status of its enrollees.