Prospective Trend. We trended the CY 2017 FFS BH base data to the CY 2019 rate period. Trend assumptions were developed through a review of historical BH service trends, and were applied separately to child and adult rate cells. ◾ Managed Care Efficiencies. ODM provided us with information from the MCP provider agreements related to transition requirements associated with BH carve-in. MCPs are required to follow FFS BH coverage policies, prior authorizations, and coverage of out-of-network providers for specified durations. As a result of these requirements, we have not applied managed care efficiencies on BH carve-in expenditures.
Prospective Trend. We trended the CY 2016 FFS BH base data to the midpoint of the July through December 2018 rating period. Trend assumptions were developed through a detailed review of historical BH service trends, and were applied separately to child and adult rate cells. In developing trend assumptions for BH services, we utilized FFS data with incurred dates through October 2017. Managed Care Efficiencies. ODM provided us with information from the MCP provider agreements related to transition requirements associated with BH carve-in. This document indicates that the MCPs must “honor Medicaid FFS PAs for no less than 90 calendar days from the enrollment effective date”. In addition, MCPs are required to follow FFS BH coverage policies, prior authorizations, and coverage of out-of-network providers for specified durations. As a result of these requirements, we have not applied any managed care efficiencies on BH carve-in expenditures.
Prospective Trend. Trend is an estimate of the change in the overall cost of providing a specific benefit service over a finite period of time. A trend factor is necessary to estimate the expenses of providing health care services in some future year, based in whole or in part upon expenses incurred in prior years. CMS requires the FFSEs be trended forward from the base period to the contract period, and actual trend experience is used to the fullest extent possible. Cost and utilization trend factors were developed by category of service using monthly Ohio historical experience, with some consideration of national trends and indices. The base data was trended forward 39 months from the midpoint of the base period (July 1, 2000) to the midpoint of the contract period (October 1, 2003) for the 6-month rates. For the 12-month rates, the base data was trended forward 48 months from the midpoint of the base period (July 1, 2000) to the midpoint of the contract period (July 1, 2004).
