Common use of Risk Adjustment Methodology Clause in Contracts

Risk Adjustment Methodology. The MEMA adjustment is applied by region for the NFLOC rate cell for each MCOP. Each population group within the NFLOC rate cell is given a weight based on its relative capitation rate compared to the composite NFLOC capitation rate. Each MCOP will receive a calculated MEMA score based on their enrollment of each population group within the NFLOC rate cell. To ensure budget neutrality, the MEMA scores will be normalized to 1.000 for each region. MEMA methodology uses generally accepted actuarial principles and practices.

Risk Adjustment Methodology. The MEMA adjustment is applied by region for the NFLOC rate cell for each MCOP. Each population group within the NFLOC rate cell is given a weight based on its relative capitation rate compared to the composite NFLOC capitation rate. Each MCOP will receive a calculated MEMA score based on their enrollment of each population group within the NFLOC rate cell. To ensure budget neutrality, the MEMA scores will be normalized to 1.000 for each region. MEMA methodology uses generally accepted actuarial principles and practices.