As part of the Commission’s ongoing work examining alternative approaches to federal financing reforms, this presentation takes a closer look at two methodologies currently used in Medicaid—managed care capitation rate-setting and Section 1115 budget neutrality calculations—that have parallels to methods that might be used in constructing per capita caps nationally.
The presentation describes the key commonalities and distinctions between managed care rate setting, methods for determining budget neutrality under Section 1115 waivers, and per capita cap calculations.
