Medicaid managed care payments vary in amount and complexity depending on the populations served, benefit packages provided, and whether the plans are at risk for the costs of services.
Section D of MACPAC’s June 2011 report primarily focuses on risk-based plans to which states typically make per member per month capitation payments. States use a variety of different approaches for setting payment rates for these risk-based plans, including risk adjustment and risk sharing methodologies. Read more about state approaches to determining managed care payment rates and methods used by states to mitigate plan risk.
From: June 2011 Report to Congress: The Evolution of Managed Care in Medicaid