Common use of Development of Weights Clause in Contracts

Development of Weights. The risk adjustment method utilizes two sets of weights, one for Medical Assistance only (non-Dual) enrollees, and one for Dual Eligible enrollees. These two models are identical in structure, but distinct with respect to specific values of the risk factor weights. The weights were developed using multiple regression methods and were based upon the fee-for-service population for people with disabilities. The model includes: 1) demographic information; 2) diagnoses from health care claims and costs for services provided to individuals during Calendar Year 2005; 3) Institutional status (MMIS indication of living arrangement of NF, ICF and ICF/DD upon enrollment); and 4) home and community based waiver status (MMIS indication of one of the following waivers upon enrollment; CAC, CADI, TBI and DD). The risk adjustment weights are found in Exhibit III.