Limitations and Data Reliance. The information contained in this report has been prepared for the Ohio Department of Medicaid (ODM) to provide documentation of the development of the July 1, 2016 amendment to the certified calendar year (CY) 2016 capitation rates for the Medicaid Managed Care Program (MMC). The data and information presented may not be appropriate for any other purpose. The information contained in this report, including the enclosures, has been prepared for ODM and their consultants and advisors. It is our understanding that the information contained in this report will be shared with CMS and may be utilized in a public document. Any distribution of the information should be in its entirety. Any user of the data must possess a certain level of expertise in actuarial science and healthcare modeling so as not to misinterpret the information presented. Milliman makes no representations or warranties regarding the contents of this report to third parties. Likewise, third parties are instructed that they are to place no reliance upon this report prepared for ODM by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this report must rely upon their own experts in drawing conclusions about the capitation rates, assumptions, and trends. Milliman has relied upon certain data and information provided by ODM and the participating Medicaid MCPs in the development of the July 1, 2016 amendment to the certified CY 2016 capitation rates. Milliman has relied upon ODM and the MCPs for the accuracy of the data and accept it without audit. To the extent that the data provided is not accurate, the capitation rate development would need to be modified to reflect revised information. It should be emphasized that capitation rates are a projection of future costs based on a set of assumptions. Results will differ if actual experience is different from the assumptions contained in this report. The services provided by Milliman to ODM were performed under the signed contract agreement between Milliman and ODM dated June 11, 2015. Guidelines issued by the American Academy of Actuaries require actuaries to include their professional qualifications in all actuarial communications. The authors of this report are members of the American Academy of Actuaries and meet the qualification standards for performing the analyses contained herein. APPENDIX 1 Rate Cell CY 2016 Average Monthly Enroll...
