Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2017 through first half 2021 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. We determined that the 4.0% trend increase over the current PMPM care management values, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the YTD June 2017 cost report data. As a result, care management costs for the Institutional, Community Waiver 18 – 44 and all Community Well populations were increased by 4.0% over current levels. The resulting PMPMs were then averaged based upon July 2017 MyCare enrollment to develop plan management rates that are uniform across regions. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 18-44 and 65+ amounts.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Care management costs from the YTD June 2016 cost reports were used to develop expenditure estimates for these populations. Because large variances exist among MCOP care management costs on a population by population basis, the cost report care management data was composited and normalized for comparison to composite care management costs included in the current capitation rates. We determined that the 2.0% trend increase over the current PMPM care management values, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the YTD June 2016 cost report data. As a result, care management costs for the Institutional, Community Waiver 18 – 44 and all Community Well populations were increased by 2.0% over current levels. The resulting PMPMs were then averaged based upon August 2016 MyCare enrollment to develop plan management rates that are uniform across. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 18-44 and 65+ amounts.
