The rate relativity process used to develop the capitation rates for the C2A/C2B and C3A/C3B rating categories can be described at a high level as: Relative total costs of C2A/C2B and C3A/C3B to the overall C2 and C3 rating categories, respectively, were developed using the base data. Projected costs for the C2 and C3 rating categories were developed by region following the same process as was used for CY 2013 rates. The C2A/C2B and the C3A/C3B relativity factors were applied to the total projected medical PMPM for the C2 and C3 rating categories, respectively, to develop projected costs for the C2A/C2B and C3A/C3B rating categories. Adjustments for administration, seasonality, savings and enrollee contribution to care were applied to produce the final capitation rates. The C2A and C2B rate relativity factors applied to the C2 projected expenditures are: Eastern Western The Cape -10.3% -10.1% -7.1% C2A 43.0% 43.3% 48.1% C2B The C3A and C3B rate relativity factors applied to the C3 projected expenditures are: Eastern Western The Cape -3.9% -0.9% -3.4% C3A 73.3% 78.8% 74.3% C3B Category of Service Mapping: The following is a category of service mapping between the services reflected in the MassHealth base data and the service categories used in the rate development process. Descriptions of the MassHealth detailed categories of service can be found in Section 3 of the MassHealth Information Sharing Data Package, “Base Detail.” Medicaid Claims: Rate Development MassHealth Base Data Category of Service Detailed Category of Service Inpatient Non-MH/SA IP Non-Behavioral Health – – Inpatient MH/SA IP Behavioral Health – Hospital Outpatient Hospital Outpatient Outpatient MH/SA Outpatient BH
The rate relativity process used to develop the capitation rates for the C2A/C2B and C3A/C3B rating categories can be described at a high level as: Relative total costs of C2A/C2B and C3A/C3B to the overall C2 and C3 rating categories, respectively, were developed using the base data. Projected costs for the C2 and C3 rating categories were developed by region following the same process as was used for CY 2013 rates. The C2A/C2B and the C3A/C3B relativity factors were applied to the total projected medical PMPM for the C2 and C3 rating categories, respectively, to develop projected costs for the C2A/C2B and C3A/C3B rating categories. Adjustments for administration, seasonality, savings and enrollee contribution to care were applied to produce the final capitation rates. The C2A and C2B rate relativity factors applied to the C2 projected expenditures are: Eastern Western The Cape C2A -10.3% -10.1% -7.1% C2B 43.0% 43.3% 48.1% The C3A and C3B rate relativity factors applied to the C3 projected expenditures are: Eastern Western The Cape C3A -3.9% -0.9% -3.4% C3B 73.3% 78.8% 74.3% Category of Service Mapping: The following is a category of service mapping between the services reflected in the MassHealth base data and the service categories used in the rate development process. Descriptions of the MassHealth detailed categories of service can be found in Section 3 of the MassHealth Information Sharing Package, “Base Data Detail.” Medicaid Claims: Rate Development Category of Service MassHealth Base Data Detailed Category of Service Inpatient – Non-MH/SA IP – Non-Behavioral Health Inpatient MH/SA IP – Behavioral Health Hospital Outpatient Hospital Outpatient Outpatient MH/SA Outpatient BH