Table of Contents
Presentation for DataSpeak
Context: Maryland’s Medicaid Managed Care Program
Persons Not In HealthChoice
Features for Special Needs Children
Rate Structure Used in HealthChoice
Objectives of Risk Adjustment (Health-Based Payments)
Adjusted Clinical Groups (ACGs) Used for Health-based Payments (Developed by Johns Hopkins University)
Reasons for choosing ACG:
Who Gets an ACG?
Children in the ACG System
ACG Assignments
Results of ACG Payments (Relative PMPM Based on Maryland Medicaid Data)
SUMMARY
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