Table 2. Medicaid Monthly Capitation Amounts for Long-Term Care Services, by Program: 1998.
| Program | Amount per Member per Month |
|---|---|
| PACE | $1,786-4,632 |
| ALTCS1 | 1,849-2,338 |
| MSHO2 | |
| Institutional | 301-565 |
| NHC Conversion | 1,460-2,322 |
| Community NHC | 1,048-1,513 |
| Community non-NHC | 394-741 |
| CCN3 | |
| Institutional | 3,896-4,493 |
| NHC Conversion | 3,896-4,493 |
| Community NHC | |
| DMS-1 Score of 1 | 1,544 |
| DMS-1 Score of 2 | 2,164 |
| DMS-1 Score of 3 | 3,183 |
| Community non-NHC | 323-451 |
| Medical Assistance Only | 418 |
| Supplemental Security Income | 133 |
| Texas STAR+PLUS4 | |
| Nursing Facility Clients | |
| Medical Assistance Only | 1,461 |
| Supplemental Security Income | 1,710 |
| HCBS Waiver Clients5 | 1,428 |
| Other Community Clients | 77 |
Capitation for elderly and physically disabled enrollees. Includes acute care services, LTC services, and behavioral health. Varies by contractor.
Rates vary by age, sex, and county. Prepaid Medical Assistance Program rate component of institutional and NHC conversion rate cells includes Medicaid acute and ancillary services only; does not include nursing home room and board, and nursing services.
CCN institutional rate includes room and board, ancillary costs, and transportation costs. CCN institutional and NHC conversion rates vary by facility. CCN community non-NHC rate represents average across elderly age groups.
Per member per month for dually eligible beneficiaries. Includes LTC services only.
Meets NHC criteria.
NOTES: PACE is Program of All-Inclusive Care for the Elderly. ALTCS is Arizona Long-Term Care System. MSHO is Minnesota Senior Health Options. NHC is nursing home certifiable. CCN is Continuing Care Networks. DMS is division of medical services. HCBS is home and community-based services. LTC is long-term care.
SOURCE: (Arizona Health Care Cost Containment System, 1999; Community Coalition for Long Term Care, New York Department of Health, and New York State Department of Social Services 1996; National PACE Association, 1999; Minnesota Department of Human Services, 1999; Texas Health and Human Services Commission, 1997.)