Table 4. Factors Used in Determination of Capitation Amounts for Long-Term Care Services, by Program.
Program | Comparison Groups Used to Establish Current FFS Costs | Discount Factors | ||
---|---|---|---|---|
| ||||
Nursing Facility | Nursing Facility and HCBS | Variation | ||
PACE | ||||
California1 | Yes | No | No | Yes |
Colorado1 | No | Yes | No | Yes |
Hawaii | Yes | No | No | Yes |
Illinois | No | Yes | No | Yes |
Massachusetts1 | Yes | Yes | No | Yes |
Maryland | No | Yes | Adult Day Care | Yes |
Michigan1 | Yes | Yes | No | Yes |
New Mexico | Yes | No | No | Yes |
New York1 | Yes | No | No | Yes |
Ohio | No | Yes | No | Yes |
Oregon1 | No | No | Assisted Living Facility | Yes |
Pennsylvania | Yes | No | No | Yes |
South Carolina1 | Yes | No | No | Yes |
Texas1 | Yes | No | No | Yes |
Virginia | No | Yes | No | Yes |
Washington1 | Yes | No | No | Yes |
Wisconsin1,2 | Yes | No | No | Yes |
ALTCS | Yes | Yes | No | No |
Texas STAR+PLUS | No | Yes | No | Yes |
MSHO | No | Yes | No | Yes |
CCN | Yes | Yes | No | Yes |
State operating PACE site.
Nursing facility component of rate is blended skilled nursing facility/intermediate care facility based on the site's enrollee mix.
NOTES: FFS is fee-for-service. HCBS is home and community-based services. PACE is Program of All-Inclusive Care for the Elderly. ALTCS is Arizona Long-Term Care System. MSHO is Minnesota Senior Health Options. CCN is Continuing Care Networks.