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Medicaid HMO 2007-2008 Capitation Rates

AHCA uses the methodology that was developed by Milliman and Robertson in FY 00/01 to:

  • Establish an upper payment limit as an estimate of the cost of providing care for the HMO population in a fee-for-service setting;
  • Set capitation rates less than the upper payment limit;
  • Develop rates acceptable to HCFA;
  • Provide fair reimbursement to the HMOs;
  • Foster an increase in rural HMO participation; and
  • Minimize the impact of year-to-year fluctuation.

The Summary by Age, Eligibility Category, and Area 2006-2009 provides general information about the January 1, 2008 through August 31, 2008 Medicaid HMO.

More detailed information is posted in the appendices listed below in Excel format for the State Fiscal Year 2007-2008.

TANF/AFDC (Appendix A)
SSI - No Medicare (Appendix B)
SSI - Medicare A & B (Appendix C)
SSI - Medicare B (Appendix D)
PrePaid Dental (Appendix E)