Health-based capitation risk adjustment in Minnesota public health care programs

Gregory A. Gifford, Kevan R. Edwards, David J Knutson

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model.

Original languageEnglish (US)
Pages (from-to)21-41
Number of pages21
JournalHealth Care Financing Review
Volume26
Issue number2
StatePublished - Dec 1 2004

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