Actuarial Assessment of PACE Enrollment Characteristics in Developing Capitated Payments Final rept

摘要

The purpose of this analysis is to (1) revisit the Medicare PACE adjustment factor, expanding the Abt analysis beyond the first year following enrollment, and, (2) summarize the size risk PACE sites face due to actual service demand varying from expected levels. In addition to these two primary objectives, we also address specific issues related to the implications of the high mortality rates exhibited by PACE enrollees and the joint capitation of both Medicare and Medicaid services.