In the care delivery for children with medical complexity, alternate payment models, particularly risk-based models, require an understanding of the population’s acuity level as compared to other populations for actuarial analysis. The white paper was commissioned by the Children's Hospital Association (CHA) and performed by Milliman Inc. to evaluate the acuity level across the claims data sets acquired for analysis of the CARE Award. The analysis explores the potential for
- Higher claims
- More volatile claims
- Reversion to the mean
These aspects should be considered when comparing a medical intervention such as care coordination with a new payment model.
This publication was made possible by Grant Number 1C1CMS331335 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. Pub # 3221, Approved 9/11/17