Are demographics destiny in managed care risk pools?
The changing composition of the ICHC Medicaid managed care population has coincided with a dramatic increase in the amount of money paid out of capitation risk pools for claims. The increase in claims during 1997 reduced the end of year pool balances to nearly zero. In three years the ICHC capitated population has changed from one made up largely of families with dependant children (AFDC) to one with a much larger proportion of old, blind and disabled adults. The change is illustrated by the chart below. The chart shows that during the first full year of Medicaid capitation, the enrolled adult population included few people covered under Medicaid category that provides aid to the blind and disabled (ABAD) and fewer still who were covered under the category called old age assistance (OAA). This changed in 1996 and 1997 and both groups are now well represented among adult enrollees. Changes in referral pool balances over the same three year period have been dramatic. This is illustrated
