Managed Care Plan Reimbursement Type Code

SAS Name
MC_PLAN_REIMBRSMT_TYPE_CD

A code indicating the how the managed care entity is reimbursed; most recent in the calendar year.

Comments

The value was chosen using the last-best method for values from the monthly TAF (calendar year).

Source: T-MSIS Annual Managed Care Plan TAF

Code Code value
1 Risk-based capitation, no incentives or risk-sharing
2 Risk-based capitation with Incentive arrangements
3 Risk-based capitation with other risk-sharing arrangements
4 Non-risk capitation
5 Fee-for-service (FFS)
6 Primary care case management (PCCM) payment
7 Other
8 Primary Care Case Management Payment plus Fee-For-Service
Null/missing Unknown/Missing