2) The capitation rate is more than the assessed share of cost
On April 28, 2021, an ALTCS customer died at a nursing home in Pima County. The assessed share of cost (SOC) was $1335.00. The customer did not have Medicare and was enrolled with Banner University Family Care. The daily capitation rate for Banner University Family Care in Pima County in April 2021 for a person without Medicare is $238.80.
238.80 x 28 (the number of days in April the customer was at the nursing home) = $6686.40. The prorated capitation rate is more than the customer’s share of cost. The customer’s SOC is not adjusted and is still $1335.00.