About this Dataset

Medi-Cal Managed Care Capitation Rates By Managed Care Plan Models

The datasets contain reimbursement rates paid to participating County Organized Health Systems, Geographic Managed Care, Regional, Senior Care Act (SCAN), Single Plan, and Two-Plan model counties as well as Program of All-Inclusive Care for the Elderly (PACE) organizations for calendar years 2021-2024.
Organization: State of California
Last updated: 2025-09-23T12:40:26.947134
Tags: california-department-of-health-care-services, capitation-rates, cohs, dhcs, gmc-rates, managed-care, pace-rates, plan-models, regional-model-rates, scan, single-plan, two-plan-rates

Tables

County Organized Health Systems (COHS) Model

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.county_organized_health_systems_cohs_model

23.02 kB
2,181 rows
9 columns

CREATE TABLE county_organized_health_systems_cohs_model (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR
);

Data Dictionary - County Organized Health Systems (COHS) Model

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.data_dictionary_county_organized_health_systems_cohs_model

4.73 kB
9 rows
4 columns

CREATE TABLE data_dictionary_county_organized_health_systems_cohs_model (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Data Dictionary - Geographic Managed Care (GMC)

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.data_dictionary_geographic_managed_care_gmc

4.67 kB
9 rows
4 columns

CREATE TABLE data_dictionary_geographic_managed_care_gmc (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Data Dictionary - Regional Model/Rural Expansion

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.data_dictionary_regional_model_rural_expansion

4.73 kB
9 rows
4 columns

CREATE TABLE data_dictionary_regional_model_rural_expansion (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Data Dictionary - Senior Care Action Network (SCAN)

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.data_dictionary_senior_care_action_network_scan

4.61 kB
8 rows
4 columns

CREATE TABLE data_dictionary_senior_care_action_network_scan (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Data Dictionary - Single Plan Model

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.data_dictionary_single_plan_model

4.61 kB
8 rows
4 columns

CREATE TABLE data_dictionary_single_plan_model (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Data Dictionary - Two-Plan Model

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.data_dictionary_two_plan_model

4.75 kB
9 rows
4 columns

CREATE TABLE data_dictionary_two_plan_model (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Geographic Managed Care (GMC)

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.geographic_managed_care_gmc

20.98 kB
677 rows
9 columns

CREATE TABLE geographic_managed_care_gmc (
  "rate_period" VARCHAR,
  "calendar" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR
);

Data Dictionary - Program Of All-Inclusive Care For The Elderly (PACE) Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.n__dictionary_program_of_all_inclusive_care_for_the_el_072cd073

4.24 kB
10 rows
4 columns

CREATE TABLE n__dictionary_program_of_all_inclusive_care_for_the_el_072cd073 (
  "column" VARCHAR,
  "type" VARCHAR,
  "label" VARCHAR,
  "description" VARCHAR
);

Program Of All-Inclusive Care For The Elderly (PACE) Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.program_of_all_inclusive_care_for_the_elderly_pace_rates

33.68 kB
1,418 rows
10 columns

CREATE TABLE program_of_all_inclusive_care_for_the_elderly_pace_rates (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "pace_organization" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR,
  "awop" VARCHAR
);

Regional Model/Rural Expansion

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.regional_model_rural_expansion

13.93 kB
1,887 rows
9 columns

CREATE TABLE regional_model_rural_expansion (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "n__lower_bound" VARCHAR  -- Lower Bound,
  "n__midpoint" VARCHAR  -- Midpoint,
  "n__upper_bound" VARCHAR  -- Upper Bound
);

Senior Care Action Network (SCAN)

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.senior_care_action_network_scan

7.76 kB
96 rows
8 columns

CREATE TABLE senior_care_action_network_scan (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR
);

Single Plan Model

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.single_plan_model

8.48 kB
138 rows
8 columns

CREATE TABLE single_plan_model (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan_name" VARCHAR,
  "category_of_aid" VARCHAR,
  "n__lower_bound" VARCHAR  -- Lower Bound,
  "n__upper_bound" VARCHAR  -- Upper Bound
);

Two-Plan Model

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_by_manag_8b8d23b3.two_plan_model

38.65 kB
2,123 rows
9 columns

CREATE TABLE two_plan_model (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "n__lower_bound" VARCHAR  -- Lower Bound,
  "n__midpoint" VARCHAR  -- Midpoint,
  "n__upper_bound" VARCHAR  -- Upper Bound
);