About this Dataset

Medi-Cal Managed Care Capitation Rates – Regional Model/Rural Expansion

This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in the Regional model, by State Fiscal Year. The Regional Model serves beneficiaries in 28 rural counties: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Inyo, Imperial, Lake, Lassen, Mariposa, Mendocino, Modoc, Mono, Nevada, Placer, Plumas, San Benito, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, and Yuba. The Department of Health Care Services (DHCS) contracts with two Commercial plans to provide services in each county. San Benito is the only exception where beneficiaries can choose either the managed care plan or (fee-for-service) Medi-Cal.
Organization: State of California
Last updated: 2023-08-25T21:30:44.672156
Tags: california-department-of-health-care-services, dhcs, managed-care-rates, medi-cal-managed-care, medi-cal-managed-care-capitation-rates, regional-model, regional-model-rates, rm, rural-expansion, rural-expansion-rate

Tables

Bridge Period 2019-20 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.bridge_period_2019_20_regional_model_rates

10.73 kB
1,398 rows
9 columns

CREATE TABLE bridge_period_2019_20_regional_model_rates (
  "rating_period" VARCHAR,
  "fiscal_year_bp" VARCHAR,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" DOUBLE,
  "midpoint" DOUBLE,
  "upper_bound" DOUBLE
);

CY 2021 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.cy_2021_regional_model_rates

9.05 kB
424 rows
9 columns

CREATE TABLE cy_2021_regional_model_rates (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "n__lower_bound" DOUBLE  -- Lower Bound,
  "n__midpoint" DOUBLE  -- Midpoint,
  "n__upper_bound" DOUBLE  -- Upper Bound
);

CY 2022 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.cy_2022_regional_model_rates

8.49 kB
341 rows
9 columns

CREATE TABLE cy_2022_regional_model_rates (
  "rating_period" VARCHAR,
  "calendar_year" DOUBLE,
  "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
);

CY 2023 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.cy_2023_regional_model_rates

10.01 kB
874 rows
9 columns

CREATE TABLE cy_2023_regional_model_rates (
  "rating_period" VARCHAR,
  "calendar_year" BIGINT,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan_name" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR
);

State Fiscal Year 2015-16 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.state_fiscal_year_2015_16_regional_model_rates

10.82 kB
600 rows
10 columns

CREATE TABLE state_fiscal_year_2015_16_regional_model_rates (
  "rating_period" VARCHAR,
  "state_fiscal_year" VARCHAR,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" DOUBLE,
  "midpoint" DOUBLE,
  "upper_bound" DOUBLE,
  "unnamed_9" VARCHAR  -- Unnamed: 9
);

State Fiscal Year 2016-17 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.state_fiscal_year_2016_17_regional_model_rates

11.2 kB
608 rows
10 columns

CREATE TABLE state_fiscal_year_2016_17_regional_model_rates (
  "rating_period" VARCHAR,
  "state_fiscal_year" VARCHAR,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" DOUBLE,
  "midpoint" DOUBLE,
  "upper_bound" DOUBLE,
  "unnamed_9" VARCHAR  -- Unnamed: 9
);

State Fiscal Year 2017-18 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.state_fiscal_year_2017_18_regional_model_rates

11.75 kB
708 rows
10 columns

CREATE TABLE state_fiscal_year_2017_18_regional_model_rates (
  "rating_period" VARCHAR,
  "state_fiscal_year" VARCHAR,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR,
  "unnamed_9" VARCHAR  -- Unnamed: 9
);

State Fiscal Year 2018-19 Regional Model Rates

@usgov.ca_gov_medi_cal_managed_care_capitation_rates_regional_0637f406.state_fiscal_year_2018_19_regional_model_rates

9.27 kB
506 rows
9 columns

CREATE TABLE state_fiscal_year_2018_19_regional_model_rates (
  "rating_period" VARCHAR,
  "state_fiscal_year" VARCHAR,
  "model" VARCHAR,
  "county" VARCHAR,
  "health_plan" VARCHAR,
  "category_of_aid" VARCHAR,
  "lower_bound" VARCHAR,
  "midpoint" VARCHAR,
  "upper_bound" VARCHAR
);