Baselight

Managed Care Programs By State

U.S. Department of Health & Human Services

@usgov.hhs_gov_managed_care_programs_by_state

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About this Dataset

Managed Care Programs By State

Provides program names, program features, population enrolled, benefits covered, quality assurance and improvement, performance incentives, provider value-based purchasing, participating plans, regions served and program notes.
Organization: U.S. Department of Health & Human Services
Last updated: 2025-11-05T12:40:34.534969
Tags: medicaid

Tables

Table 1

@usgov.hhs_gov_managed_care_programs_by_state.table_1
  • 111.62 kB
  • 195 rows
  • 69 columns
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CREATE TABLE table_1 (
  "state" VARCHAR,
  "program_name" VARCHAR,
  "program_type" VARCHAR,
  "statewide_or_region_specific" VARCHAR  -- Statewide Or Region-specific?,
  "federal_operating_authority" VARCHAR,
  "program_start_date" TIMESTAMP,
  "waiver_expiration_date_if_applicable" VARCHAR  -- Waiver Expiration Date (if Applicable),
  "if_the_program_ended_in_2014_indicate_the_end_date" VARCHAR  -- If The Program Ended In 2014, Indicate The End Date,
  "populations_enrolled" VARCHAR,
  "low_income_adults_not_eligible_under_aca_section_viii" VARCHAR,
  "aged_blind_or_disabled_children_or_adults" VARCHAR  -- Aged, Blind Or Disabled Children Or Adults,
  "non_disabled_children_excluding_children_in_foster_car_15bd2b28" VARCHAR  -- Non-Disabled Children (excluding Children In Foster Care Or Receiving Adoption Assistance),
  "individuals_receiving_limited_benefits" VARCHAR,
  "low_income_adults_eligible_under_aca_section_viii" VARCHAR,
  "full_duals" VARCHAR,
  "partial_duals" VARCHAR,
  "children_with_special_health_care_needs" VARCHAR,
  "native_american_alaskan_natives" VARCHAR,
  "foster_care_and_adoption_assistance_children" VARCHAR,
  "enrollment_choice_period" VARCHAR,
  "enrollment_broker_name_if_applicable" VARCHAR  -- Enrollment Broker Name (if Applicable),
  "notes_on_enrollment_choice_period" VARCHAR,
  "benefits_covered" VARCHAR,
  "inpatient_hospital_physical_health" VARCHAR,
  "inpatient_hospital_behavioral_health_mh_and_or_sud" VARCHAR  -- Inpatient Hospital Behavioral Health (MH And/or SUD),
  "outpatient_hospital_physical_health" VARCHAR,
  "outpatient_hospital_behavioral_health_mh_and_or_sud" VARCHAR  -- Outpatient Hospital Behavioral Health (MH And/or SUD),
  "partial_hospitalization" VARCHAR,
  "physician" VARCHAR,
  "nurse_practitioner" VARCHAR,
  "rural_health_clinics_and_fqhcs" VARCHAR,
  "clinic_services" VARCHAR,
  "lab_and_x_ray" VARCHAR,
  "prescription_drugs_and_prosthetic_devices" VARCHAR,
  "epsdt" VARCHAR,
  "case_management" VARCHAR,
  "health_home_ssa_1945" VARCHAR  -- Health Home (SSA 1945),
  "family_planning" VARCHAR,
  "dental_services_medical_surgical" VARCHAR  -- Dental Services (medical/surgical),
  "dental_preventative_or_corrective" VARCHAR  -- Dental (preventative Or Corrective),
  "home_health_agency_services" VARCHAR,
  "personal_care_state_plan_option" VARCHAR  -- Personal Care (state Plan Option),
  "hcbs_waiver_services" VARCHAR,
  "private_duty_nursing" VARCHAR,
  "icf_idd" VARCHAR,
  "nursing_facility_services" VARCHAR,
  "hospice_care" VARCHAR,
  "non_emergency_medical_transportation" VARCHAR,
  "other_e_g_nurse_midwife_services_freestanding_birth_ce_3ff71834" VARCHAR  -- Other (e.g., Nurse Midwife Services, Freestanding Birth Centers, Podiatry, Etc.),
  "quality_assurance_and_improvement" VARCHAR,
  "hedis_data_required" VARCHAR  -- HEDIS Data Required?,
  "cahps_data_required" VARCHAR  -- CAHPS Data Required?,
  "accreditation_required" VARCHAR  -- Accreditation Required?,
  "accrediting_organization" VARCHAR,
  "eqro_contractor_name_if_applicable" VARCHAR  -- EQRO Contractor Name (if Applicable),
  "performance_incentives" VARCHAR  -- Performance Incentives?,
  "payment_bonuses_differentials_to_reward_plans" VARCHAR,
  "preferential_auto_enrollment_to_reward_plans" VARCHAR,
  "public_reports_comparing_mco_performance_on_key_metrics" VARCHAR,
  "withholds_tied_to_performance_metrics" VARCHAR,
  "mcos_phps_required_encouraged_to_pay_providers_for_val_5fb59e4d" VARCHAR  -- MCOs/PHPs Required/encouraged To Pay Providers For Value/quality Outcomes Using Shared-risk Or Shared-savings Methods,
  "provider_value_based_purchasing" VARCHAR,
  "state_pays_provider_based_entities_such_as_acos_or_pcm_b5a9abb0" VARCHAR  -- State Pays Provider-based Entities (such As ACOs Or PCMHs) Directly For Value/quality Outcomes Using Shared-risk Or Shared-savings Methods,
  "participating_plans_and_regions_served" VARCHAR,
  "plans_in_program" VARCHAR,
  "notes" VARCHAR,
  "program_notes" VARCHAR,
  "year" DOUBLE,
  "location" VARCHAR
);

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