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Chronic Conditions Experienced by Californians with Original Medicare, 2021
The dataset contains information about the prevalence of chronic conditions among Original Medicare beneficiaries as well as about the spending and co-occurring conditions for those with each condition. The data are available for California and for the rest of the United States, overall and by demographic and geographic groups. Additionally, the data are available for each of 19 California geographic regions overall and by demographic and geographic groups. The data represent Medicare beneficiaries who are in the Original Medicare program. Medicare offers health care coverage for older adults and certain individuals with disabilities. The Original Medicare program is Parts A and B of Medicare, administered by the U.S. Centers for Medicare & Medicaid Services. The analysis excludes enrollees of the Medicare Advantage program, administered by private insurers, because Medicare Advantage data are incomplete.
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Medi-Cal Annual Renewals by County
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This dataset includes information regarding annual Medi-Cal eligibility renewals conducted for beneficiaries by counties each month. The data is from the Statewide Automated Welfare System (SAWS), which determines Medi-Cal eligibility and conducts ongoing case management. The SAWS reports the number of renewals due and the renewals completed by the due date and within the renewals processing timeframe. This dataset is part of the public reporting requirements set forth in California Welfare and Institutions Code 14102.5(3) et seq.
Eligible Individuals Enrolled in Medi-Cal Managed Care COHS Health Plans
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This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care County Organized Health System (COHS) Health Plans by reporting period. COHS is a Medi-Cal managed care health plan model that operates in 22 California counties. Each COHS is created by a county board of supervisors and governed by an independent commission. In COHS counties, a single plan serves all Medi-Cal beneficiaries enrolled in managed care. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.
Enrollment Data
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Medi-Cal enrollment data grouped by total enrollment, sex, age group, region, county, language, and race/ethnicity.
Medi-Cal Managed Care Capitation Rates – Two-Plan Model
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This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in Two-Plan model counties by State Fiscal Year. In Two-Plan model counties, the Department of Health Care Services (DHCS) contracts with a local initiative (county organized) and a commercial plan.
Medi-Cal Certified Eligibles Data by Month with Demographics
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These files contain monthly data by county for Medi-Cal certified eligibles, by various demographics traits. The data is split out and not distributed as a single dataset for the purposes of de-identification.
CA Wellness Plan Data Reference Guide
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The purpose of the California Wellness Plan (CWP) Data Reference Guide (Reference Guide) is to provide access to the lowest-level data for each CWP Objective; lowest-level data source, instructions to access data, and additional details are described. Some CWP Objectives do not have program leads, data sources, baselines, and/or targets, but are included because they were a result of CDPH program or partner input and were felt to be important to the reduction of chronic disease incidence, prevalence, and health disparities. Agencies, programs and/or partners identified with an objective may be either data stewards and/or engaged in activities to achieve the target, but may not have adequate resources for statewide activities. Developmental Objectives will be updated as information becomes available. Background: The California Wellness Plan, California's Chronic Disease Prevention and Health Promotion Plan was released February 2014 by the California Department of Public Health (CDPH). The overarching goal of CWP is Equity in Health and Wellbeing; additional CWP Goals include: 1) Healthy Communities, 2) Optimal Health Systems Linked with Community Prevention, 3) Accessible and Usable Health Information, and 4) Prevention Sustainability and Capacity. All CWP objectives fall under the framework of Let's Get Healthy California Task Force priorities. [California Wellness Plan](https://archive.cdph.ca.gov/programs/cdcb/Documents/CDPH-CAWellnessPlan2014%20(Agency%20Approved)%20FINAL%202-27-14(Protected)%20rev%20(8).pdf) Green text in the “Objective” column indicates updates that were made to the California Wellness Plan objectives in 2016.
Medi-Cal Managed Care Capitation Rates by Managed Care Plan Models
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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.
Dual Medi-Cal Enrollment and Medicare Advantage Enrollment in the Medicare Population in California Counties
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This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage. DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.
Number of Individuals Transitioned from Covered California Qualified Health Plans to Medi-Cal
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This dataset includes the number of individuals transitioned from Covered California Qualified Health Plan (QHP) eligibility to Medi-Cal enrollment commencing with the 2016 Quarter 4 Report. The individuals in this dataset represent Covered California clients, regardless of QHP enrollment status, who are in a Carry Forward Status (CFS) after reporting a change making them potentially eligible for MAGI Medi-Cal during a reporting period. The total number of individuals transitioned from Covered California includes Medi-Cal eligible individuals who did not have Medi-Cal eligibility in the month prior to the reporting period. This is a new dataset as a result of implementing the Covered California QHP Carry Forward Status indicator in release 16.9 and is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.