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Medi-Cal Managed Care Capitation Rates - Geographic Managed Care (GMC)
Medi-Cal Managed Care Capitation Rates – Geographic Managed Care (GMC) by State Fiscal Year. Medi- Cal managed care health plans in the Sacramento and San Diego counties.
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Medi-Cal Managed Care Enrollment Report
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This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.
Medi-Cal Managed Care Supplemental Rates - Hepatitis C
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This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans for hepatitis C services, by county and State Fiscal Year. Medi- Cal managed care models and health plans are located in all 58 counties.
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.
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.
Medi-Cal Managed Care Provider Listing
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Chronic Conditions Experienced by Californians with Original Medicare, 2021
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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.
Newly Eligible Individuals enrolled in Medi-Cal Managed Care Health Plans
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This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care Health Plans by type of enrollment by reporting period. Medi-Cal Managed Care program contracts for health care services through established networks of organized systems of care emphasizing primary and preventive care. Newly eligible Medi-Cal beneficiaries must choose a Managed Care health plan within 30 days of Medi-Cal enrollment, or they will be enrolled in a Managed Care health plan by default. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.
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.
Medi Cal FFS Provider Listing
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The dataset provides basic information of the FFS providers enrolled in the Medi-Cal program as of April 1, 2024. The data was retrieved from the Provider Master File (PMF), which has been used in the claims payment process and maintained by the Provider Enrollment Division (PED). The Variables in the dataset include provider number, name, type, specialty, geographic information, etc. This dataset does not include the Managed Care providers.
Medi-Cal Birth Statistics, by Select Characteristics and California Resident Hospital Births
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California Birth Report totals by Birth Characteristics to inform the public, stakeholders, and researchers. The DHCS Medi-Cal Birth Statistics tables present the descriptive statistics for California resident births that occurred in a hospital setting, including data on maternal characteristics, delivery methods, and select birth outcomes such as low birthweight and preterm delivery. Tables also include key comorbidities and health behaviors known to influence birth outcomes, such as hypertension, diabetes, substance use, pre-pregnancy weight, and smoking during pregnancy. DHCS additionally presents birth statistics for women participating in the Medi-Cal Fee-For-Service (FFS) and managed care delivery systems, as well as births financed by private insurance, births financed by other public funding sources, and births among uninsured mothers. Medi-Cal data reflect mothers that were deemed as Medi-Cal certified eligible. __Note:__ Data for maternal comorbidities including hypertension, diabetes, and substance use have been provisionally omitted among calendar years 2020-2022 for the time being.