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 Managed Care Capitation Rates – Two-Plan Model

공공데이터포털

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 Managed Care Capitation Rates - Geographic Managed Care (GMC)

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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.

Medi-Cal Managed Care Capitation Rates – County Organized Health Systems (COHS) Model

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This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in the COHS model, by State Fiscal Year. The COHS serve beneficiaries in 22 counties. In the COHS model counties, the Department of Health Care Services (DHCS) contracts with a health plan created by the county Board of Supervisors. In a COHS county, all Medi-Cal members are enrolled in the same managed care health plan.

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

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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.

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.

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

공공데이터포털

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.

Program of All-Inclusive Care for the Elderly (PACE) Rates

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The datasets contain reimbursement rates paid to participating Program of All-Inclusive Care for the Elderly (PACE) organizations for calendar years 2015-2022. To be eligible for the PACE program, a person must be 55 years of age or older and reside in one of the following PACE service areas: Alameda, Contra Costa, Fresno, Humboldt, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Stanislaus.

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.

Program of All-Inclusive Care for the Elderly (PACE) Rates

공공데이터포털

The datasets contain reimbursement rates paid to participating Program of All-Inclusive Care for the Elderly (PACE) organizations for calendar years 2015-2022. To be eligible for the PACE program, a person must be 55 years of age or older and reside in one of the following PACE service areas: Alameda, Contra Costa, Fresno, Humboldt, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Stanislaus.