VladaOmega
Sign inStart free
State programs

Medicaid managed care capitation rates by rate cell, 28 jurisdictions (cross-state layer v1), PMPM, rating periods 2018-2027

medicare_silver.medicaid_capitation_rate_cell_v1·partial·silver
Rows
54,981
Columns
16
History
N/A
Card
nocolumns only
Typed tools
0

Superseded by medicare_silver.medicaid_capitation_rate_cell_v2 (restated whole 2026-10-07, #3243, with the served defects CAP-1..21 fixed; 53,651 cells, every one placed and value-equal to the publisher). This v1 table carries those defects (FL budgetary rates served as final, a wrong TX value, SC add-on groups swapped, MA/PA/WV/LA labels). Kept frozen as the rollback; never read it beside v2..

What it is

  1. 1The capitation rates themselves: the per-member-per-month (PMPM) amount a state Medicaid agency pays its managed care organizations for an enrollee in each rate cell, as each state publishes it (rate certification exhibits, contract rate exhibits, rate schedules, the DHCS rate CSVs). rate_pmpm is dollars per member per month at the publisher's printed precision unless unit_raw says otherwise (kick payments are per event, e.g. per delivery). rate_kind separates final (contracted) rates from CA's actuarially sound ranges (lower_bound, midpoint, upper_bound), base rates before a named add-on or risk adjustment, and kick payments. plan, rate cell, population, region and age/sex are the publisher's own labels.
  2. 2Jurisdictions with cells: AZ CA DC FL GA IA ID IN LA MA MS NC NE NH NJ NV OH OK OR PA PR SC TX UT VA VT WI WV;
  3. 3CA is 29,409 of the rows.
  4. 4Every row cites document_url, SHA-256 and a page/line evidence_locator; join its cycle on (state_code, program_name_raw, rating_period_start, rating_period_end, amendment_seq), where a cell may carry a sub-period of its cycle.

Grain

KeyGrain
N/A
  1. 1One row per published rate: the cycle key x plan_name_raw x rate_cell_raw x population_raw x region_raw x age_sex_raw x rate_kind x unit_raw;
  2. 254,981 rows in 28 jurisdictions, rating periods 2018-01-01 to 2027-09-30, 0 duplicate keys, 0 NULL rate_pmpm (Athena c54592ae; key and lineage checks verify_tracker_loads --lane CAP, cloud run 20261007T004245Z-dedf4193).

Columns (16)

ColumnTypeMeaning
state_codestring
program_name_rawstring
rating_period_startdate
rating_period_enddate
amendment_seqint
plan_name_rawstring
rate_cell_rawstring
population_rawstring
region_rawstring
age_sex_rawstring
rate_pmpmdouble
rate_kindstring
unit_rawstring
document_urlstring
sha256_content_hashstring
evidence_locatorstring

Query it

describe_data_source(source_fqn="medicare_silver.medicaid_capitation_rate_cell_v1")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.medicaid_capitation_rate_cell_v1 WHERE <filter> LIMIT 100")
ItemValue
Typed tools that read itnone; raw SQL
Identity keystate_code,program_name_raw,rating_period_start,rating_period_end,amendment_seq,plan_name_raw,rate_cell_raw,population_raw,region_raw,age_sex_raw,rate_kind,unit_raw
Joinhow_to_join(source_fqn="medicare_silver.medicaid_capitation_rate_cell_v1")
Raw doorAthena (read-only via query_substrate): medicare_silver.medicaid_capitation_rate_cell_v1 (pin state_code, the rating period and rate_kind; take the highest amendment_seq per cell)
NoteROLLBACK ONLY. Superseded 2026-10-07 by medicare_silver.medicaid_capitation_rate_cell_v2 when register source medicaid_capitation_v1 (w8) was repointed to v2 (#3243 accepted by Data Tracker); listed in that register source only as the rollback. Versioned (_v1), append-only, frozen.

This page as markdown: /docs-md/data/medicare_silver_medicaid_capitation_rate_cell_v1.md · every page in one file: /llms-full.txt