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State programs

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

medicare_silver.medicaid_capitation_rate_cell_v2·partial·silver
Rows
53,651
Columns
16
History
N/A
Card
nocolumns only
Typed tools
0

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. v2 restates v1 whole with the served defects CAP-1..21 fixed (#3243): FL budgetary rates dropped, TX, SC, WV, MA, PA, LA, MS, NJ, NH labels and values as printed.

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. 253,651 rows in 28 jurisdictions, rating periods 2018-01-01 to 2027-09-30 (Athena d6771896);
  3. 30 duplicate keys (verify_tracker_loads --lane CAP, gates run 20261007T092022Z-92425b52).

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_v2")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.medicaid_capitation_rate_cell_v2 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_v2")
Raw doorAthena (read-only via query_substrate): medicare_silver.medicaid_capitation_rate_cell_v2 (pin state_code, the rating period and rate_kind; take the highest amendment_seq per cell)
NoteRegister source medicaid_capitation_v1 (w8, serve raw), repointed to v2 on 2026-10-07 after Data Tracker accepted it (#3243, 0ee0a68568: "ship it as partial"). status partial: 28 jurisdictions with cells and the MA SCO 2026 source limit. Supersedes medicare_silver.medicaid_capitation_rate_cell_v1, kept as the rollback.

This page as markdown: /docs-md/data/medicare_silver_medicaid_capitation_rate_cell_v2.md · every page in one file: /llms-full.txt