55 datasets found
  1. Medi-Cal Managed Care Enrollment Report

    • data.chhs.ca.gov
    • data.ca.gov
    • +3more
    csv, zip
    Updated Nov 19, 2025
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    Department of Health Care Services (2025). Medi-Cal Managed Care Enrollment Report [Dataset]. https://data.chhs.ca.gov/dataset/medi-cal-managed-care-enrollment-report
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    zip, csv(2503571)Available download formats
    Dataset updated
    Nov 19, 2025
    Dataset provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    Authors
    Department of Health Care Services
    Description

    This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

  2. Newly Eligible Individuals enrolled in Medi-Cal Managed Care Health Plans

    • data.ca.gov
    • data.chhs.ca.gov
    • +4more
    csv, zip
    Updated Nov 7, 2025
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    California Department of Health Care Services (2025). Newly Eligible Individuals enrolled in Medi-Cal Managed Care Health Plans [Dataset]. https://data.ca.gov/dataset/newly-eligible-individuals-enrolled-in-medi-cal-managed-care-health-plans
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    zip, csvAvailable download formats
    Dataset updated
    Nov 7, 2025
    Dataset authored and provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    License

    Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
    License information was derived automatically

    Description

    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.

  3. Managed Care Enrollment by Program and Population (Duals)

    • catalog.data.gov
    Updated Feb 3, 2025
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    Centers for Medicare & Medicaid Services (2025). Managed Care Enrollment by Program and Population (Duals) [Dataset]. https://catalog.data.gov/dataset/managed-care-enrollment-by-program-and-population-duals-2fed4
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    Dataset updated
    Feb 3, 2025
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees. The “Total dually eligible individuals” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including enrollees receiving full Medicaid benefits or Medicaid cost sharing. "--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.

  4. g

    Medi-Cal Managed Care Enrollment Report | gimi9.com

    • gimi9.com
    Updated Oct 31, 2018
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    (2018). Medi-Cal Managed Care Enrollment Report | gimi9.com [Dataset]. https://gimi9.com/dataset/california_medi-cal-managed-care-enrollment-report
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    Dataset updated
    Oct 31, 2018
    License

    Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
    License information was derived automatically

    Description

    This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

  5. Eligible Individuals Enrolled in Medi-Cal Managed Care COHS Health Plans

    • catalog.data.gov
    • data.ca.gov
    • +2more
    Updated Jul 24, 2025
    + more versions
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    California Department of Health Care Services (2025). Eligible Individuals Enrolled in Medi-Cal Managed Care COHS Health Plans [Dataset]. https://catalog.data.gov/dataset/eligible-individuals-enrolled-in-medi-cal-managed-care-cohs-health-plans-de24a
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    Dataset updated
    Jul 24, 2025
    Dataset provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    Description

    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.

  6. Medi-Cal Managed Care Enrollment Report - wpz7-jrrn - Archive Repository

    • healthdata.gov
    csv, xlsx, xml
    Updated Nov 20, 2025
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    (2025). Medi-Cal Managed Care Enrollment Report - wpz7-jrrn - Archive Repository [Dataset]. https://healthdata.gov/dataset/Medi-Cal-Managed-Care-Enrollment-Report-wpz7-jrrn-/vsf9-h5g4
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    xml, csv, xlsxAvailable download formats
    Dataset updated
    Nov 20, 2025
    Description

    This dataset tracks the updates made on the dataset "Medi-Cal Managed Care Enrollment Report" as a repository for previous versions of the data and metadata.

  7. Managed Care Enrollment Summary

    • catalog.data.gov
    Updated Feb 3, 2025
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    Centers for Medicare & Medicaid Services (2025). Managed Care Enrollment Summary [Dataset]. https://catalog.data.gov/dataset/managed-care-enrollment-summary-d8634
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    Dataset updated
    Feb 3, 2025
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Total Medicaid Enrollees represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and Medicare-Medicaid ("dual") enrollees. Total Medicaid enrollment in Any Type of Managed Care represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, and PCCMs. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), or PACE program. It excludes beneficiaries who are enrolled in a Financial Alignment Demonstration Medicare-Medicaid Plan as their only form of managed care. The “Medicaid Enrollment in Comprehensive MCOs Under ACA Section VIII Expansion” column is a subset of the total reported in column C and includes individuals who are enrolled in comprehensive MCOs and are low-income adults, with or without dependent children, eligible for Medicaid under ACA Section VIII. n/a" indicates that a state or territory was either not able to report data or does not operate a managed care program.

  8. Managed Care Information for Medicaid and CHIP Beneficiaries by Year

    • catalog.data.gov
    • data.virginia.gov
    • +4more
    Updated Nov 5, 2025
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    Centers for Medicare & Medicaid Services (2025). Managed Care Information for Medicaid and CHIP Beneficiaries by Year [Dataset]. https://catalog.data.gov/dataset/managed-care-information-for-medicaid-and-chip-beneficiaries-by-year-dc72d
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    Dataset updated
    Nov 5, 2025
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each managed care plan type over the year (duplicated count); (2) the number of beneficiaries enrolled in each managed care plan type as of an individual’s last month of enrollment (duplicated count); and (3) average monthly enrollment in each managed care plan type. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some cells have a value of “DS”. Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

  9. A

    Medicaid Managed Care Enrollment Report

    • data.amerigeoss.org
    html
    Updated Jul 27, 2019
    + more versions
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    United States (2019). Medicaid Managed Care Enrollment Report [Dataset]. https://data.amerigeoss.org/ja/dataset/medicaid-managed-care-enrollment-report-e187f
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    htmlAvailable download formats
    Dataset updated
    Jul 27, 2019
    Dataset provided by
    United States
    Description

    This report is composed annually and profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. This report also provides national-level summary tables relating to trends, breakout of managed care entities, managed care enrollment by state, regional breakout and states with comprehensive health care reform demonstrations.

  10. Share of Medicaid Enrollees in Managed Care

    • data.virginia.gov
    • datahub.hhs.gov
    • +1more
    csv
    Updated Oct 16, 2024
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    Centers for Medicare & Medicaid Services (2024). Share of Medicaid Enrollees in Managed Care [Dataset]. https://data.virginia.gov/dataset/share-of-medicaid-enrollees-in-managed-care
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    csvAvailable download formats
    Dataset updated
    Oct 16, 2024
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data.

    1. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program.

    2. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing.

    3. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities.

    4. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.

  11. Managed Care Enrollment by Program and Plan

    • catalog.data.gov
    Updated Feb 3, 2025
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    Centers for Medicare & Medicaid Services (2025). Managed Care Enrollment by Program and Plan [Dataset]. https://catalog.data.gov/dataset/managed-care-enrollment-by-program-and-plan-2631d
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    Dataset updated
    Feb 3, 2025
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. The information in this table was provided by state officials. In some cases, program or plan names in this table differ from those used in publicly available sources. Questions regarding state-specific information in this table should be directed to State/territorial Medicaid officials.

  12. Share of Medicaid Enrollees in Managed Care

    • catalog.data.gov
    Updated Feb 3, 2025
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    Centers for Medicare & Medicaid Services (2025). Share of Medicaid Enrollees in Managed Care [Dataset]. https://catalog.data.gov/dataset/share-of-medicaid-enrollees-in-managed-care-712a3
    Explore at:
    Dataset updated
    Feb 3, 2025
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.

  13. Managed Care Information for Medicaid and CHIP Beneficiaries by Month

    • catalog.data.gov
    • data.virginia.gov
    • +2more
    Updated Nov 5, 2025
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    Centers for Medicare & Medicaid Services (2025). Managed Care Information for Medicaid and CHIP Beneficiaries by Month [Dataset]. https://catalog.data.gov/dataset/managed-care-information-for-medicaid-and-chip-beneficiaries-by-month-e82e3
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    Dataset updated
    Nov 5, 2025
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

  14. Managed Care Features By Enrollment Population

    • data.virginia.gov
    • datahub.hhs.gov
    • +3more
    csv
    Updated Oct 16, 2024
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    Centers for Medicare & Medicaid Services (2024). Managed Care Features By Enrollment Population [Dataset]. https://data.virginia.gov/dataset/managed-care-features-by-enrollment-population
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    csvAvailable download formats
    Dataset updated
    Oct 16, 2024
    Dataset provided by
    Centers for Medicare & Medicaid Services
    Description

    Number of Managed Care Programs Enrolling Certain Populations on a Mandatory or Voluntary Basis at any point in 2022

  15. Medi-Cal Managed Care Capitation Rates – County Organized Health Systems...

    • data.ca.gov
    • data.chhs.ca.gov
    csv, zip
    Updated Nov 7, 2025
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    California Department of Health Care Services (2025). Medi-Cal Managed Care Capitation Rates – County Organized Health Systems (COHS) Model [Dataset]. https://data.ca.gov/dataset/medi-cal-managed-care-capitation-rates-county-organized-health-systems-cohs-model
    Explore at:
    csv, zipAvailable download formats
    Dataset updated
    Nov 7, 2025
    Dataset authored and provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    License

    Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
    License information was derived automatically

    Description

    This page is considered archival. please refer to the new data landing page at Medi-Cal Managed Care Capitation Rates by Managed Care Plan Models.

    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.

  16. Managed Care Performance Monitoring Dashboard Report

    • catalog.data.gov
    • data.ca.gov
    • +2more
    Updated Jul 24, 2025
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    California Department of Health Care Services (2025). Managed Care Performance Monitoring Dashboard Report [Dataset]. https://catalog.data.gov/dataset/managed-care-performance-monitoring-dashboard-report-e2418
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    Dataset updated
    Jul 24, 2025
    Dataset provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    Description

    This report contains data regarding enrollment demographics, utilization of services, grievances, state fair hearings, provider ratios, encounter completeness, Healthcare Effectiveness Data and Information Set (HEDIS) rates, and medical audit findings.

  17. ​Profile of Enrolled Medi-Cal Fee-for-Service (FFS) Providers

    • data.chhs.ca.gov
    • s.cnmilf.com
    csv, html, zip
    Updated Dec 2, 2025
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    Department of Health Care Services (2025). ​Profile of Enrolled Medi-Cal Fee-for-Service (FFS) Providers [Dataset]. https://data.chhs.ca.gov/dataset/profile-of-enrolled-medi-cal-fee-for-service-ffs-providers
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    zip, csv(2439), html, csv(2888), csv(110799631)Available download formats
    Dataset updated
    Dec 2, 2025
    Dataset provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    Authors
    Department of Health Care Services
    Description

    The dataset provides basic information of the FFS providers enrolled in the Medi-Cal program as of December 1, 2025. 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.

  18. g

    Medi-Cal Managed Care Capitation Rates – County Organized Health Systems...

    • gimi9.com
    Updated Jul 1, 2018
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    (2018). Medi-Cal Managed Care Capitation Rates – County Organized Health Systems (COHS) Model | gimi9.com [Dataset]. https://gimi9.com/dataset/california_medi-cal-managed-care-capitation-rates-county-organized-health-systems-cohs-model
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    Dataset updated
    Jul 1, 2018
    License

    Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
    License information was derived automatically

    Description

    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.

  19. Medicaid Managed Care Penetration Rates and Expansion Enr...

    • data.wu.ac.at
    application/unknown
    Updated Apr 4, 2018
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    U.S. Department of Health & Human Services (2018). Medicaid Managed Care Penetration Rates and Expansion Enr... [Dataset]. https://data.wu.ac.at/schema/data_gov/MzU3MzY5YmEtMWRlMi00N2I5LThmYWYtZmUyNzQwYTNlYzQw
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    application/unknownAvailable download formats
    Dataset updated
    Apr 4, 2018
    Dataset provided by
    United States Department of Health and Human Serviceshttp://www.hhs.gov/
    Description

    The Medicaid managed care penetration rates and expansion enrollment by state charts are composed annually by the Data and System Group (DSG) of the Centers for Medicare and Medicaid Services (CMS). The enrollment statistics profile Medicaid managed care programs on a state specific basis as of December 31, 2010. The information was collected from State Medicaid agencies and CMS regional offices. Data is presented for all states, the District of Columbia, Puerto Rico, and the Virgin Islands. Data is not presented for the following territories, Guam, Northern Mariana Islands, and American Samoa. The charts provide national-level summary tables relating to Medicaid and managed care enrollment by State and States with comprehensive health care reform demonstrations.

  20. ​Profile of Enrolled Medi-Cal Fee-for-Service (FFS) Providers

    • catalog.data.gov
    Updated Nov 23, 2025
    + more versions
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    California Department of Health Care Services (2025). ​Profile of Enrolled Medi-Cal Fee-for-Service (FFS) Providers [Dataset]. https://catalog.data.gov/dataset/profile-of-enrolled-medi-cal-fee-for-service-ffs-providers-ff4b9
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    Dataset updated
    Nov 23, 2025
    Dataset provided by
    California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
    Description

    The dataset provides basic information of the FFS providers enrolled in the Medi-Cal program as of November 13, 2025. 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.

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Department of Health Care Services (2025). Medi-Cal Managed Care Enrollment Report [Dataset]. https://data.chhs.ca.gov/dataset/medi-cal-managed-care-enrollment-report
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Medi-Cal Managed Care Enrollment Report

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11 scholarly articles cite this dataset (View in Google Scholar)
zip, csv(2503571)Available download formats
Dataset updated
Nov 19, 2025
Dataset provided by
California Department of Health Care Serviceshttp://www.dhcs.ca.gov/
Authors
Department of Health Care Services
Description

This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

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