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

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage. DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2023. That is a significant increase from around ** million ten years earlier. Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare. From the beginning to ObamacareMedicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2022. Who is enrolled in Medicaid?Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for **** percent of total enrollment, were responsible for **** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.

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.

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.

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.

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.

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. 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.

This data is from the Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program, part of California’s Medi-Cal 2020 1115 waiver approved by the Centers for Medicare and Medicaid Services (CMS). This dataset includes self-reported data from designated public hospitals (DPHs) and municipal public hospitals (DMPHs) and municipal public hospitals (DMPHs) annual reports, which include self-reported data on performance of PRIME required metrics.

These datasets include the total number of individuals under age 21 (0-20) enrolled in Medi-Cal. The data are from the Medi-Cal Eligibility Data System (MEDS).

This dataset identifies California’s eligibility groups by aid code. California uses aid codes to account for eligibility group populations and the eligibility requirements, scope of benefits, services, costs, claims, encounter data, and managed care arrangements related to those populations. Aid codes in this dataset are mapped to the Transformed Medicaid Statistical Information System (T-MSIS) eligibility group descriptions and codes. California uses this mapping to submit claims data, enrollee encounter data, and supporting information to the Centers for Medicare & Medicaid Services (CMS), as required by Section 4735 of the Balanced Budget Act of 1997 and Section 6504 of the Affordable Care Act for the purpose of program integrity, program oversight, and administration. This dataset includes aid codes that do not have Medi-Cal benefits or have benefits and are not federal programs. Some aid codes may appear to be identical but possess distinct benefits or grouping factors. An aid code may appear more than once if multiple populations are represented in one aid code and can be identified and mapped to distinct T-MSIS groups.

This dataset shows the use of Medi-Cal dental benefits by Medi-Cal members, displayed by age group and calendar year (for 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, and 2022). This information is displayed in the following categories: Continuity Care oral evaluation or a prophylaxis, Usual Source of Care, Overall Utilization of Dental Services 1 year, 2 years and 3 years. The Medi-Cal members were continuously enrolled in either Dental Managed Care or the dental Fee-for-Service delivery system for the entire measurement period.

This dataset contains information on the Family Planning, Access, Care, and Treatment (Family PACT) Program providers for Calendar Year (CY) 2022. The data comes from the Provider Master File (PMF) in the Management Information System/Decision Support System (MIS/DSS) data warehouse, which is maintained by the California Department of Health Care Services (DHCS), Provider Enrollment Division, and from the DHCS, Office of Family Planning (OFP), which creates its own production files/datasets. This dataset includes the following variables: provider number, owner number, service location number, provider legal name, enrollment status effective date, provider address (city/state/zip).

This dataset tracks the updates made on the dataset "Medi-Cal Birth Statistics, by Select Characteristics and California Resident Hospital Births" as a repository for previous versions of the data and metadata.

The purpose of the National CLAS Physician Survey was to understand the provision of culturally and linguistically appropriate services among office-based physicians. The National CLAS Physician Survey was a supplement to the National Ambulatory Medical Care Survey (NAMCS), which is a national probability sample survey of visits to office-based physicians. NAMCS is a component of the National Health Care Surveys that measured health care utilization across a variety of health care providers’ settings. NAMCS and the National CLAS Physician Survey were conducted by the National Center for Health Statistics (NCHS). The National CLAS Physician Survey public use file includes data from office-based physicians. No patient level data were collected. This documentation describes the public use micro-data file produced from data collected in the National CLAS Physician Survey.

Editor’s Choice

• The global biopharmaceuticals market size is expected to be worth around USD 566 billion by 2032 from USD 263 billion in 2022, growing at a CAGR of 8.2% during the forecast period from 2022 to 2032.
• The overall success rate for phase I trials is around 16%, while for phase II trials it is around 10%. Phase III trials, which involve larger patient populations, have a success rate of around 25%.
• The average cost of bringing a new drug to market is projected to be around USD 2.6 billion.
• The National Genome Institute estimates that the cost of sequencing a human genome has fallen from around USD 100 million in 2001 to less than USD 1,000 in recent years.
• In 2020, WIPO received over 23,500 biotechnology-related patent applications, demonstrating the growing innovation and research in the field.
• The US biotechnology industry employed over 2.1 million people in 2020, including direct and indirect jobs.

(Source: Journal of Clinical Oncology, Journal of Health Economics, World Intellectual Property Organization, Biotechnology Innovation Organization)

This dataset includes race/ethnicity of newly Medi-Cal eligible individuals who identified their race/ethnicity as Hispanic, White, Other Asian or Pacific Islander, Black, Chinese, Filipino, Vietnamese, Asian Indian, Korean, Alaskan Native or American Indian, Japanese, Cambodian, Samoan, Laotian, Hawaiian, Guamanian, Amerasian, or Other, by reporting period. The race/ethnicity data is from the Medi-Cal Eligibility Data System (MEDS) and includes eligible individuals without prior Medi-Cal Eligibility. This dataset is part of the public reporting requirements set forth in California Welfare and Institutions Code 14102.5.

In order to facilitate public review and access, enrollment data published on the Open Data Portal is provided as promptly as possible after the end of each month or year, as applicable to the data set. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly.

As a general practice, for monthly data sets published on the Open Data Portal, DSS will continue to refresh the monthly enrollment data for three months, after which time it will remain static. For example, when March data is published the data in January and February will be refreshed. When April data is published, February and March data will be refreshed, but January will not change. This allows the Department to account for the most common enrollment variations in published data while also ensuring that data remains as stable as possible over time. In the event of a significant change in enrollment data, the Department may republish reports and will notate such republication dates and reasons accordingly. In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. Effective January 1, 2021, this coverage group have been separated: (1) the COVID-19 Testing Coverage for the Uninsured is now G06-I and is now listed as a limited benefit plan that rolls up into “Program Name” of Medicaid and “Medical Benefit Plan” of HUSKY Limited Benefit; (2) the emergency medical coverage has been separated into G06-II as a limited benefit plan that rolls up into “Program Name” of Emergency Medical and “Medical Benefit Plan” of Other Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. This data represents number of active recipients who received benefits under a medical benefit plan in that calendar year and month. A recipient may have received benefits from multiple plans in the same month; if so that recipient will be included in multiple categories in this dataset (counted more than once.) 2021 is a partial year. For privacy considerations, a count of zero is used for counts less than five. NOTE: On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, corrections in the ImpaCT system for January and February 2019 caused the addition of around 2000 and 3000 recipients respectively, and the counts for many types of assistance (e.g. SNAP) were adjusted upward for those 2 months. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. 2. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree.
NOTE: On February 14 2019, the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged. NOTE: On 11/30/2018 the counts were revised because of a change in the way active recipients were counted in one source system.