Medicaid Managed Care Payment Methods and Capitation Rates

Research Report

Medicaid Managed Care Payment Methods and Capitation Rates

Results of a National Survey

Abstract

The first nationwide comparison of how much states are paying for Medicaid managed care shows more than a two-fold variation in the rates set by 36 states. Of the 36 states responding to the survey, the highest managed care capitation rates occur in Connecticut, Hawaii, Kentucky, Massachusetts, New Hampshire, New Mexico, Texas, Utah, and the District of Columbia; the lowest rates occur in California, Florida, Georgia, Indiana, Kansas, Nevada, South Carolina, Tennessee, and Wisconsin. Capitation rates refer to the amount per Medicaid enrollee that the state pays to the managed care plan per month. The survey found several reasons why rates vary.

Research Area: 
To reuse content from Urban Institute, visit copyright.com, search for the publications, choose from a list of licenses, and complete the transaction.