Exhibit 3.7: Adjusted Medicaid Managed Care Monthly Payment Rates and Comparison to the National Median Payment Rate, 2001
There is substantial geographic variation in the amount states pay plans for public managed care coverage through Medicaid. This is likely the result of variations in fee-for-service spending levels, eligibility, local health care costs, and demographics. The national median Medicaid managed care (MMC) payment rate for 2001 was $150.60 per month, with a low of $105.35 in Michigan and a high of $209.34 in North Dakota.
State | Adjusted MMC Rate | Rate To 50th Percentile |
North Dakota | $209.34 | 39% |
Minnesota | $202.36 | 34% |
Kentucky | $191.95 | 27% |
Virginia | $190.35 | 26% |
North Carolina | $188.68 | 25% |
New Mexico | $186.94 | 24% |
Washington, DC | $186.40 | 24% |
Iowa | $181.43 | 20% |
Maryland | $180.05 | 20% |
New Hampshire | $175.95 | 17% |
Massachusetts | $170.96 | 14% |
Connecticut | $169.37 | 12% |
Indiana | $164.84 | 9% |
Ohio | $162.30 | 8% |
Delaware | $159.61 | 6% |
Rhode Island | $159.29 | 6% |
Washington | $154.67 | 3% |
Missouri | $151.79 | 1% |
U.S. 50th Percentile | $150.60 | - |
New York | $149.41 | -1% |
Hawaii | $147.64 | -2% |
Illinois | $146.36 | -3% |
West Virginia | $143.81 | -5% |
New Jersey | $143.04 | -5% |
South Carolina | $141.38 | -6% |
Utah | $140.21 | -7% |
California | $137.79 | -9% |
Florida | $135.82 | -10% |
Kansas | $134.84 | -10% |
Colorado | $134.36 | -11% |
Pennsylvania | $132.52 | -12% |
Wisconsin | $132.44 | -12% |
Arizona | $131.54 | -13% |
Nevada | $128.06 | -15% |
Texas | $127.63 | -15% |
Oklahoma | $118.32 | -21% |
Michigan | $105.35 | -30% |
Source: The Urban Institute, John Holahan and Shinobu Suzuki, “Medicaid Managed Care Payment Methods and Capitation Rates in 2001, Results of a New National Survey,” March 31, 2003, at http://www.urban.org/urlprint.cfm?ID=8357.
