Managed Care Capitation Rate Review: Total Days to Approve Rates

About This Measure

This measure reports the total number of days it took to review and approve states’ managed care base capitation rates and capitation rate amendments. CMS conducts actuarial reviews of these rates and amendments as part of an approval process. CMS often sends questions to states and requests additional information as part of the reviews. The total time of the review has two parts: (1) the time it takes CMS to conduct the review and (2) the time it takes states to answer questions and provide additional information.

This measure includes both parts of the review – CMS review time and states’ time to answer questions and provide additional information. The number of days for the two parts of the total review time are here: CMS Time and State Time.

The purple dash-dotted line represents the mean, or average of all values. The red dashed line represents the median, or middle of all values.

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Histogram with a median of 111 days, a mean of 137 days, and the values:

Number of Days Count
0-30 days 13
31-60 days 44
61-90 days 43
91-120 days 50
121-150 days 40
151-180 days 17
181-210 days 6
211-240 days 13
241-270 days 7
271-300 days 20
301-330 days 7
331-360 days 2
360+ days 8

Source: CMS Office of the Actuary (OACT)

Note: The figure includes the 270 managed care capitation rates and capitation rate amendments that CMS approved in calendar year 2016.