Managed Care Capitation Rate Review: Total Days to Approve Rates

VISIT THE PILLAR: Federal Administrative Accountability

National Context

State Health System Performance

State Administrative Accountability

Federal Administrative Accountability

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

Managed Care Capitation Rate Review: Total Days to Approve Rates

This measure reports the total number of days it took to review and approve states’ managed care base capitation rates and capitation rate amendments.

Federal Administrative Accountability

Detailed description of visualization provided below.

Managed Care Capitation Rate Review: Total Days to Approve Rates

Bar Graph shows total days it took CMS to review and approve states' managed care contract actions

Days	Count of Rate Certifications and Amendments Approved
0-30	28
31-60	31
61-90	43
91-120	42
121-150	22
151-180	20
181-210	10
211-240	3
241-270	4
271-300	2
301-330	0
331-360	1
360+	5

Source: CMS Office of the Actuary (OACT)

Note: The figure includes the 211 managed care capitation rates and capitation rate amendments that were submitted to CMS in federal fiscal year 2020 and approved as of April 2021.