The following tables list monthly capitation rates for Family Care, Family Care Partnership, and PACE (Program of All-Inclusive Care for the Elderly) managed care organizations (MCOs). Family Care rates are listed by geographic service region (GSR). View monthly capitation rates from prior years.
- Family Care GSR map (PDF)
- PACE/Partnership GSR map (PDF)
2021 Family Care Capitation Rates
| MCO | Geographic Service Region Counties | Development Disability | Physical Disability | Frail Elder | Non-Nursing Home |
|---|---|---|---|---|---|
| Community Care, Inc. | GSR 6: Ozaukee, Sheboygan, Walworth, Washington, Waukesha | $4,283.19 | $3,184.00 | $3,114.93 | $564.05 |
| Community Care, Inc. | GSR 8: Milwaukee | $4,376.90 | $2,925.38 | $2,947.51 | $587.56 |
| Community Care, Inc. | GSR 9: Fond du Lac, Manitowoc, Winnebago | $3,445.23 | $2,529.67 | $2,789.81 | $531.11 |
| Community Care, Inc. | GSR 10: Calumet, Outagamie, Waupaca | $4,084.51 | $2,906.49 | $2,849.84 | $517.86 |
| Community Care, Inc. | GSR 11: Kenosha, Racine | $4,259.49 | $2,995.17 | $2,970.57 | $590.03 |
| Community Care, Inc. | GSR 12: Dane | $4,658.29 | $3,629.71 | $3,702.11 | $545.16 |
| Inclusa, Inc. | GSR 1: Chippewa, Dunn, Eau Claire, Pierce, St. Croix, Taylor | $4,561.55 | $2,904.45 | $2,911.38 | $530.68 |
| Inclusa, Inc. | GSR 2: Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, Vernon | $3,977.35 | $2,434.24 | $2,700.08 | $507.55 |
| Inclusa, Inc. | GSR 3: Crawford, Grant, Green, Iowa, Juneau, Lafayette, Richland, Sauk | $3,829.12 | $2,487.69 | $2,686.46 | $517.20 |
| Inclusa, Inc. | GSR 4: Florence, Forest, Langlade, Lincoln, Marathon, Oneida, Portage, Vilas, Wood | $3,704.20 | $2,664.45 | $2,782.70 | $511.87 |
| Inclusa, Inc. | GSR 5: Adams, Columbia, Dodge, Green Lake, Jefferson, Marquette, Waushara | $3,874.41 | $2,649.79 | $2,646.41 | $510.75 |
| Inclusa, Inc. | GSR 6: Ozaukee, Sheboygan, Walworth, Washington, Waukesha | $4,002.92 | $3,150.13 | $2,945.11 | $571.73 |
| Inclusa, Inc. | GSR 7: Ashland, Barron, Bayfield, Burnett, Douglas, Iron, Polk, Price, Rusk, Sawyer, Washburn | $3,947.39 | $2,653.45 | $2,708.99 | $523.18 |
| Inclusa, Inc. | GSR 9: Fond du Lac, Manitowoc, Winnebago* | $3,932.09 | $2,566.07 | $2,795.25 | $526.35 |
| Inclusa, Inc. | GSR 10: Calumet, Outagamie, Waupaca* | $4,266.25 | $2,892.70 | $2,826.04 | $519.55 |
| Inclusa, Inc. | GSR 13: Brown, Door, Kewaunee, Marinette, Menominee, Oconto, Shawano | $4,555.56 | $3,277.53 | $2,708.00 | 578.32 |
| Inclusa, Inc. | GSR 14: Rock | $5,031.44 | $2,719.12 | $3,092.87 | $584.25 |
| Lakeland Care Inc. | GSR 4: Florence, Forest, Langlade, Lincoln, Marathon, Oneida, Portage, Vilas, Wood | $3,557.92 | $2,710.69 | $2,725.56 | $521.22 |
| Lakeland Care Inc. | GSR 9: Fond du Lac, Manitowoc, Winnebago | $3,776.86 | $2,564.20 | $2,819.63 | $528.79 |
| Lakeland Care Inc. | GSR 10: Calumet, Outagamie, Waupaca | $3,897.37 | $2,819.20 | $2,796.20 | $524.00 |
| Lakeland Care Inc. | GSR 13: Brown, Door, Kewaunee, Marinette, Menominee, Oconto, Shawano | $4,028.87 | $3,139.81 | $3,082.05 | $602.27 |
| My Choice Wisconsin | GSR 1: Chippewa, Dunn, Eau Claire, Pierce, St. Croix, Taylor | $3,332.22 | $2,636.45 | $2,657.49 | $497.20 |
| My Choice Wisconsin | GSR 2: Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, Vernon | $2,927.25 | $2,109.15 | $2,408.77 | $506.63 |
| My Choice Wisconsin | GSR 3: Crawford, Grant, Green, Iowa, Juneau, Lafayette, Richland, Sauk | $3,091.59 | $2,292.36 | $2,449.33 | $547.34 |
| My Choice Wisconsin | GSR 5: Adams, Columbia, Dodge, Green Lake, Jefferson, Marquette, Waushara | $3,927.10 | $2,804.39 | $2,789.45 | $508.54 |
| My Choice Wisconsin | GSR 6: Ozaukee, Sheboygan, Walworth, Washington, Waukesha | $4,378.91 | $3,187.94 | $3,156.78 | $583.10 |
| My Choice Wisconsin | GSR 8: Milwaukee | $4,063.94 | $2,689.23 | $2,805.75 | $602.95 |
| My Choice Wisconsin | GSR 11: Kenosha, Racine | $4,509.54 | $2,576.55 | $3,160.61 | $589.40 |
| My Choice Wisconsin | GSR 12: Dane | $4,647.40 | $4,053.57 | $3,778.88 | $543.41 |
| My Choice Wisconsin | GSR 14: Rock | $3,692.55 | $3,172.34 | $2,790.66 | $611.66 |
Note: Effective January 1, 2021, Family Care capitation rates will be paid at the MCO GSR target group level.
*Effective April 1, 2021, Inclusa will begin operations in GSR 9 and GSR 10.
2021 Family Care Capitation Rate Report (PDF)
2021 Partnership and PACE Capitation Rates
| MCO | Geographic Service Region | Developmental Disability, DE | Developmental Disability, MA | Physical Disability, DE | Physical Disability, MA | Frail Elder, DE | Frail Elder, MA |
|---|---|---|---|---|---|---|---|
| Community Care Health Plan | GSR 6: Ozaukee, Washington, Waukesha | $3,822.92 | $5,437.83 | $3,059.20 | $4,674.10 | $3,333.26 | $4,948.17 |
| Community Care Health Plan | GSR 8: Milwaukee | $6,336.36 | $7,946.92 | $3,966.04 | $5,576.59 | $3,539.47 | $5,150.02 |
| Community Care Health Plan | GSR 10: Calumet, Outagamie, Waupaca | $5,256.89 | $6,618.67 | $2,832.66 | $4,194.43 | $3,186.51 | $4,548.29 |
| Community Care Health Plan | GSR 11: Kenosha, Racine | $4,132.76 | $5,740.76 | $2,843.36 | $4,451.36 | $3,322.02 | $4,930.02 |
| Community Care Health Plan | PACE (Kenosha*, Milwaukee, Racine, Waukesha) | $5,142.72 | $8,514.75 | $3,376.40 | $6,748.42 | $3,349.39 | $6,721.41 |
| Independent Care Health Plan | GSR 3: Sauk | $3,620.43 | $4,683.98 | $3,547.27 | $4,610.81 | $3,547.02 | $4,610.55 |
| Independent Care Health Plan | GSR 8: Milwaukee | $4,966.30 | $6,489.88 | $3,081.72 | $4,605.31 | $2,920.51 | $4,444.09 |
| Independent Care Health Plan | GSR 11: Kenosha, Racine | $4,967.20 | $6,072.09 | $2,819.16 | $4,194.06 | $3,428.39 | $4,803.30 |
| Independent Care Health Plan | GSR 12: Dane | $4,142.71 | $5,993.60 | $2,797.56 | $4,648.45 | $2,955.86 | $4,806.76 |
| My Choice Wisconsin Health Plan | GSR 3: Sauk | $3,606.22 | $4,740.21 | $3,533.05 | $4,667.04 | $3,532.80 | $4,666.78 |
| My Choice Wisconsin Health Plan | GSR 5: Columbia, Dodge, Jefferson | $4,510.58 | $5,731.78 | $3,056.72 | $4,277.92 | $3,089.99 | $4,311.19 |
| My Choice Wisconsin Health Plan | GSR 6: Ozaukee, Washington, Waukesha | $3,731.37 | $5,374.08 | $3,234.56 | $4,877.26 | $3,248.74 | $4,891.44 |
| My Choice Wisconsin Health Plan | GSR 12: Dane | $3,852.18 | $5,512.99 | $3,043.86 | $4,704.68 | $3,155.22 | $4,816.03 |
Note: Effective January 1, 2021, Family Care Partnership-PACE capitation rates will be paid at the MCO GSR eligibility target group level.
Note: DE indicates Medicare-Medicaid dual eligibility. MA indicates Medicaid only eligibility.
*Effective date for PACE operations in Kenosha county is 8/1/2021.
2021 PACE Capitation Rate Report (PDF)
Last Revised: July 8, 2021
