This edition looks at the progression of capitation contracting in the Medicaid program at the national and state levels.  As a percentage of total Medicaid spending, capitation contracting has grown 31.1% in FFY2013 to 55.9% in FFY2021. National Medicaid spending via capitation was 47% larger than fee-for-service payments during FFY2021.  In two states, Iowa and Hawaii, capitation payments represented more than 90% of overall Medicaid expenditures during FFY2021.