Managed Care

RECIPIENTS ELIGIBLE FOR ENROLLMENT IN MANAGED CARE:
ENROLLMENT STATUS BY AID CATEGORY AND COUNTY, AND TOTAL PERCENT ENROLLED BY PROVIDER PLAN
NYS August 2002
  Å Return to Monthly Medicaid Managed Care Enrollment Report 

  TANF ADC & MA-ADC SNA HR & MA-HR TANF & MA-ADC, SNA & MA-HR EXPECTED PENETRATION RATE SSI & MA-SSI  
County Provider Eligibles Enrolled Eligibles Enrolled Total Eligibles Total Enrolled Percent Enrolled Expected Target* % of Target* Eligibles Enrolled Total Eligibles Total Enrolled Percent Enrolled
    eltanf tanf elsna sna elsub sub       elssi ssi eltot entot  
Albany TOTALS: 15,427 12,032 1,856 1,066 17,283 13,098 76% 92% 82% 4,299 820 21,582 13,918 64%
  CDPHP   9,977   911   10,888 63%       707   11,595 54%
  Fidelis/NYS Catholic Hlth   1,036   86   1,122 6%       71   1,193 6%
  Wellcare   1,019   69   1,088 6%       42   1,130 5%
Allegany TOTALS: 3,523 754 331 53 3,854 460 12% 89% 13% 1,005 224 4,859 1,031 21%
  Health Choice (Partial)   426   34   460 12%       207   667 14%
  HealthNow/BCBS-WNY/Community Blue   328   19   347 9%       17   364 7%
Broome TOTALS: 11,751 10,005 1,234 870 12,985 10,875 84% 89% 94% 3,461 882 16,446 11,757 71%
  Broome MC   5,110   372   5,482 42%       664   6,146 37%
  Fidelis/NYS Catholic Hlth   443   34   477 4%       21   498 3%
  CDPHP   4,452   464   4,916 38%       197   5,113 31%
Cattauragus TOTALS: 5,652 3,999 352 256 6,004 4,255 71% 91% 78% 1,568 581 7,572 4,836 64%
  HealthNow/BCBS-WNY/Community Blue   3,030   209   3,239 54%       520   3,759 50%
  Fidelis/NYS Catholic Hlth   969   47   1,016 17%       61   1,077 14%
Cayuga TOTALS: 4,776 0 275 0 5,051 0 0% 88% 0% 1,164 0 6,215 0 0%
Chautauqua TOTALS: 11,149 8,000 1,446 912 12,595 8,912 71% 82% 86% 2,619 969 15,214 9,881 65%
  HealthNow/BCBS-WNY/Community Blue   2,518   247   2,765 22%       294   3,059 20%
  Primary Health   595   100   695 6%       226   921 6%
  Fidelis/NYS Catholic Hlth   4,887   565   5,452 43%       449   5,901 39%
Chemung TOTALS: 7,521 3,605 593 209 8,114 3,814 47% 88% 53% 1,918 970 10,032 4,784 48%
  Southern Tier Pediatrics (Partial)   2,588   0   2,588 32%       257   2,845 28%
  Southern Tier Priority (Partial)   1,017   209   1,226 15%       713   1,939 19%
Chenango TOTALS: 4,074 0 203 0 4,277 0 0% 92% 0% 968 0 5,245 0 0%
Clinton TOTALS: 5,205 0 414 0 5,619 0 0% 85% 0% 1,547 0 7,166 0 0%
Columbia TOTALS: 2,883 2,146 239 146 3,122 2,292 73% 93% 79% 856 175 3,978 2,467 62%
  CDPHP   1,696   123   1,819 58%       143   1,962 49%
  Wellcare   319   16   335 11%       27   362 9%
  Fidelis/NYS Catholic Hlth   131   7   138 4%       5   143 4%
Cortland TOTALS: 3,729 355 259 11 3,988 366 9% 90% 10% 779 89 4,767 455 10%
  Fidelis/NYS Catholic Hlth   355   11   366 9%       89   455 10%
Delaware TOTALS: 2,468 139 217 11 2,685 150 6% 91% 6% 755 4 3,440 154 4%
  Wellcare   139   11   150 6%       4   154 4%
Dutchess TOTALS: 8,117 1,348 700 34 8,817 1,382 16% 90% 17% 2,593 116 11,410 1,498 13%
  Wellcare   1,348   34   1,382 16%       116   1,498 13%
Erie TOTALS: 61,532 48,288 8,341 4,633 69,873 52,921 76% 92% 82% 17,191 7,155 87,064 60,076 69%
  Buffalo Community Health   6,386   500   6,886 10%       241   7,127 8%
  HealthNow/BCBS-WNY/Community Blue   9,028   798   9,826 14%       849   10,675 12%
  Independent Health Assoc/IHA   18,312   1,429   19,741 28%       1299   21,040 24%
  Fidelis/NYS Catholic Hlth   13,865   772   14,637 21%       1287   15,924 18%
  Total Full Risk   47,591   3,499   51,090 73%       3,676   54,766 63%
  PCMP II (Partial)   125   40   165 0%       310   475 1%
  PCMP III (Partial)   36   54   90 0%       410   500 1%
  PCMP II-A Special Care (Partial)   536   1,040   1,576 2%       2759   4,335 5%
  Total Partial Risk   697   1,134   1,831 3%       3,479   5,310 6%
Essex TOTALS: 1,793 0 143 0 1,936 0 0% 91% 0% 585 0 2,521 0 0%
Franklin TOTALS: 3,092 0 245 0 3,337 0 0% 89% 0% 993 0 4,330 0 0%
Fulton TOTALS: 4,617 729 390 40 5,007 769 15% 92% 17% 1,080 35 6,087 804 13%
  CDPHP   729   40   769 15%       35   804 13%
Genesee TOTALS: 2,791 1,251 134 89 2,925 1,340 46% 87% 53% 615 85 3,540 1,425 40%
  HealthNow/BCBS-WNY/Community Blue   7   1   8 0%       1   9 0%
  Preferred Care   1,244   88   1,332 46%       84   1,416 40%
Greene TOTALS: 2,834 2,214 274 160 3,108 2,374 76% 93% 82% 683 189 3,791 2,563 68%
  CDPHP   1,458   115   1,573 51%       139   1,712 45%
  Wellcare   568   28   596 19%       41   637 17%
  Fidelis/NYS Catholic Hlth   188   17   205 7%       9   214 6%
Hamilton TOTALS: 131 0 13 0 144 0 0% 92% 0% 47 0 191 0 0%
Herkimer TOTALS: 4,188 1,036 269 85 4,457 1,121 25% 90% 28% 882 47 5,339 1,168 22%
  Fidelis/NYS Catholic Hlth   416   36   452 10%       30   482 9%
  United Healthcare of Upstate   620   49   669 15%       17   686 13%
Jefferson TOTALS: 7,641 0 667 0 8,308 0 0% 84% 0% 1,878 0 10,186 0 0%
Lewis TOTALS: 2,033 0 137 0 2,170 0 0% 92% 0% 401 0 2,571 0 0%
Livingston TOTALS: 3,054 1,584 274 111 3,328 1,695 51% 90% 57% 676 150 4,004 1,845 46%
  Excellus   965   73   1,038 31%       59   1,097 27%
  Preferred Care   619   38   657 20%       91   748 19%
Madison TOTALS: 3,208 0 168 0 3,376 0 0% 89% 0% 754 0 4,130 0 0%
Monroe TOTALS: 49,621 42,199 7,667 4,494 57,288 46,693 82% 90% 91% 12,204 2,831 69,492 49,524 71%
  Excellus   30,779   3,459   34,238 60%       2252   36,490 53%
  Preferred Care   11,420   1,035   12,455 22%       579   13,034 19%
Montgomery TOTALS: 3,957 869 400 38 4,357 907 21% 91% 23% 793 57 5,150 964 19%
  CDPHP   869   38   907 21%       57   964 19%
Nassau TOTALS: 31,402 21,856 3,147 1,484 34,549 23,340 68% 92% 73% 10,096 1,174 44,645 24,514 55%
  Vytra   2,801   147   2,948 9%       140   3,088 7%
  HIP   4,245   483   4,728 14%       378   5,106 11%
  HealthFirst PHSP   5,332   290   5,622 16%       235   5,857 13%
  Affinity Health Plan   4,642   196   4,838 14%       226   5,064 11%
  Fidelis/NYS Catholic Hlth   3,396   221   3,617 10%       121   3,738 8%
  United Healthcare of NY   1,440   147   1,587 5%       74   1,661 4%
Niagara TOTALS: 12,180 10,679 1,423 861 13,603 11,540 85% 92% 92% 3,363 1,475 16,966 13,015 77%
  Independent Health Assoc/IHA   5,204   411   5,615 41%       792   6,407 38%
  Fidelis/NYS Catholic Hlth   1,909   169   2,078 15%       288   2,366 14%
  HealthNow/BCBS-WNY/Community Blue   3,566   281   3,847 28%       395   4,242 25%
Oneida TOTALS: 16,722 12,747 1,678 1,075 18,400 13,822 75% 92% 82% 5,139 1,331 23,539 15,153 64%
  Fidelis/NYS Catholic Hlth   7,194   616   7,810 42%       955   8,765 37%
  United Healthcare of Upstate   4,469   327   4,796 26%       339   5,135 22%
  Excellus   1,084   132   1,216 7%       37   1,253 5%
Onondaga TOTALS: 30,565 23,551 3,121 1,589 33,686 25,140 75% 86% 87% 7,805 2,164 41,491 27,304 66%
  Fidelis/NYS Catholic Hlth   5,263   319   5,582 17%       533   6,115 15%
  Total Care/Syracuse PHSP   9,493   643   10,136 30%       997   11,133 27%
  United Healthcare of Upstate   6,823   462   7,285 22%       577   7,862 19%
  Excellus   1,972   165   2,137 6%       57   2,194 7%
Ontario TOTALS: 4,100 3,236 347 139 4,447 3,375 76% 91% 83% 1,090 365 5,537 3,740 68%
  Excellus   2,575   113   2,688 60%       299   2,987 54%
  Preferred Care   661   26   687 15%       66   753 14%
Orange TOTALS: 22,281 5,698 3,563 337 25,844 6,035 23% 90% 26% 4,116 649 29,960 6,684 22%
  Affinity Health Plan   4,425   258   4,683 18%       569   5,252 18%
  Wellcare   1,273   79   1,352 5%       80   1,432 5%
  Care Plus Health Plan   0   0   0 0%       0   0 0%
Orleans TOTALS: 3,101 1,013 300 63 3,401 1,076 32% 92% 34% 612 75 4,013 1,151 29%
  Excellus   429   20   449 13%       46   495 12%
  Fidelis/NYS Catholic Hlth   467   28   495 15%       21   516 13%
  HealthNow/BCBS-WNY/Community Blue   117   15   132 4%       8   140 3%
Oswego TOTALS: 9,386 7,595 706 457 10,092 8,052 80% 91% 88% 1,943 590 12,035 8,642 72%
  Fidelis/NYS Catholic Hlth   1,441   120   1,561 15%       96   1,657 14%
  Total Care/Syracuse PHSP   2,724   195   2,919 29%       245   3,164 26%
  United Healthcare of Upstate   3,430   142   3,572 35%       249   3,821 32%
Otsego TOTALS: 2,857 31 154 0 3,011 31 1% 91% 1% 831 1 3,842 32 1%
  Wellcare   31   0   31 1%       1   32 1%
Putnam TOTALS: 938 167 157 14 1,095 181 17% 88% 19% 548 33 1,643 214 13%
  Care Plus Health Plan   167   14   181 17%       33   214 13%
Rensselaer TOTALS: 8,122 7,081 895 615 9,017 7,696 85% 90% 95% 2,160 434 11,177 8,130 73%
  CDPHP   6,210   543   6,753 75%       369   7,122 64%
  Fidelis/NYS Catholic Hlth   576   45   621 7%       47   668 6%
  Wellcare   295   27   322 4%       18   340 3%
Rockland TOTALS: 20,437 19,187 1,364 744 21,801 19,931 91% 92% 99% 2,644 515 24,445 20,446 84%
  Affinity Health Plan   1,361   109   1,470 7%       122   1,592 7%
  Fidelis/NYS Catholic Hlth   13,362   377   13,739 63%       231   13,970 57%
  Wellcare   2,079   90   2,169 10%       53   2,222 9%
  Westchester PHSP   2,226   141   2,367 11%       96   2,463 10%
  Community Choice Hlth Plan   159   27   186 1%       13   199 1%
St. Lawrence TOTALS: 7,889 0 742 0 8,631 0 0% 91% 0% 2,446 0 11,077 0 0%
Saratoga TOTALS: 5,215 3,975 370 215 5,585 4,190 75% 91% 82% 1,897 198 7,482 4,388 59%
  Wellcare   51   3   54 1%       0   54 1%
  CDPHP   3,310   172   3,482 62%       176   3,658 49%
  Fidelis/NYS Catholic Hlth   614   40   654 12%       22   676 9%
Schenectady TOTALS: 8,665 5,711 773 353 9,438 6,064 64% 89% 72% 2,520 664 11,958 6,728 56%
  CDPHP   5,164   304   5,468 58%       609   6,077 51%
  Fidelis/NYS Catholic Hlth   547   49   596 6%       55   651 5%
Schoharie TOTALS: 1,868 67 111 1 1,979 68 3% 92% 4% 384 4 2,363 72 3%
  CDPHP   67   1   68 3%       4   72 3%
Schuyler TOTALS: 1,199 0 118 0 1,317 0 0% 91% 0% 330 0 1,647 0 0%
Seneca TOTALS: 1,720 1,038 131 28 1,851 1,066 58% 92% 63% 450 162 2,301 1,228 53%
  Excellus   1,038   28   1,066 58%       162   1,228 53%
Steuben TOTALS: 6,960 1,699 582 149 7,542 1,848 25% 90% 27% 2,080 612 9,622 2,460 26%
  Southern Tier Pediatrics (Partial)   82   0   82 1%       11   93 1%
  Southern Tier Priority (Partial)   1,617   149   1,766 23%       601   2,367 25%
Suffolk TOTALS: 41,557 29,834 3,716 1,496 45,273 31,330 69% 90% 77% 13,281 2,582 58,554 33,912 58%
  Vytra   3,389   145   3,534 8%       279   3,813 7%
  HIP   3,558   340   3,898 9%       226   4,124 7%
  HealthFirst PHSP   4,764   183   4,947 11%       509   5,456 9%
  Suffolk Plan HMO   8,983   441   9,424 21%       1161   10,585 18%
  Affinity Health Plan   2,773   105   2,878 6%       150   3,028 5%
  United Healthcare of NY   4,097   170   4,267 9%       127   4,394 8%
  Fidelis/NYS Catholic Hlth   2,270   112   2,382 5%       130   2,512 4%
Sullivan TOTALS: 5,080 1,356 285 43 5,365 1,399 26% 90% 29% 1,442 103 6,807 1,502 22%
  Wellcare   637   29   666 12%       63   729 11%
  Westchester PHSP   719   14   733 14%       40   773 11%
Tioga TOTALS: 2,631 59 175 1 2,806 60 2% 93% 2% 714 1 3,520 61 2%
  CDPHP   59   1   60 2%       1   61 2%
Tompkins TOTALS: 4,137 0 496 0 4,633 0 0% 89% 0% 982 0 5,615 0 0%
Ulster TOTALS: 8,568 2,369 783 82 9,351 2,451 26% 90% 29% 2,566 177 11,917 2,628 22%
  Wellcare   2,369   82   2,451 26%       177   2,628 22%
Warren TOTALS: 2,723 1,600 173 8 2,896 1,608 56% 91% 61% 883 62 3,779 1,670 44%
  HealthNow/BlueShield of NENY   1,600   8   1,608 56%       62   1,670 44%
Washington TOTALS: 3,255 1,275 215 35 3,470 1,310 38% 89% 42% 933 132 4,403 1,442 33%
  HealthNow/BlueShield of NENY   832   29   861 25%       107   968 22%
  CDPHP   443   6   449 13%       25   474 11%
Wayne TOTALS: 3,877 2,206 218 84 4,095 2,290 56% 91% 61% 1,205 215 5,300 2,505 47%
  Excellus   690   24   714 17%       72   786 15%
  Preferred Care   1,516   60   1,576 38%       143   1,719 32%
Westchester TOTALS: 44,491 31,986 5,916 2,401 50,407 34,387 68% 86% 79% 9,969 2,474 60,376 36,861 61%
  HIP   2,526   474   3,000 6%       317   3,317 5%
  Westchester PHSP   15,605   828   16,433 33%       1044   17,477 29%
  Affinity Health Plan   5,308   372   5,680 11%       463   6,143 10%
  Community Choice Hlth Plan   5,784   459   6,243 12%       441   6,684 11%
  Fidelis/NYS Catholic Hlth   2,763   268   3,031 6%       209   3,240 5%
Wyoming TOTALS: 1,652 0 120 0 1,772 0 0% 91% 0% 416 0 2,188 0 0%
Yates TOTALS: 1,314 951 72 35 1,386 986 71% 91% 78% 284 79 1,670 1,065 64%
  Excellus   951   35   986 71%       79   1,065 64%
Upstate Total   551,659 337,520 59,092 25,527 610,751 362,700 59% 90% 66% 145,443 31,650 756,194 394,697 52%
NYC Affinity Health Plan   49,705   4,936   54,641 4%       2,778   57,419 4%
  Fidelis/NYS Catholic Hlth   43,312   5,672   48,984 4%       1,771   50,755 3%
  HealthFirst PHSP   69,432   9,902   79,334 6%       4,870   84,204 6%
  HIP   76,608   18,708   95,316 8%       7,106   102,422 7%
  Health Plus PHSP   75,667   8,531   84,198 7%       2,070   86,268 6%
  AmeriChoice of New York/MHS   52,121   12,513   64,634 5%       3,495   68,129 5%
  Manhattan PHSP/Center Care   38,279   5,329   43,608 3%       1,648   45,256 3%
  MetroPlus Health Plan   63,870   7,378   71,248 6%       4,266   75,514 5%
  United Healthcare of NY   8,941   2,586   11,527 1%       369   11,896 1%
  St Barnabas/Partners in Health   15,897   2,087   17,984 1%       1,076   19,060 1%
  Neighborhood Health Providers   43,969   3,777   47,746 4%       1,725   49,471 3%
  Wellcare   11,560   1,911   13,471 1%       375   13,846 1%
  ABC Health Plan   5,512   837   6,349 1%       155   6,504 0%
  Community Choice Hlth Plan   3,412   571   3,983 0%       67   4,050 0%
  Community Premier Plus   12,366   1,179   13,545 1%       909   14,454 1%
  NY Hospital Community PHSP   18,337   3,127   21,464 2%       762   22,226 1%
  Care Plus Health Plan   29,379   3,200   32,579 3%       883   33,462 2%
  NYC Total 1,017,540 618,367 238,069 92,244 1,255,609 710,611 57% 86% 66% 253,686 34,325 1,509,295 744,936 49%
                               
  UPSTATE TOTALS: 551,659 337,520 59,092 25,527 610,751 362,700 59% 90% 66% 145,443 31,650 756,194 394,697 52%
  NEW YORK CITY TOTALS: 1,017,540 618,367 238,069 92,244 1,255,609 710,611 57% 86% 66% 253,686 34,325 1,509,295 744,936 49%
  GRAND TOTALS 1,569,199 955,887 297,161 117,771 1,866,360 1,073,311 58% 89% 65% 399,129 65,975 2,265,489 1,139,633 50%
NYC Boroughs Bronx 268,951 177,009 58,468 21,924 327,419 198,933 61%     64,258 8,759 391,677 207,692 53%
  Brooklyn 374,235 243,102 91,460 42,968 465,695 286,071 61%     88,334 13,140 554,029 299,210 54%
  Manhattan 150,392 56,622 46,471 9,023 196,863 65,645 33%     48,934 5,202 245,797 70,847 29%
  Queens 197,848 120,054 36,673 15,398 234,521 135,452 58%     44,340 5,479 278,861 140,931 51%
  Staten Island 26,114 21,579 4,997 2,931 31,111 24,510 79%     7,820 1,745 38,931 26,256 67%
  Borough Total 1,017,540 618,367 238,069 92,244 1,255,609 710,611 57% 86% 66% 253,686 34,325 1,509,295 744,936 49%

NOTES:

  1. The Managed Care eligible counts are based upon January, 2002 total eligibles adjusted for excluded populations. The counts include recipients who are exempt from mandatory enrollment. (See about statement for further details).
  2. The source of plan enrollment counts was revised in March, 1999 to be based on the Medicaid Encounter Data System (MEDS). The MEDS data reflects enrollees as of the end of the enrollment month. (See about statement for further details).
  3. All percents are rounded to the nearest whole number.
  4. The expected penetration rate columns reflect an adjustment to total eligibles and the percent enrolled to account for the portion of the exempt population who are expected to choose not to enroll in managed care and for retroactive Medicaid eligibility determinations precluding enrollment for the month being measured. (An exempt recipient is one who will not be mandated to enroll in Medicaid managed care, but is eligible to enroll voluntarily. This would include Medicaid recipients with AIDS, HIV or a serious and persistent mental illness. See the about statement for further details of this adjustment).
  5. New plans added this month: None