Managed Care

RECIPIENTS ELIGIBLE FOR ENROLLMENT IN MANAGED CARE:
ENROLLMENT STATUS BY AID CATEGORY AND COUNTY,
AND TOTAL PERCENT ENROLLED BY PROVIDER PLAN

NYS November, 2002

  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
Albany TOTALS: 15,427 12,512 1,856 1,023 17,283 13,535 78% 92% 85% 4,299 831 21,582 14,366 67%
  CDPHP   10,425   866   11,291 65%       719   12,010 56%
  Fidelis/NYS Catholic Hlth   1,101   98   1,199 7%       73   1,272 6%
  Wellcare   986   59   1,045 6%       39   1,084 5%
Allegany TOTALS: 3,523 846 331 54 3,854 422 11% 90% 12% 1,005 200 4,859 1,100 23%
  Health Choice (Partial)   399   23   422 11%       174   596 12%
  HealthNow/BCBS-WNY/Community Blue   447   31   478 12%       26   504 10%
Broome TOTALS: 11,751 10,267 1,234 831 12,985 11,098 85% 90% 95% 3,461 915 16,446 12,013 73%
  Broome MC   5,052   319   5,371 41%       690   6,061 37%
  Fidelis/NYS Catholic Hlth   418   39   457 4%       21   478 3%
  CDPHP   4,797   473   5,270 41%       204   5,474 33%
Cattauragus TOTALS: 5,652 4,307 352 263 6,004 4,570 76% 91% 83% 1,568 581 7,572 5,151 68%
  HealthNow/BCBS-WNY/Community Blue   3,292   210   3,502 58%       522   4,024 53%
  Fidelis/NYS Catholic Hlth   1,015   53   1,068 18%       59   1,127 15%
Cayuga TOTALS: 4,776 0 275 0 5,051 0 0% 89% 0% 1,164 0 6,215 0 0%
Chautauqua TOTALS: 11,149 8,422 1,446 913 12,595 9,335 74% 85% 87% 2,619 1,028 15,214 10,363 68%
  HealthNow/BCBS-WNY/Community Blue   2,749   236   2,985 24%       312   3,297 22%
  Primary Health   594   90   684 5%       233   917 6%
  Fidelis/NYS Catholic Hlth   5,079   587   5,666 45%       483   6,149 40%
Chemung TOTALS: 7,521 3,724 593 214 8,114 3,938 49% 89% 55% 1,918 977 10,032 4,915 49%
  Southern Tier Pediatrics (Partial)   2,654   0   2,654 33%       262   2,916 29%
  Southern Tier Priority (Partial)   1,070   214   1,284 16%       715   1,999 20%
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% 86% 0% 1,547 0 7,166 0 0%
Columbia TOTALS: 2,883 2,234 239 145 3,122 2,379 76% 93% 82% 856 176 3,978 2,555 64%
  CDPHP   1,746   114   1,860 60%       146   2,006 50%
  Wellcare   347   20   367 12%       26   393 10%
  Fidelis/NYS Catholic Hlth   141   11   152 5%       4   156 4%
Cortland TOTALS: 3,729 340 259 14 3,988 354 9% 91% 10% 779 88 4,767 442 9%
  Fidelis/NYS Catholic Hlth   340   14   354 9%       88   442 9%
Delaware TOTALS: 2,468 120 217 7 2,685 127 5% 92% 5% 755 4 3,440 131 4%
  Wellcare   120   7   127 5%       4   131 4%
Dutchess TOTALS: 8,117 1,381 700 33 8,817 1,414 16% 90% 18% 2,593 109 11,410 1,523 13%
  Wellcare   1,381   33   1,414 16%       109   1,523 13%
Erie TOTALS: 61,532 49,164 8,341 4,500 69,873 53,664 77% 93% 83% 17,191 7,229 87,064 60,893 70%
  Buffalo Community Health   6,785   474   7,259 10%       265   7,524 9%
  HealthNow/BCBS-WNY/Community Blue   9,472   815   10,287 15%       875   11,162 13%
  Independent Health Assoc/IHA   18,341   1,404   19,745 28%       1388   21,133 24%
  Fidelis/NYS Catholic Hlth   13,909   771   14,680 21%       1276   15,956 18%
  Total Full Risk   48,507   3,464   51,971 74%       3,804   55,775 64%
  PCMP II (Partial)   114   39   153 0%       297   450 1%
  PCMP III (Partial)   27   37   64 0%       375   439 1%
  PCMP II-A Special Care (Partial)   516   960   1,476 2%       2753   4,229 5%
  Total Partial Risk   657   1,036   1,693 2%       3,425   5,118 6%
Essex TOTALS: 1,793 0 143 0 1,936 0 0% 92% 0% 585 0 2,521 0 0%
Franklin TOTALS: 3,092 0 245 0 3,337 0 0% 91% 0% 993 0 4,330 0 0%
Fulton TOTALS: 4,617 836 390 40 5,007 876 17% 92% 19% 1,080 34 6,087 910 15%
  CDPHP   836   40   876 17%       34   910 15%
Genesee TOTALS: 2,791 1,334 134 74 2,925 1,408 48% 89% 54% 615 99 3,540 1,507 43%
  HealthNow/BCBS-WNY/Community Blue   105   4   109 4%       2   111 3%
  Preferred Care   1,229   70   1,299 44%       97   1,396 39%
Greene TOTALS: 2,834 2,339 274 143 3,108 2,482 80% 93% 86% 683 200 3,791 2,682 71%
  CDPHP   1,522   97   1,619 52%       143   1,762 46%
  Wellcare   600   30   630 20%       45   675 18%
  Fidelis/NYS Catholic Hlth   217   16   233 7%       12   245 6%
Hamilton TOTALS: 131 0 13 0 144 0 0% 91% 0% 47 0 191 0 0%
Herkimer TOTALS: 4,188 1,188 269 81 4,457 1,269 28% 92% 31% 882 54 5,339 1,323 25%
  Fidelis/NYS Catholic Hlth   535   43   578 13%       32   610 11%
  United Healthcare of Upstate   653   38   691 16%       22   713 13%
Jefferson TOTALS: 7,641 0 667 0 8,308 0 0% 87% 0% 1,878 0 10,186 0 0%
Lewis TOTALS: 2,033 0 137 0 2,170 0 0% 93% 0% 401 0 2,571 0 0%
Livingston TOTALS: 3,054 2,064 274 150 3,328 2,214 67% 92% 73% 676 165 4,004 2,379 59%
  Excellus   1,307   103   1,410 42%       71   1,481 37%
  Preferred Care   757   47   804 24%       94   898 22%
Madison TOTALS: 3,208 0 168 0 3,376 0 0% 91% 0% 754 0 4,130 0 0%
Monroe TOTALS: 49,621 41,592 7,667 4,136 57,288 45,728 80% 91% 87% 12,204 2,990 69,492 48,718 70%
  Excellus   30,528   3,166   33,694 59%       2377   36,071 52%
  Preferred Care   11,064   970   12,034 21%       613   12,647 18%
Montgomery TOTALS: 3,957 872 400 29 4,357 901 21% 92% 23% 793 60 5,150 961 19%
  CDPHP   872   29   901 21%       60   961 19%
Nassau TOTALS: 31,402 22,979 3,147 1,590 34,549 24,569 71% 92% 77% 10,096 1,373 44,645 25,942 58%
  Vytra   2,653   128   2,781 8%       145   2,926 7%
  HIP   4,539   501   5,040 15%       466   5,506 12%
  HealthFirst PHSP   5,518   324   5,842 17%       263   6,105 14%
  Affinity Health Plan   4,815   197   5,012 15%       234   5,246 12%
  Fidelis/NYS Catholic Hlth   3,569   248   3,817 11%       153   3,970 9%
  United Healthcare of NY   1,885   192   2,077 6%       112   2,189 5%
Niagara TOTALS: 12,180 11,167 1,423 840 13,603 12,007 88% 93% 95% 3,363 1,503 16,966 13,510 80%
  Independent Health Assoc/IHA   5,297   408   5,705 42%       808   6,513 38%
  Fidelis/NYS Catholic Hlth   1,979   164   2,143 16%       290   2,433 14%
  HealthNow/BCBS-WNY/Community Blue   3,891   268   4,159 31%       405   4,564 27%
Oneida TOTALS: 16,722 14,020 1,678 1,090 18,400 15,110 82% 92% 89% 5,139 1,397 23,539 16,507 70%
  Fidelis/NYS Catholic Hlth   7,755   623   8,378 46%       984   9,362 40%
  United Healthcare of Upstate   4,901   320   5,221 28%       369   5,590 24%
  Excellus   1,364   147   1,511 8%       44   1,555 7%
Onondaga TOTALS: 30,565 24,133 3,121 1,633 33,686 25,766 76% 89% 86% 7,805 2,257 41,491 28,023 68%
  Fidelis/NYS Catholic Hlth   5,354   338   5,692 17%       554   6,246 15%
  Total Care/Syracuse PHSP   9,665   657   10,322 31%       1029   11,351 27%
  United Healthcare of Upstate   7,024   482   7,506 22%       601   8,107 20%
  Excellus   2,090   156   2,246 7%       73   2,319 7%
Ontario TOTALS: 4,100 3,470 347 147 4,447 3,617 81% 91% 89% 1,090 371 5,537 3,988 72%
  Excellus   2,790   112   2,902 65%       307   3,209 58%
  Preferred Care   680   35   715 16%       64   779 14%
Orange TOTALS: 22,281 6,017 3,563 310 25,844 6,327 24% 91% 27% 4,116 688 29,960 7,015 23%
  Affinity Health Plan   4,510   228   4,738 18%       591   5,329 18%
  Wellcare   1,319   56   1,375 5%       87   1,462 5%
  Westchester PHSP   188   26   214 1%       10   224 1%
Orleans TOTALS: 3,101 1,143 300 72 3,401 1,215 36% 92% 39% 612 83 4,013 1,298 32%
  Excellus   467   29   496 15%       46   542 14%
  Fidelis/NYS Catholic Hlth   486   25   511 15%       26   537 13%
  HealthNow/BCBS-WNY/Community Blue   190   18   208 6%       11   219 5%
Oswego TOTALS: 9,386 7,957 706 459 10,092 8,416 83% 92% 90% 1,943 594 12,035 9,010 75%
  Fidelis/NYS Catholic Hlth   1,553   108   1,661 16%       100   1,761 15%
  Total Care/Syracuse PHSP   2,792   205   2,997 30%       244   3,241 27%
  United Healthcare of Upstate   3,606   146   3,752 37%       250   4,002 33%
  Excellus   6   0   6 0%       0   6 0%
Otsego TOTALS: 2,857 27 154 0 3,011 27 1% 91% 1% 831 1 3,842 28 1%
  Wellcare   27   0   27 1%       1   28 1%
Putnam TOTALS: 938 139 157 13 1,095 152 14% 88% 16% 548 34 1,643 186 11%
  Care Plus Health Plan   139   13   152 14%       34   186 11%
Rensselaer TOTALS: 8,122 7,355 895 639 9,017 7,994 89% 92% 96% 2,160 433 11,177 8,427 75%
  CDPHP   6,424   564   6,988 77%       369   7,357 66%
  Fidelis/NYS Catholic Hlth   635   47   682 8%       44   726 6%
  Wellcare   269   25   294 3%       18   312 3%
  HealthNow/BlueShield of NENY   27   3   30 0%       2   32 0%
Rockland TOTALS: 20,437 19,987 1,364 737 21,801 20,724 95% 92% 103% 2,644 527 24,445 21,251 87%
  Affinity Health Plan   1,420   102   1,522 7%       120   1,642 7%
  Fidelis/NYS Catholic Hlth   13,817   366   14,183 65%       236   14,419 59%
  Wellcare   2,076   86   2,162 10%       51   2,213 9%
  Westchester PHSP   2,549   161   2,710 12%       108   2,818 12%
  Community Choice Hlth Plan   125   22   147 1%       12   159 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 4,332 370 225 5,585 4,557 82% 92% 89% 1,897 217 7,482 4,774 64%
  Wellcare   45   5   50 1%       0   50 1%
  CDPHP   3,627   180   3,807 68%       195   4,002 53%
  Fidelis/NYS Catholic Hlth   660   40   700 13%       22   722 10%
Schenectady TOTALS: 8,665 6,111 773 362 9,438 6,473 69% 90% 76% 2,520 691 11,958 7,164 60%
  CDPHP   5,528   313   5,841 62%       630   6,471 54%
  Fidelis/NYS Catholic Hlth   583   49   632 7%       61   693 6%
Schoharie TOTALS: 1,868 68 111 3 1,979 71 4% 92% 4% 384 5 2,363 76 3%
  CDPHP   68   3   71 4%       5   76 3%
Schuyler TOTALS: 1,199 0 118 0 1,317 0 0% 92% 0% 330 0 1,647 0 0%
Seneca TOTALS: 1,720 1,160 131 32 1,851 1,192 64% 92% 70% 450 171 2,301 1,363 59%
  Excellus   1,160   32   1,192 64%       171   1,363 59%
Steuben TOTALS: 6,960 1,909 582 161 7,542 2,070 27% 91% 30% 2,080 616 9,622 2,686 28%
  Southern Tier Pediatrics (Partial)   103   0   103 1%       12   115 1%
  Southern Tier Priority (Partial)   1,806   161   1,967 26%       604   2,571 27%
Suffolk TOTALS: 41,557 33,793 3,716 1,863 45,273 35,656 79% 91% 86% 13,281 2,714 58,554 38,370 66%
  Vytra   3,236   117   3,353 7%       291   3,644 6%
  HIP   4,294   471   4,765 11%       245   5,010 9%
  HealthFirst PHSP   5,156   213   5,369 12%       527   5,896 10%
  Suffolk Plan HMO   9,646   493   10,139 22%       1173   11,312 19%
  Affinity Health Plan   3,547   155   3,702 8%       169   3,871 7%
  United Healthcare of NY   5,248   244   5,492 12%       164   5,656 10%
  Fidelis/NYS Catholic Hlth   2,666   170   2,836 6%       145   2,981 5%
Sullivan TOTALS: 5,080 1,692 285 42 5,365 1,734 32% 91% 36% 1,442 118 6,807 1,852 27%
  Wellcare   536   15   551 10%       54   605 9%
  Westchester PHSP   1,156   27   1,183 22%       64   1,247 18%
Tioga TOTALS: 2,631 65 175 2 2,806 67 2% 92% 3% 714 0 3,520 67 2%
  CDPHP   65   2   67 2%       0   67 2%
Tompkins TOTALS: 4,137 0 496 0 4,633 0 0% 90% 0% 982 0 5,615 0 0%
Ulster TOTALS: 8,568 2,383 783 101 9,351 2,484 27% 91% 29% 2,566 176 11,917 2,660 22%
  Wellcare   2,383   101   2,484 27%       176   2,660 22%
Warren TOTALS: 2,723 1,736 173 9 2,896 1,745 60% 92% 66% 883 67 3,779 1,812 48%
  HealthNow/BlueShield of NENY   1,736   9   1,745 60%       67   1,812 48%
Washington TOTALS: 3,255 1,385 215 30 3,470 1,415 41% 91% 45% 933 134 4,403 1,549 35%
  HealthNow/BlueShield of NENY   898   22   920 27%       111   1,031 23%
  CDPHP   487   8   495 14%       23   518 12%
Wayne TOTALS: 3,877 2,918 218 124 4,095 3,042 74% 92% 81% 1,205 274 5,300 3,316 63%
  Excellus   861   37   898 22%       91   989 19%
  Preferred Care   2,057   87   2,144 52%       183   2,327 44%
Westchester TOTALS: 44,491 32,580 5,916 2,465 50,407 35,045 70% 89% 79% 9,969 2,496 60,376 37,541 62%
  HIP   2,615   451   3,066 6%       321   3,387 6%
  Westchester PHSP   16,320   892   17,212 34%       1066   18,278 30%
  Affinity Health Plan   5,206   386   5,592 11%       457   6,049 10%
  Community Choice Hlth Plan   5,655   473   6,128 12%       440   6,568 11%
  Fidelis/NYS Catholic Hlth   2,784   263   3,047 6%       212   3,259 5%
Wyoming TOTALS: 1,652 0 120 0 1,772 0 0% 91% 0% 416 0 2,188 0 0%
Yates TOTALS: 1,314 1,022 72 43 1,386 1,065 77% 93% 83% 284 78 1,670 1,143 68%
  Excellus   1,022   43   1,065 77%       78   1,143 68%
Upstate Total   551,659 353,090 59,092 25,642 610,751 378,254 62% 91% 68% 145,443 32,758 756,194 411,490 54%
NYC Affinity Health Plan   58,640   7,043   65,683 5%       2,962   68,645 5%
  Fidelis/NYS Catholic Hlth   49,264   7,233   56,497 4%       1,907   58,404 4%
  HealthFirst PHSP   79,054   12,223   91,277 7%       5,141   96,418 6%
  HIP   90,452   24,816   115,268 9%       7,802   123,070 8%
  Health Plus PHSP   88,002   12,269   100,271 8%       2,338   102,609 7%
  AmeriChoice of New York/MHS   56,028   14,196   70,224 6%       3,542   73,766 5%
  Manhattan PHSP/Center Care   44,100   7,051   51,151 4%       1,787   52,938 4%
  MetroPlus Health Plan   75,944   11,445   87,389 7%       4,275   91,664 6%
  United Healthcare of NY   12,078   4,053   16,131 1%       539   16,670 1%
  St Barnabas/Partners in Health   17,111   2,477   19,588 2%       1,134   20,722 1%
  Neighborhood Health Providers   48,685   4,900   53,585 4%       1,756   55,341 4%
  Wellcare   13,879   2,576   16,455 1%       426   16,881 1%
  ABC Health Plan   6,271   1,042   7,313 1%       169   7,482 0%
  Community Choice Hlth Plan   3,672   656   4,328 0%       76   4,404 0%
  Community Premier Plus   15,933   1,987   17,920 1%       1,015   18,935 1%
  NY Hospital Community PHSP   21,371   4,190   25,561 2%       874   26,435 2%
  Care Plus Health Plan   36,129   4,611   40,740 3%       990   41,730 3%
  NYC Total 1,017,540 716,613 238,069 122,768 1,255,609 839,381 67% 90% 74% 253,686 36,733 1,509,295 876,114 58%
                               
  UPSTATE TOTALS: 551,659 353,090 59,092 25,642 610,751 378,254 62% 91% 68% 145,443 32,758 756,194 411,490 54%
  NEW YORK CITY TOTALS: 1,017,540 716,613 238,069 122,768 1,255,609 839,381 67% 90% 74% 253,686 36,733 1,509,295 876,114 58%
  GRAND TOTALS 1,569,199 1,069,703 297,161 148,410 1,866,360 1,217,635 65% 91% 72% 399,129 69,491 2,265,489 1,287,604 57%
NYC Boroughs Bronx 268,951 207,578 58,468 29,987 327,419 237,566 73%     64,258 9,472 391,677 247,037 63%
  Brooklyn 374,235 274,483 91,460 54,875 465,695 329,357 71%     88,334 13,679 554,029 343,036 62%
  Manhattan 150,392 64,483 46,471 12,084 196,863 76,567 39%     48,934 5,464 245,797 82,031 33%
  Queens 197,848 146,573 36,673 22,278 234,521 168,851 72%     44,340 6,265 278,861 175,116 63%
  Staten Island 26,114 23,495 4,997 3,545 31,111 27,040 87%     7,820 1,853 38,931 28,894 74%
  Borough Total 1,017,540 716,613 238,069 122,768 1,255,609 839,381 67% 90% 74% 253,686 36,733 1,509,295 876,114 58%

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:
      Oswego County - Excellus
      Rensselaer County - HealthNow/BlueShield of NENY