Managed Care

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

NYS October, 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 12,218 1,856 1,010 17,283 13,228 77% 92% 83% 4,299 824 21,582 14,052 65%
  CDPHP   10,201   858   11,059 64%       710   11,769 55%
  Fidelis/NYS Catholic Hlth   1,040   95   1,135 7%       73   1,208 6%
  Wellcare   977   57   1,034 6%       41   1,075 5%
Allegany TOTALS: 3,523 814 331 48 3,854 429 11% 90% 12% 1,005 200 4,859 1,062 22%
  Health Choice (Partial)   406   23   429 11%       177   606 12%
  HealthNow/BCBS-WNY/Community Blue   408   25   433 11%       23   456 9%
Broome TOTALS: 11,751 10,190 1,234 830 12,985 11,020 85% 90% 94% 3,461 908 16,446 11,928 73%
  Broome MC   5,068   328   5,396 42%       689   6,085 37%
  Fidelis/NYS Catholic Hlth   434   40   474 4%       21   495 3%
  CDPHP   4,688   462   5,150 40%       198   5,348 33%
Cattauragus TOTALS: 5,652 4,216 352 249 6,004 4,465 74% 91% 81% 1,568 586 7,572 5,051 67%
  HealthNow/BCBS-WNY/Community Blue   3,206   201   3,407 57%       528   3,935 52%
  Fidelis/NYS Catholic Hlth   1,010   48   1,058 18%       58   1,116 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 8,317 1,446 905 12,595 9,222 73% 85% 86% 2,619 985 15,214 10,207 67%
  HealthNow/BCBS-WNY/Community Blue   2,676   236   2,912 23%       300   3,212 21%
  Primary Health   587   93   680 5%       224   904 6%
  Fidelis/NYS Catholic Hlth   5,054   576   5,630 45%       461   6,091 40%
Chemung TOTALS: 7,521 3,713 593 217 8,114 3,930 48% 89% 55% 1,918 985 10,032 4,915 49%
  Southern Tier Pediatrics (Partial)   2,650   0   2,650 33%       265   2,915 29%
  Southern Tier Priority (Partial)   1,063   217   1,280 16%       720   2,000 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 2,214 239 143 3,122 2,357 75% 93% 81% 856 182 3,978 2,539 64%
  CDPHP   1,725   116   1,841 59%       149   1,990 50%
  Wellcare   347   19   366 12%       28   394 10%
  Fidelis/NYS Catholic Hlth   142   8   150 5%       5   155 4%
Cortland TOTALS: 3,729 349 259 14 3,988 363 9% 91% 10% 779 88 4,767 451 9%
  Fidelis/NYS Catholic Hlth   349   14   363 9%       88   451 9%
Delaware TOTALS: 2,468 126 217 7 2,685 133 5% 92% 5% 755 3 3,440 136 4%
  Wellcare   126   7   133 5%       3   136 4%
Dutchess TOTALS: 8,117 1,375 700 36 8,817 1,411 16% 90% 18% 2,593 111 11,410 1,522 13%
  Wellcare   1,375   36   1,411 16%       111   1,522 13%
Erie TOTALS: 61,532 48,723 8,341 4,549 69,873 53,272 76% 93% 82% 17,191 7,219 87,064 60,491 69%
  Buffalo Community Health   6,622   483   7,105 10%       256   7,361 8%
  HealthNow/BCBS-WNY/Community Blue   9,204   809   10,013 14%       870   10,883 13%
  Independent Health Assoc/IHA   18,303   1,398   19,701 28%       1356   21,057 24%
  Fidelis/NYS Catholic Hlth   13,925   775   14,700 21%       1275   15,975 18%
  Total Full Risk   48,054   3,465   51,519 74%       3,757   55,276 63%
  PCMP II (Partial)   111   38   149 0%       303   452 1%
  PCMP III (Partial)   34   47   81 0%       403   484 1%
  PCMP II-A Special Care (Partial)   524   999   1,523 2%       2756   4,279 5%
  Total Partial Risk   669   1,084   1,753 3%       3,462   5,215 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: 4,617 812 390 36 5,007 848 17% 92% 18% 1,080 31 6,087 879 14%
  CDPHP   812   36   848 17%       31   879 14%
Genesee TOTALS: 2,791 1,305 134 78 2,925 1,383 47% 89% 53% 615 96 3,540 1,479 42%
  HealthNow/BCBS-WNY/Community Blue   59   1   60 2%       2   62 2%
  Preferred Care   1,246   77   1,323 45%       94   1,417 40%
Greene TOTALS: 2,834 2,328 274 149 3,108 2,477 80% 93% 85% 683 192 3,791 2,669 70%
  CDPHP   1,514   101   1,615 52%       136   1,751 46%
  Wellcare   610   32   642 21%       45   687 18%
  Fidelis/NYS Catholic Hlth   204   16   220 7%       11   231 6%
Hamilton TOTALS: 131 0 13 0 144 0 0% 91% 0% 47 0 191 0 0%
Herkimer TOTALS: 4,188 1,133 269 81 4,457 1,214 27% 92% 30% 882 50 5,339 1,264 24%
  Fidelis/NYS Catholic Hlth   482   41   523 12%       31   554 10%
  United Healthcare of Upstate   651   40   691 16%       19   710 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 1,945 274 148 3,328 2,093 63% 92% 69% 676 158 4,004 2,251 56%
  Excellus   1,210   102   1,312 39%       68   1,380 34%
  Preferred Care   735   46   781 23%       90   871 22%
Madison TOTALS: 3,208 0 168 0 3,376 0 0% 91% 0% 754 0 4,130 0 0%
Monroe TOTALS: 49,621 42,036 7,667 4,352 57,288 46,388 81% 91% 89% 12,204 2,965 69,492 49,353 71%
  Excellus   30,744   3,327   34,071 59%       2353   36,424 52%
  Preferred Care   11,292   1,025   12,317 22%       612   12,929 19%
Montgomery TOTALS: 3,957 872 400 33 4,357 905 21% 92% 23% 793 57 5,150 962 19%
  CDPHP   872   33   905 21%       57   962 19%
Nassau TOTALS: 31,402 22,730 3,147 1,553 34,549 24,283 70% 92% 76% 10,096 1,295 44,645 25,578 57%
  Vytra   2,715   131   2,846 8%       144   2,990 7%
  HIP   4,493   500   4,993 14%       430   5,423 12%
  HealthFirst PHSP   5,465   302   5,767 17%       251   6,018 13%
  Affinity Health Plan   4,745   203   4,948 14%       229   5,177 12%
  Fidelis/NYS Catholic Hlth   3,572   244   3,816 11%       138   3,954 9%
  United Healthcare of NY   1,740   173   1,913 6%       103   2,016 5%
Niagara TOTALS: 12,180 11,063 1,423 843 13,603 11,906 88% 93% 94% 3,363 1,505 16,966 13,411 79%
  Independent Health Assoc/IHA   5,300   404   5,704 42%       807   6,511 38%
  Fidelis/NYS Catholic Hlth   1,961   169   2,130 16%       295   2,425 14%
  HealthNow/BCBS-WNY/Community Blue   3,802   270   4,072 30%       403   4,475 26%
Oneida TOTALS: 16,722 13,848 1,678 1,072 18,400 14,920 81% 92% 88% 5,139 1,379 23,539 16,299 69%
  Fidelis/NYS Catholic Hlth   7,704   614   8,318 45%       979   9,297 39%
  United Healthcare of Upstate   4,815   318   5,133 28%       359   5,492 23%
  Excellus   1,329   140   1,469 8%       41   1,510 6%
Onondaga TOTALS: 30,565 23,844 3,121 1,606 33,686 25,450 76% 89% 85% 7,805 2,230 41,491 27,680 67%
  Fidelis/NYS Catholic Hlth   5,329   336   5,665 17%       554   6,219 15%
  Total Care/Syracuse PHSP   9,557   638   10,195 30%       1017   11,212 27%
  United Healthcare of Upstate   6,893   469   7,362 22%       589   7,951 19%
  Excellus   2,065   163   2,228 7%       70   2,298 7%
Ontario TOTALS: 4,100 3,383 347 136 4,447 3,519 79% 91% 87% 1,090 369 5,537 3,888 70%
  Excellus   2,690   104   2,794 63%       303   3,097 56%
  Preferred Care   693   32   725 16%       66   791 14%
Orange TOTALS: 22,281 5,987 3,563 318 25,844 6,305 24% 91% 27% 4,116 687 29,960 6,992 23%
  Affinity Health Plan   4,545   231   4,776 18%       597   5,373 18%
  Wellcare   1,300   66   1,366 5%       83   1,449 5%
  Westchester PHSP   142   21   163 1%       7   170 1%
Orleans TOTALS: 3,101 1,050 300 65 3,401 1,115 33% 92% 36% 612 81 4,013 1,196 30%
  Excellus   434   24   458 13%       45   503 13%
  Fidelis/NYS Catholic Hlth   466   23   489 14%       27   516 13%
  HealthNow/BCBS-WNY/Community Blue   150   18   168 5%       9   177 4%
Oswego TOTALS: 9,386 7,814 706 453 10,092 8,267 82% 92% 89% 1,943 588 12,035 8,855 74%
  Fidelis/NYS Catholic Hlth   1,500   111   1,611 16%       97   1,708 14%
  Total Care/Syracuse PHSP   2,784   204   2,988 30%       239   3,227 27%
  United Healthcare of Upstate   3,530   138   3,668 36%       252   3,920 33%
Otsego TOTALS: 2,857 29 154 0 3,011 29 1% 91% 1% 831 1 3,842 30 1%
  Wellcare   29   0   29 1%       1   30 1%
Putnam TOTALS: 938 147 157 13 1,095 160 15% 88% 17% 548 34 1,643 194 12%
  Care Plus Health Plan   147   13   160 15%       34   194 12%
Rensselaer TOTALS: 8,122 7,280 895 643 9,017 7,923 88% 92% 96% 2,160 422 11,177 8,345 75%
  CDPHP   6,376   566   6,942 77%       360   7,302 65%
  Fidelis/NYS Catholic Hlth   622   47   669 7%       45   714 6%
  Wellcare   282   30   312 3%       17   329 3%
Rockland TOTALS: 20,437 19,667 1,364 740 21,801 20,407 94% 92% 102% 2,644 522 24,445 20,929 86%
  Affinity Health Plan   1,402   99   1,501 7%       119   1,620 7%
  Fidelis/NYS Catholic Hlth   13,561   380   13,941 64%       234   14,175 58%
  Wellcare   2,076   83   2,159 10%       53   2,212 9%
  Westchester PHSP   2,498   152   2,650 12%       102   2,752 11%
  Community Choice Hlth Plan   130   26   156 1%       14   170 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 4,265 370 226 5,585 4,491 80% 92% 88% 1,897 217 7,482 4,708 63%
  Wellcare   54   5   59 1%       0   59 1%
  CDPHP   3,562   176   3,738 67%       196   3,934 53%
  Fidelis/NYS Catholic Hlth   649   45   694 12%       21   715 10%
Schenectady TOTALS: 8,665 6,025 773 353 9,438 6,378 68% 90% 75% 2,520 669 11,958 7,047 59%
  CDPHP   5,455   306   5,761 61%       610   6,371 53%
  Fidelis/NYS Catholic Hlth   570   47   617 7%       59   676 6%
Schoharie TOTALS: 1,868 76 111 2 1,979 78 4% 92% 4% 384 4 2,363 82 3%
  CDPHP   76   2   78 4%       4   82 3%
Schuyler TOTALS: 1,199 0 118 0 1,317 0 0% 92% 0% 330 0 1,647 0 0%
Seneca TOTALS: 1,720 1,100 131 30 1,851 1,130 61% 92% 66% 450 169 2,301 1,299 56%
  Excellus   1,100   30   1,130 61%       169   1,299 56%
Steuben TOTALS: 6,960 1,847 582 148 7,542 1,995 26% 91% 29% 2,080 608 9,622 2,603 27%
  Southern Tier Pediatrics (Partial)   99   0   99 1%       11   110 1%
  Southern Tier Priority (Partial)   1,748   148   1,896 25%       597   2,493 26%
Suffolk TOTALS: 41,557 32,544 3,716 1,674 45,273 34,218 76% 91% 83% 13,281 2,684 58,554 36,902 63%
  Vytra   3,291   128   3,419 8%       291   3,710 6%
  HIP   4,122   429   4,551 10%       237   4,788 8%
  HealthFirst PHSP   5,032   197   5,229 12%       527   5,756 10%
  Suffolk Plan HMO   9,549   460   10,009 22%       1175   11,184 19%
  Affinity Health Plan   3,159   111   3,270 7%       159   3,429 6%
  United Healthcare of NY   4,913   212   5,125 11%       156   5,281 9%
  Fidelis/NYS Catholic Hlth   2,478   137   2,615 6%       139   2,754 5%
Sullivan TOTALS: 5,080 1,574 285 39 5,365 1,613 30% 91% 33% 1,442 111 6,807 1,724 25%
  Wellcare   541   18   559 10%       56   615 9%
  Westchester PHSP   1,033   21   1,054 20%       55   1,109 16%
Tioga TOTALS: 2,631 60 175 2 2,806 62 2% 92% 2% 714 0 3,520 62 2%
  CDPHP   60   2   62 2%       0   62 2%
Tompkins TOTALS: 4,137 0 496 0 4,633 0 0% 90% 0% 982 0 5,615 0 0%
Ulster TOTALS: 8,568 2,439 783 101 9,351 2,540 27% 91% 30% 2,566 175 11,917 2,715 23%
  Wellcare   2,439   101   2,540 27%       175   2,715 23%
Warren TOTALS: 2,723 1,677 173 8 2,896 1,685 58% 92% 64% 883 67 3,779 1,752 46%
  HealthNow/BlueShield of NENY   1,677   8   1,685 58%       67   1,752 46%
Washington TOTALS: 3,255 1,354 215 32 3,470 1,386 40% 91% 44% 933 134 4,403 1,520 35%
  HealthNow/BlueShield of NENY   882   25   907 26%       110   1,017 23%
  CDPHP   472   7   479 14%       24   503 11%
Wayne TOTALS: 3,877 2,650 218 109 4,095 2,759 67% 92% 73% 1,205 250 5,300 3,009 57%
  Excellus   770   34   804 20%       81   885 17%
  Preferred Care   1,880   75   1,955 48%       169   2,124 40%
Westchester TOTALS: 44,491 32,542 5,916 2,445 50,407 34,987 69% 89% 78% 9,969 2,504 60,376 37,491 62%
  HIP   2,622   456   3,078 6%       323   3,401 6%
  Westchester PHSP   16,161   871   17,032 34%       1061   18,093 30%
  Affinity Health Plan   5,264   380   5,644 11%       459   6,103 10%
  Community Choice Hlth Plan   5,749   480   6,229 12%       447   6,676 11%
  Fidelis/NYS Catholic Hlth   2,746   258   3,004 6%       214   3,218 5%
Wyoming TOTALS: 1,652 0 120 0 1,772 0 0% 91% 0% 416 0 2,188 0 0%
Yates TOTALS: 1,314 1,009 72 43 1,386 1,052 76% 93% 82% 284 79 1,670 1,131 68%
  Excellus   1,009   43   1,052 76%       79   1,131 68%
Upstate Total   551,659 348,690 59,092 25,539 610,751 373,796 61% 91% 67% 145,443 32,424 756,194 406,653 54%
NYC Affinity Health Plan   54,036   5,832   59,868 5%       2,872   62,740 4%
  Fidelis/NYS Catholic Hlth   47,362   6,663   54,025 4%       1,883   55,908 4%
  HealthFirst PHSP   76,307   11,461   87,768 7%       5,045   92,813 6%
  HIP   87,132   23,099   110,231 9%       7,618   117,849 8%
  Health Plus PHSP   82,756   11,110   93,866 7%       2,263   96,129 6%
  AmeriChoice of New York/MHS   54,660   13,582   68,242 5%       3,546   71,788 5%
  Manhattan PHSP/Center Care   42,653   6,553   49,206 4%       1,753   50,959 3%
  MetroPlus Health Plan   72,334   10,044   82,378 7%       4,251   86,629 6%
  United Healthcare of NY   11,089   3,529   14,618 1%       475   15,093 1%
  St Barnabas/Partners in Health   16,778   2,356   19,134 2%       1,117   20,251 1%
  Neighborhood Health Providers   46,796   4,503   51,299 4%       1,758   53,057 4%
  Wellcare   13,274   2,368   15,642 1%       405   16,047 1%
  ABC Health Plan   5,996   962   6,958 1%       169   7,127 0%
  Community Choice Hlth Plan   3,775   674   4,449 0%       72   4,521 0%
  Community Premier Plus   14,471   1,614   16,085 1%       952   17,037 1%
  NY Hospital Community PHSP   20,393   3,792   24,185 2%       834   25,019 2%
  Care Plus Health Plan   34,143   4,142   38,285 3%       952   39,237 3%
  NYC Total 1,017,540 683,955 238,069 112,284 1,255,609 796,239 63% 90% 70% 253,686 35,965 1,509,295 832,204 55%
                               
  UPSTATE TOTALS: 551,659 348,690 59,092 25,539 610,751 373,796 61% 91% 67% 145,443 32,424 756,194 406,653 54%
  NEW YORK CITY TOTALS: 1,017,540 683,955 238,069 112,284 1,255,609 796,239 63% 90% 70% 253,686 35,965 1,509,295 832,204 55%
  GRAND TOTALS 1,569,199 1,032,645 297,161 137,823 1,866,360 1,170,035 63% 91% 69% 399,129 68,389 2,265,489 1,238,857 55%
NYC Boroughs Bronx 268,951 197,994 58,468 27,125 327,419 225,118 69%     64,258 9,250 391,677 234,368 60%
  Brooklyn 374,235 264,015 91,460 51,079 465,695 315,093 68%     88,334 13,515 554,029 328,609 59%
  Manhattan 150,392 61,019 46,471 10,749 196,863 71,767 36%     48,934 5,303 245,797 77,070 31%
  Queens 197,848 138,077 36,673 20,041 234,521 158,118 67%     44,340 6,078 278,861 164,197 59%
  Staten Island 26,114 22,851 4,997 3,291 31,111 26,142 84%     7,820 1,819 38,931 27,960 72%
  Borough Total 1,017,540 683,955 238,069 112,284 1,255,609 796,239 63% 90% 70% 253,686 35,965 1,509,295 832,204 55%

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