Managed Care

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

NYS September, 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 12,335 1,856 1,083 17,283 13,418 78% 92% 84% 4,299 817 21,582 14,235 66%
  CDPHP   10,266   921   11,187 65%       700   11,887 55%
  Fidelis/NYS Catholic Hlth   1,038   98   1,136 7%       73   1,209 6%
  Wellcare   1,031   64   1,095 6%       44   1,139 5%
Allegany TOTALS: 3,523 803 331 53 3,854 442 11% 90% 13% 1,005 200 4,859 1,056 22%
  Health Choice (Partial)   415   27   442 11%       178   620 13%
  HealthNow/BCBS-WNY/Community Blue   388   26   414 11%       22   436 9%
Broome TOTALS: 11,751 10,174 1,234 873 12,985 11,047 85% 90% 94% 3,461 902 16,446 11,949 73%
  Broome MC   5,114   351   5,465 42%       682   6,147 37%
  Fidelis/NYS Catholic Hlth   422   41   463 4%       22   485 3%
  CDPHP   4,638   481   5,119 39%       198   5,317 32%
Cattauragus TOTALS: 5,652 4,164 352 251 6,004 4,415 74% 91% 80% 1,568 590 7,572 5,005 66%
  HealthNow/BCBS-WNY/Community Blue   3,161   203   3,364 56%       530   3,894 51%
  Fidelis/NYS Catholic Hlth   1,003   48   1,051 18%       60   1,111 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 8,228 1,446 929 12,595 9,157 73% 85% 86% 2,619 988 15,214 10,145 67%
  HealthNow/BCBS-WNY/Community Blue   2,638   245   2,883 23%       300   3,183 21%
  Primary Health   595   97   692 5%       229   921 6%
  Fidelis/NYS Catholic Hlth   4,995   587   5,582 44%       459   6,041 40%
Chemung TOTALS: 7,521 3,734 593 215 8,114 3,949 49% 89% 55% 1,918 980 10,032 4,929 49%
  Southern Tier Pediatrics (Partial)   2,665   0   2,665 33%       259   2,924 29%
  Southern Tier Priority (Partial)   1,069   215   1,284 16%       721   2,005 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 2,195 239 153 3,122 2,348 75% 93% 80% 856 178 3,978 2,526 63%
  CDPHP   1,718   126   1,844 59%       147   1,991 50%
  Wellcare   342   19   361 12%       27   388 10%
  Fidelis/NYS Catholic Hlth   135   8   143 5%       4   147 4%
Cortland TOTALS: 3,729 368 259 11 3,988 379 10% 91% 10% 779 86 4,767 465 10%
  Fidelis/NYS Catholic Hlth   368   11   379 10%       86   465 10%
Delaware TOTALS: 2,468 137 217 9 2,685 146 5% 92% 6% 755 4 3,440 150 4%
  Wellcare   137   9   146 5%       4   150 4%
Dutchess TOTALS: 8,117 1,381 700 38 8,817 1,419 16% 90% 18% 2,593 115 11,410 1,534 13%
  Wellcare   1,381   38   1,419 16%       115   1,534 13%
Erie TOTALS: 61,532 48,897 8,341 4,669 69,873 53,566 77% 93% 83% 17,191 7,215 87,064 60,781 70%
  Buffalo Community Health   6,532   478   7,010 10%       252   7,262 8%
  HealthNow/BCBS-WNY/Community Blue   9,207   829   10,036 14%       859   10,895 13%
  Independent Health Assoc/IHA   18,509   1,431   19,940 29%       1334   21,274 24%
  Fidelis/NYS Catholic Hlth   13,965   787   14,752 21%       1295   16,047 18%
  Total Full Risk   48,213   3,525   51,738 74%       3,740   55,478 64%
  PCMP II (Partial)   119   38   157 0%       304   461 1%
  PCMP III (Partial)   34   54   88 0%       406   494 1%
  PCMP II-A Special Care (Partial)   531   1,052   1,583 2%       2765   4,348 5%
  Total Partial Risk   684   1,144   1,828 3%       3,475   5,303 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: 4,617 774 390 31 5,007 805 16% 92% 17% 1,080 36 6,087 841 14%
  CDPHP   774   31   805 16%       36   841 14%
Genesee TOTALS: 2,791 1,294 134 87 2,925 1,381 47% 89% 53% 615 94 3,540 1,475 42%
  HealthNow/BCBS-WNY/Community Blue   34   2   36 1%       1   37 1%
  Preferred Care   1,260   85   1,345 46%       93   1,438 41%
Greene TOTALS: 2,834 2,264 274 150 3,108 2,414 78% 93% 83% 683 190 3,791 2,604 69%
  CDPHP   1,480   106   1,586 51%       135   1,721 45%
  Wellcare   594   29   623 20%       45   668 18%
  Fidelis/NYS Catholic Hlth   190   15   205 7%       10   215 6%
Hamilton TOTALS: 131 0 13 0 144 0 0% 91% 0% 47 0 191 0 0%
Herkimer TOTALS: 4,188 1,104 269 84 4,457 1,188 27% 92% 29% 882 49 5,339 1,237 23%
  Fidelis/NYS Catholic Hlth   447   37   484 11%       32   516 10%
  United Healthcare of Upstate   657   47   704 16%       17   721 14%
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 1,797 274 135 3,328 1,932 58% 92% 63% 676 160 4,004 2,092 52%
  Excellus   1,104   91   1,195 36%       69   1,264 32%
  Preferred Care   693   44   737 22%       91   828 21%
Madison TOTALS: 3,208 0 168 0 3,376 0 0% 91% 0% 754 0 4,130 0 0%
Monroe TOTALS: 49,621 42,178 7,667 4,413 57,288 46,591 81% 91% 89% 12,204 2,888 69,492 49,479 71%
  Excellus   30,780   3,384   34,164 60%       2291   36,455 52%
  Preferred Care   11,398   1,029   12,427 22%       597   13,024 19%
Montgomery TOTALS: 3,957 891 400 37 4,357 928 21% 92% 23% 793 54 5,150 982 19%
  CDPHP   891   37   928 21%       54   982 19%
Nassau TOTALS: 31,402 22,540 3,147 1,537 34,549 24,077 70% 92% 75% 10,096 1,267 44,645 25,344 57%
  Vytra   2,779   139   2,918 8%       142   3,060 7%
  HIP   4,429   492   4,921 14%       418   5,339 12%
  HealthFirst PHSP   5,479   292   5,771 17%       247   6,018 13%
  Affinity Health Plan   4,720   211   4,931 14%       229   5,160 12%
  Fidelis/NYS Catholic Hlth   3,499   237   3,736 11%       134   3,870 9%
  United Healthcare of NY   1,634   166   1,800 5%       97   1,897 4%
Niagara TOTALS: 12,180 10,944 1,423 867 13,603 11,811 87% 93% 93% 3,363 1,493 16,966 13,304 78%
  Independent Health Assoc/IHA   5,284   410   5,694 42%       812   6,506 38%
  Fidelis/NYS Catholic Hlth   1,951   173   2,124 16%       285   2,409 14%
  HealthNow/BCBS-WNY/Community Blue   3,709   284   3,993 29%       396   4,389 26%
Oneida TOTALS: 16,722 13,530 1,678 1,098 18,400 14,628 80% 92% 86% 5,139 1,355 23,539 15,983 68%
  Fidelis/NYS Catholic Hlth   7,536   630   8,166 44%       967   9,133 39%
  United Healthcare of Upstate   4,728   337   5,065 28%       350   5,415 23%
  Excellus   1,266   131   1,397 8%       38   1,435 6%
Onondaga TOTALS: 30,565 23,725 3,121 1,599 33,686 25,324 75% 89% 85% 7,805 2,212 41,491 27,536 66%
  Fidelis/NYS Catholic Hlth   5,328   330   5,658 17%       545   6,203 15%
  Total Care/Syracuse PHSP   9,515   635   10,150 30%       1020   11,170 27%
  United Healthcare of Upstate   6,865   467   7,332 22%       586   7,918 19%
  Excellus   2,017   167   2,184 6%       61   2,245 7%
Ontario TOTALS: 4,100 3,314 347 134 4,447 3,448 78% 91% 85% 1,090 369 5,537 3,817 69%
  Excellus   2,636   107   2,743 62%       305   3,048 55%
  Preferred Care   678   27   705 16%       64   769 14%
Orange TOTALS: 22,281 5,837 3,563 330 25,844 6,167 24% 91% 26% 4,116 659 29,960 6,826 23%
  Affinity Health Plan   4,461   240   4,701 18%       579   5,280 18%
  Wellcare   1,290   77   1,367 5%       79   1,446 5%
  Westchester PHSP   86   13   99 0%       1   100 0%
Orleans TOTALS: 3,101 1,038 300 64 3,401 1,102 32% 92% 35% 612 77 4,013 1,179 29%
  Excellus   425   22   447 13%       46   493 12%
  Fidelis/NYS Catholic Hlth   473   26   499 15%       23   522 13%
  HealthNow/BCBS-WNY/Community Blue   140   16   156 5%       8   164 4%
Oswego TOTALS: 9,386 7,803 706 469 10,092 8,272 82% 92% 89% 1,943 597 12,035 8,869 74%
  Fidelis/NYS Catholic Hlth   1,488   127   1,615 16%       100   1,715 14%
  Total Care/Syracuse PHSP   2,766   204   2,970 29%       245   3,215 27%
  United Healthcare of Upstate   3,549   138   3,687 37%       252   3,939 33%
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: 938 154 157 14 1,095 168 15% 88% 17% 548 34 1,643 202 12%
  Care Plus Health Plan   154   14   168 15%       34   202 12%
Rensselaer TOTALS: 8,122 7,181 895 624 9,017 7,805 87% 92% 94% 2,160 412 11,177 8,217 74%
  CDPHP   6,288   550   6,838 76%       346   7,184 64%
  Fidelis/NYS Catholic Hlth   603   43   646 7%       47   693 6%
  Wellcare   290   31   321 4%       19   340 3%
Rockland TOTALS: 20,437 19,569 1,364 731 21,801 20,300 93% 92% 101% 2,644 524 24,445 20,824 85%
  Affinity Health Plan   1,410   106   1,516 7%       123   1,639 7%
  Fidelis/NYS Catholic Hlth   13,516   371   13,887 64%       236   14,123 58%
  Wellcare   2,077   86   2,163 10%       53   2,216 9%
  Westchester PHSP   2,423   143   2,566 12%       99   2,665 11%
  Community Choice Hlth Plan   143   25   168 1%       13   181 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 4,175 370 219 5,585 4,394 79% 92% 86% 1,897 209 7,482 4,603 62%
  Wellcare   55   5   60 1%       0   60 1%
  CDPHP   3,481   175   3,656 65%       187   3,843 51%
  Fidelis/NYS Catholic Hlth   639   39   678 12%       22   700 9%
Schenectady TOTALS: 8,665 5,891 773 349 9,438 6,240 66% 90% 73% 2,520 652 11,958 6,892 58%
  CDPHP   5,325   302   5,627 60%       593   6,220 52%
  Fidelis/NYS Catholic Hlth   566   47   613 6%       59   672 6%
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% 92% 0% 330 0 1,647 0 0%
Seneca TOTALS: 1,720 1,079 131 27 1,851 1,106 60% 92% 65% 450 164 2,301 1,270 55%
  Excellus   1,079   27   1,106 60%       164   1,270 55%
Steuben TOTALS: 6,960 1,783 582 151 7,542 1,934 26% 91% 28% 2,080 606 9,622 2,540 26%
  Southern Tier Pediatrics (Partial)   93   0   93 1%       11   104 1%
  Southern Tier Priority (Partial)   1,690   151   1,841 24%       595   2,436 25%
Suffolk TOTALS: 41,557 31,540 3,716 1,592 45,273 33,132 73% 91% 80% 13,281 2,627 58,554 35,759 61%
  Vytra   3,345   137   3,482 8%       281   3,763 6%
  HIP   3,943   387   4,330 10%       234   4,564 8%
  HealthFirst PHSP   4,925   199   5,124 11%       520   5,644 10%
  Suffolk Plan HMO   9,395   452   9,847 22%       1169   11,016 19%
  Affinity Health Plan   2,920   105   3,025 7%       157   3,182 5%
  United Healthcare of NY   4,613   190   4,803 11%       133   4,936 8%
  Fidelis/NYS Catholic Hlth   2,399   122   2,521 6%       133   2,654 5%
Sullivan TOTALS: 5,080 1,520 285 39 5,365 1,559 29% 91% 32% 1,442 105 6,807 1,664 24%
  Wellcare   588   20   608 11%       61   669 10%
  Westchester PHSP   932   19   951 18%       44   995 15%
Tioga TOTALS: 2,631 60 175 1 2,806 61 2% 92% 2% 714 0 3,520 61 2%
  CDPHP   60   1   61 2%       0   61 2%
Tompkins TOTALS: 4,137 0 496 0 4,633 0 0% 90% 0% 982 0 5,615 0 0%
Ulster TOTALS: 8,568 2,431 783 97 9,351 2,528 27% 91% 30% 2,566 177 11,917 2,705 23%
  Wellcare   2,431   97   2,528 27%       177   2,705 23%
Warren TOTALS: 2,723 1,676 173 6 2,896 1,682 58% 92% 63% 883 66 3,779 1,748 46%
  HealthNow/BlueShield of NENY   1,676   6   1,682 58%       66   1,748 46%
Washington TOTALS: 3,255 1,350 215 32 3,470 1,382 40% 91% 44% 933 136 4,403 1,518 34%
  HealthNow/BlueShield of NENY   883   25   908 26%       112   1,020 23%
  CDPHP   467   7   474 14%       24   498 11%
Wayne TOTALS: 3,877 2,378 218 85 4,095 2,463 60% 92% 65% 1,205 235 5,300 2,698 51%
  Excellus   720   27   747 18%       77   824 16%
  Preferred Care   1,658   58   1,716 42%       158   1,874 35%
Westchester TOTALS: 44,491 32,448 5,916 2,416 50,407 34,864 69% 89% 78% 9,969 2,502 60,376 37,366 62%
  HIP   2,606   471   3,077 6%       322   3,399 6%
  Westchester PHSP   15,941   853   16,794 33%       1062   17,856 30%
  Affinity Health Plan   5,298   381   5,679 11%       456   6,135 10%
  Community Choice Hlth Plan   5,816   449   6,265 12%       448   6,713 11%
  Fidelis/NYS Catholic Hlth   2,787   262   3,049 6%       214   3,263 5%
Wyoming TOTALS: 1,652 0 120 0 1,772 0 0% 91% 0% 416 0 2,188 0 0%
Yates TOTALS: 1,314 1,007 72 43 1,386 1,050 76% 93% 82% 284 81 1,670 1,131 68%
  Excellus   1,007   43   1,050 76%       81   1,131 68%
Upstate Total   551,659 345,789 59,092 25,746 610,751 371,121 61% 91% 67% 145,443 32,110 756,194 403,645 53%
NYC Affinity Health Plan   51,960   5,434   57,394 5%       2,845   60,239 4%
  Fidelis/NYS Catholic Hlth   45,321   6,168   51,489 4%       1,849   53,338 4%
  HealthFirst PHSP   73,241   10,699   83,940 7%       4,969   88,909 6%
  HIP   82,834   21,152   103,986 8%       7,408   111,394 7%
  Health Plus PHSP   79,731   9,935   89,666 7%       2,183   91,849 6%
  AmeriChoice of New York/MHS   53,535   13,080   66,615 5%       3,522   70,137 5%
  Manhattan PHSP/Center Care   40,810   6,013   46,823 4%       1,724   48,547 3%
  MetroPlus Health Plan   69,036   9,075   78,111 6%       4,188   82,299 5%
  United Healthcare of NY   10,194   3,145   13,339 1%       443   13,782 1%
  St Barnabas/Partners in Health   16,443   2,242   18,685 1%       1,104   19,789 1%
  Neighborhood Health Providers   45,391   4,194   49,585 4%       1,750   51,335 3%
  Wellcare   12,486   2,109   14,595 1%       390   14,985 1%
  ABC Health Plan   5,791   905   6,696 1%       160   6,856 0%
  Community Choice Hlth Plan   3,582   633   4,215 0%       70   4,285 0%
  Community Premier Plus   13,517   1,427   14,944 1%       932   15,876 1%
  NY Hospital Community PHSP   19,449   3,479   22,928 2%       789   23,717 2%
  Care Plus Health Plan   32,007   3,830   35,837 3%       916   36,753 2%
  NYC Total 1,017,540 655,328 238,069 103,520 1,255,609 758,848 60% 90% 67% 253,686 35,242 1,509,295 794,090 53%
                               
  UPSTATE TOTALS: 551,659 345,789 59,092 25,746 610,751 371,121 61% 91% 67% 145,443 32,110 756,194 403,645 53%
  NEW YORK CITY TOTALS: 1,017,540 655,328 238,069 103,520 1,255,609 758,848 60% 90% 67% 253,686 35,242 1,509,295 794,090 53%
  GRAND TOTALS 1,569,199 1,001,117 297,161 129,266 1,866,360 1,129,969 61% 91% 67% 399,129 67,352 2,265,489 1,197,735 53%
NYC Boroughs Bronx 268,951 188,726 58,468 24,821 327,419 213,548 65%     64,258 9,026 391,677 222,574 57%
  Brooklyn 374,235 254,768 91,460 47,443 465,695 302,211 65%     88,334 13,348 554,029 315,559 57%
  Manhattan 150,392 58,997 46,471 10,019 196,863 69,016 35%     48,934 5,250 245,797 74,266 30%
  Queens 197,848 130,486 36,673 18,105 234,521 148,591 63%     44,340 5,816 278,861 154,407 55%
  Staten Island 26,114 22,350 4,997 3,132 31,111 25,482 82%     7,820 1,802 38,931 27,285 70%
  Borough Total 1,017,540 655,328 238,069 103,520 1,255,609 758,848 60% 90% 67% 253,686 35,242 1,509,295 794,090 53%

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 : Orange County - Westchester PHSP