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 2003

  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: 17,057 14,008 2,020 1,132 19,077 15,140 79% 92% 86% 4,370 920 23,447 16,060 68%
Mandatory CDPHP   11,516   868   12,384 65%       805   13,189 56%
  Fidelis/NYS Catholic Hlth   1,531   191   1,722 9%       77   1,799 8%
  Wellcare   961   73   1,034 5%       38   1,072 5%
Allegany TOTALS: 3,620 1,086 348 77 3,968 1,163 29% 90% 32% 987 197 4,955 1,360 27%
Voluntary Health Choice (Partial)   321   32   353 9%       158   511 10%
  HealthNow/BCBS-WNY/Community Blue   765   45   810 20%       39   849 17%
Broome TOTALS: 13,263 11,423 1,325 959 14,588 12,382 85% 90% 94% 3,561 971 18,149 13,353 74%
Mandatory Broome MC   4,876   331   5,207 36%       706   5,913 33%
  CDPHP   6,147   589   6,736 46%       242   6,978 38%
  Fidelis/NYS Catholic Hlth   400   39   439 3%       23   462 3%
Cattaraugus TOTALS: 6,269 4,854 422 305 6,691 5,159 77% 91% 84% 1,525 637 8,216 5,796 71%
Mandatory Fidelis/NYS Catholic Hlth   1,045   73   1,118 17%       75   1,193 15%
  HealthNow/BCBS-WNY/Community Blue   3,809   232   4,041 60%       562   4,603 56%
Cayuga Voluntary TOTALS: 5,370 0 334 0 5,704 0 0% 89% 0% 1,145 0 6,849 0 0%
Chautauqua TOTALS: 12,843 9,578 1,554 1,090 14,397 10,668 74% 85% 87% 2,709 1,141 17,106 11,809 69%
Mandatory Fidelis/NYS Catholic Hlth   5,572   626   6,198 43%       550   6,748 39%
  HealthNow/BCBS-WNY/Community Blue   3,413   346   3,759 26%       355   4,114 24%
  Primary Health   593   118   711 5%       236   947 6%
Chemung TOTALS: 8,486 3,813 780 237 9,266 4,050 44% 89% 49% 1,955 933 11,221 4,983 44%
Voluntary Southern Tier Pediatrics (Partial)   2,636   0   2,636 28%       259   2,895 26%
  Southern Tier Priority (Partial)   1,177   237   1,414 15%       674   2,088 19%
Chenango Voluntary TOTALS: 4,787 0 244 0 5,031 0 0% 92% 0% 994 0 6,025 0 0%
Clinton Voluntary TOTALS: 5,738 0 469 0 6,207 0 0% 86% 0% 1,572 0 7,779 0 0%
Columbia TOTALS: 3,160 2,496 263 174 3,423 2,670 78% 93% 83% 869 209 4,292 2,879 67%
Mandatory CDPHP   1,965   134   2,099 61%       174   2,273 53%
  Fidelis/NYS Catholic Hlth   188   13   201 6%       7   208 5%
  Wellcare   343   27   370 11%       28   398 9%
Cortland TOTALS: 4,220 406 282 17 4,502 423 9% 91% 10% 766 79 5,268 502 10%
Voluntary Fidelis/NYS Catholic Hlth   406   17   423 9%       79   502 10%
Delaware TOTALS: 2,870 111 219 6 3,089 117 4% 92% 4% 743 3 3,832 120 3%
Voluntary Wellcare   111   6   117 4%       3   120 3%
Dutchess TOTALS: 9,392 1,913 790 80 10,182 1,993 20% 90% 22% 2,764 119 12,946 2,112 16%
Voluntary Wellcare   1,913   80   1,993 20%       119   2,112 16%
Erie TOTALS: 66,731 54,409 8,821 5,213 75,552 59,622 79% 93% 85% 17,135 7,546 92,687 67,168 72%
Mandatory Buffalo Community Health   8,014   603   8,617 11%       340   8,957 10%
  Fidelis/NYS Catholic Hlth   14,295   827   15,122 20%       1,342   16,464 18%
  HealthNow/BCBS-WNY/Community Blue   12,369   1,146   13,515 18%       997   14,512 16%
  Independent Health Assoc/IHA   19,041   1,489   20,530 27%       1,587   22,117 24%
  Total Full Risk   53,719   4,065   57,784 76%       4,266   62,050 67%
  PCMP II (Partial)   97   34   131 0%       264   395 0%
  PCMP III (Partial)   5   20   25 0%       283   308 0%
  PCMP II-A Special Care (Partial)   588   1,094   1,682 2%       2,733   4,415 5%
  Total Partial Risk   690   1,148   1,838 2%       3,280   5,118 6%
Essex Voluntary TOTALS: 2,054 0 145 0 2,199 0 0% 92% 0% 583 0 2,782 0 0%
Franklin Voluntary TOTALS: 3,478 0 278 0 3,756 0 0% 91% 0% 993 0 4,749 0 0%
Fulton TOTALS: 5,207 953 372 55 5,579 1,008 18% 92% 20% 1,080 43 6,659 1,051 16%
Voluntary CDPHP   953   55   1,008 18%       43   1,051 16%
Genesee TOTALS: 3,347 1,891 185 137 3,532 2,028 57% 89% 64% 617 119 4,149 2,147 52%
Voluntary HealthNow/BCBS-WNY/Community Blue   644   59   703 20%       14   717 17%
  Preferred Care   1,247   78   1,325 38%       105   1,430 34%
Greene TOTALS: 3,080 2,647 257 166 3,337 2,813 84% 93% 90% 669 243 4,006 3,056 76%
Mandatory CDPHP   1,794   120   1,914 57%       179   2,093 52%
  Fidelis/NYS Catholic Hlth   297   19   316 9%       15   331 8%
  Wellcare   556   27   583 17%       49   632 16%
Hamilton Voluntary TOTALS: 211 0 14 0 225 0 0% 91% 0% 47 0 272 0 0%
Herkimer TOTALS: 4,918 2,395 314 160 5,232 2,555 49% 92% 53% 898 68 6,130 2,623 43%
Mandatory Excellus   566   41   607 12%       15   622 10%
  Fidelis/NYS Catholic Hlth   1,107   82   1,189 23%       38   1,227 20%
  United Healthcare of Upstate   722   37   759 15%       15   774 13%
Jefferson Voluntary TOTALS: 8,461 0 721 0 9,182 0 0% 87% 0% 1,831 0 11,013 0 0%
Lewis Voluntary TOTALS: 2,324 0 123 0 2,447 0 0% 93% 0% 425 0 2,872 0 0%
Livingston TOTALS: 3,575 2,813 346 208 3,921 3,021 77% 92% 84% 675 188 4,596 3,209 70%
Mandatory Excellus   1,938   128   2,066 53%       89   2,155 47%
  Preferred Care   875   80   955 24%       99   1,054 23%
Madison Voluntary TOTALS: 3,969 0 220 0 4,189 0 0% 91% 0% 769 0 4,958 0 0%
Monroe TOTALS: 54,874 40,968 8,702 3,875 63,576 44,843 71% 91% 77% 12,472 3,017 76,048 47,860 63%
Mandatory Excellus   30,869   2,986   33,855 53%       2,389   36,244 48%
  Preferred Care   10,099   889   10,988 17%       628   11,616 15%
Montgomery TOTALS: 4,274 912 386 38 4,660 950 20% 92% 22% 816 70 5,476 1,020 19%
Voluntary CDPHP   912   38   950 20%       70   1,020 19%
Nassau TOTALS: 34,739 27,288 3,380 1,743 38,119 29,031 76% 92% 82% 10,221 1,569 48,340 30,600 63%
Mandatory Affinity Health Plan   5,584   215   5,799 15%       244   6,043 13%
  Fidelis/NYS Catholic Hlth   4,101   228   4,329 11%       178   4,507 9%
  HealthFirst PHSP   6,972   317   7,289 19%       296   7,585 16%
  HIP   5,181   565   5,746 15%       508   6,254 13%
  United Healthcare of NY   3,005   293   3,298 9%       182   3,480 7%
  Vytra   2,445   125   2,570 7%       161   2,731 6%
Niagara TOTALS: 13,849 12,451 1,559 1,049 15,408 13,500 88% 93% 94% 3,394 1,641 18,802 15,141 81%
Mandatory Fidelis/NYS Catholic Hlth   2,276   230   2,506 16%       322   2,828 15%
  HealthNow/BCBS-WNY/Community Blue   4,681   374   5,055 33%       451   5,506 29%
  Independent Health Assoc/IHA   5,494   445   5,939 39%       868   6,807 36%
Oneida TOTALS: 18,945 15,686 1,652 1,209 20,597 16,895 82% 92% 89% 5,309 1,564 25,906 18,459 71%
Mandatory Excellus   1,907   190   2,097 10%       69   2,166 8%
  Fidelis/NYS Catholic Hlth   8,641   714   9,355 45%       1,136   10,491 40%
  United Healthcare of Upstate   5,138   305   5,443 26%       359   5,802 22%
Onondaga TOTALS: 33,876 27,075 3,883 2,206 37,759 29,281 78% 89% 87% 7,987 2,370 45,746 31,651 69%
Mandatory Excellus   2,452   244   2,696 7%       106   2,802 6%
  Fidelis/NYS Catholic Hlth   5,917   489   6,406 17%       581   6,987 15%
  Total Care/Syracuse PHSP   10,356   890   11,246 30%       1,080   12,326 27%
  United Healthcare of Upstate   8,350   583   8,933 24%       603   9,536 25%
Ontario TOTALS: 4,735 3,968 426 219 5,161 4,187 81% 91% 89% 1,142 388 6,303 4,575 73%
Mandatory Excellus   3,228   175   3,403 66%       324   3,727 59%
  Preferred Care   740   44   784 15%       64   848 13%
Orange TOTALS: 27,083 8,245 2,122 449 29,205 8,694 30% 91% 33% 4,243 738 33,448 9,432 28%
Voluntary Affinity Health Plan   5,745   268   6,013 21%       601   6,614 20%
  Wellcare   1,508   77   1,585 5%       91   1,676 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   992   104   1,096 4%       46   1,142 3%
Orleans TOTALS: 3,439 1,788 329 126 3,768 1,914 51% 92% 55% 591 114 4,359 2,028 47%
Mandatory Excellus   619   43   662 18%       56   718 16%
  Fidelis/NYS Catholic Hlth   781   53   834 22%       46   880 20%
  HealthNow/BCBS-WNY/Community Blue   388   30   418 11%       12   430 10%
Oswego TOTALS: 11,117 9,460 803 613 11,920 10,073 85% 92% 91% 1,926 651 13,846 10,724 77%
Mandatory Excellus   188   30   218 2%       6   224 2%
  Fidelis/NYS Catholic Hlth   1,902   135   2,037 17%       115   2,152 16%
  Total Care/Syracuse PHSP   3,232   244   3,476 29%       272   3,748 27%
  United Healthcare of Upstate   4,138   204   4,342 36%       258   4,600 33%
Otsego TOTALS: 3,346 12 204 0 3,550 12 0% 91% 0% 849 0 4,399 12 0%
Voluntary Wellcare   12   0   12 0%       0   12 0%
Putnam TOTALS: 1,113 178 132 8 1,245 186 15% 88% 17% 563 29 1,808 215 12%
Voluntary Care Plus Health Plan   178   8   186 15%       29   215 12%
Rensselaer TOTALS: 9,173 7,929 961 723 10,134 8,652 85% 92% 93% 2,159 474 12,293 9,126 74%
Mandatory CDPHP   6,495   576   7,071 70%       402   7,473 61%
  Fidelis/NYS Catholic Hlth   698   38   736 7%       48   784 6%
  HealthNow/BlueShield of NENY   487   90   577 6%       13   590 5%
  Wellcare   249   19   268 3%       11   279 2%
Rockland TOTALS: 24,094 22,180 1,302 815 25,396 22,995 91% 92% 98% 2,645 584 28,041 23,579 84%
Mandatory Affinity Health Plan   1,686   122   1,808 7%       118   1,926 7%
  Community Choice Hlth Plan   120   14   134 1%       13   147 1%
  Fidelis/NYS Catholic Hlth   15,218   351   15,569 61%       258   15,827 56%
  Wellcare   2,012   100   2,112 8%       51   2,163 8%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,144   228   3,372 13%       144   3,516 13%
St Lawrence Voluntary TOTALS: 8,789 0 656 0 9,445 0 0% 91% 0% 2,559 0 12,004 0 0%
Saratoga TOTALS: 6,737 5,496 429 310 7,166 5,806 81% 92% 88% 1,889 266 9,055 6,072 67%
Mandatory CDPHP   4,692   236   4,928 69%       236   5,164 57%
  Fidelis/NYS Catholic Hlth   676   55   731 10%       26   757 8%
  HealthNow/BlueShield of NENY   77   14   91 1%       3   94 1%
  Wellcare   51   5   56 1%       1   57 1%
Schenectady TOTALS: 10,345 5,909 939 330 11,284 6,239 55% 90% 61% 2,599 731 13,883 6,970 50%
Voluntary CDPHP   5,173   290   5,463 48%       671   6,134 44%
  Fidelis/NYS Catholic Hlth   736   40   776 7%       60   836 6%
Schoharie TOTALS: 2,039 66 147 6 2,186 72 3% 92% 4% 381 5 2,567 77 3%
Voluntary CDPHP   66   6   72 3%       5   77 3%
Schuyler TOTALS: 1,423 61 116 3 1,539 64 4% 92% 5% 310 2 1,849 66 4%
Voluntary Southern Tier Priority (Partial)   61   3   64 4%       2   66 4%
Seneca TOTALS: 2,122 1,448 144 59 2,266 1,507 67% 92% 72% 463 179 2,729 1,686 62%
Voluntary Excellus   1,448   59   1,507 67%       179   1,686 62%
Steuben TOTALS: 8,070 2,191 769 226 8,839 2,417 27% 91% 30% 2,070 635 10,909 3,052 28%
Voluntary Southern Tier Pediatrics (Partial)   111   0   111 1%       14   125 1%
  Southern Tier Priority (Partial)   2,080   226   2,306 26%       621   2,927 27%
Suffolk TOTALS: 53,946 45,895 5,076 3,289 59,022 49,184 83% 91% 91% 13,448 2,934 72,470 52,118 72%
Mandatory Affinity Health Plan   5,196   274   5,470 9%       181   5,651 8%
  Fidelis/NYS Catholic Hlth   4,429   302   4,731 8%       154   4,885 7%
  HealthFirst PHSP   7,164   385   7,549 13%       558   8,107 11%
  HIP   5,860   848   6,708 11%       317   7,025 10%
  Suffolk Health Plan   11,038   685   11,723 20%       1,165   12,888 18%
  United Healthcare of NY   8,240   486   8,726 15%       244   8,970 12%
  Vytra   3,968   309   4,277 7%       315   4,592 6%
Sullivan TOTALS: 6,184 2,521 309 55 6,493 2,576 40% 91% 44% 1,493 152 7,986 2,728 34%
Voluntary Wellcare   315   2   317 5%       37   354 4%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,206   53   2,259 35%       115   2,374 30%
Tioga TOTALS: 3,130 86 218 5 3,348 91 3% 92% 3% 731 0 4,079 91 2%
Voluntary CDPHP   86   5   91 3%       0   91 2%
Tompkins TOTALS: 4,653 290 516 34 5,169 324 6% 90% 7% 1,005 23 6,174 347 6%
Voluntary Total Care/Syracuse PHSP   290   34   324 6%       23   347 6%
Ulster TOTALS: 9,395 2,294 852 77 10,247 2,371 23% 91% 25% 2,587 189 12,834 2,560 20%
Voluntary Wellcare   2,294   77   2,371 23%       189   2,560 20%
Warren TOTALS: 3,312 2,091 216 21 3,528 2,112 60% 92% 65% 922 74 4,450 2,186 49%
Voluntary HealthNow/BlueShield of NENY   2,091   21   2,112 60%       74   2,186 49%
Washington TOTALS: 3,942 1,603 213 43 4,155 1,646 40% 91% 44% 949 132 5,104 1,778 35%
Voluntary CDPHP   554   6   560 13%       30   590 12%
  Fidelis/NYS Catholic Hlth   6   0   6 0%       0   6 0%
  HealthNow/BlueShield of NENY   1,043   37   1,080 26%       102   1,182 23%
Wayne TOTALS: 4,943 4,236 292 204 5,235 4,440 85% 92% 92% 1,201 347 6,436 4,787 74%
Mandatory Excellus   1,973   103   2,076 40%       146   2,222 35%
  Preferred Care   2,263   101   2,364 45%       201   2,565 40%
Westchester TOTALS: 49,427 33,767 6,706 2,855 56,133 36,622 65% 89% 74% 10,325 2,532 66,458 39,154 59%
Mandatory Affinity Health Plan   5,041   418   5,459 10%       440   5,899 9%
  Community Choice Hlth Plan   5,778   539   6,317 11%       442   6,759 10%
  Fidelis/NYS Catholic Hlth   3,000   359   3,359 6%       222   3,581 5%
  HIP   2,602   445   3,047 5%       320   3,367 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   17,346   1,094   18,440 33%       1,108   19,548 29%
Wyoming Voluntary TOTALS: 1,908 0 116 0 2,024 0 0% 91% 0% 425 0 2,449 0 0%
Yates TOTALS: 1,713 1,171 96 54 1,809 1,225 68% 93% 73% 288 89 2,097 1,314 63%
Voluntary Excellus   1,171   54   1,225 68%       89   1,314 63%
Upstate Total   631,165 402,061 64,497 30,660 695,662 432,721 62% 91% 68% 147,644 34,915 843,306 467,636 55%
NYC ABC Health Plan   7,022   1,401   8,423 1%       176   8,599 0%
Mandatory Affinity Health Plan   70,960   14,159   85,119 5%       2,927   88,046 5%
  AmeriChoice of New York/MHS   63,292   18,530   81,822 5%       3,218   85,040 5%
  Care Plus Health Plan   52,159   8,200   60,359 4%       1,076   61,435 3%
  Community Choice Hlth Plan   3,304   619   3,923 0%       77   4,000 0%
  Community Premier Plus   34,036   6,123   40,159 3%       1,132   41,291 2%
  Fidelis/NYS Catholic Hlth   62,147   11,162   73,309 5%       2,011   75,320 4%
  Fidelis Care HealthierLife SN                            
  HealthFirst PHSP   105,327   19,772   125,099 8%       4,976   130,075 7%
  HealthFirst PHSP SN   5   4   9 0%       1   10 0%
  Health Plus PHSP   119,151   23,221   142,372 9%       2,536   144,908 8%
  HIP   112,460   37,353   149,813 9%       7,196   157,009 8%
  Manhattan PHSP/CenterCare   53,869   10,481   64,350 4%       1,768 66,118 4%
  MetroPlus Health Plan   107,483   21,382   128,865 8%       4,455   133,320 7%
  MetroPlus Health Plan SN   25   13   38 0%       44   82 0%
  Neighborhood Health Providers   58,192   8,328   66,520 4%       1,829   68,349 4%
  NY Hospital Community PHSP   28,659   7,248   35,907 2%       848   36,755 2%
  NYPS Select Health SN   0   1   1 0%       4   5 0%
  St Barnabas/Partners in Health   17,554   3,079   20,633 1%       1,080   21,713 1%
  United Healthcare of NY   19,423   7,832   27,255 2%       753   28,008 2%
  VidaCare Inc. SN   0   1   1 0%       5   6 0%
  Wellcare   18,352   4,106   22,458 1%       467   22,925 1%
  NYC Total 1,232,048 933,420 365,179 203,015 1,597,227 1,136,435 71% 90% 79% 251,856 36,579 1,849,083 1,173,014 63%
                               
  UPSTATE TOTALS: 631,165 402,061 64,497 30,660 695,662 432,721 62% 91% 68% 147,644 34,915 843,306 467,636 55%
  NEW YORK CITY TOTALS: 1,232,048 933,420 365,179 203,015 1,597,227 1,136,435 71% 90% 79% 251,856 36,579 1,849,083 1,173,014 63%
  GRAND TOTALS 1,863,213 1,335,481 429,676 233,675 2,292,889 1,569,156 68% 91% 76% 399,500 71,494 2,692,389 1,640,650 61%
NYC Boroughs Bronx 305,681 239,495 83,283 42,619 388,964 282,113 73%     64,760 9,715 453,724 291,829 64%
  Brooklyn 456,460 347,212 140,056 84,985 596,516 432,197 72%     86,314 13,338 682,830 445,535 65%
  Manhattan 175,007 119,211 69,160 29,780 244,167 148,991 61%     48,437 5,581 292,604 154,571 53%
  Queens 261,844 201,095 64,935 40,562 326,779 241,657 74%     44,510 6,195 371,289 247,852 67%
  Staten Island 33,056 26,407 7,745 5,069 40,801 31,477 77%     7,835 1,751 48,636 33,227 68%
  Borough Total 1,232,048 933,420 365,179 203,015 1,597,227 1,136,435 71% 90% 79% 251,856 36,579 1,849,083 1,173,014 63%

NOTES:

  1. The Managed Care eligible counts are based upon January, 2003 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 July, 2003 to be based on the primary and secondary roster reports. The roster reports reflect enrollees as of the first the 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: NYC - NYPS Select Health SN

MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS August, 2003

PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 417
  Total 417
CO-OP CARE PLAN NYC 515
  Total 515
COMPREHENSIVE CARE MGT NYC 983
  WESTCHESTER 106
  Total 1,089
EDDY SENIORCARE SCHENECTADY 83
  Total 83
ELANT CHOICE ORANGE 72
  Total 72
GUILDNET NYC 1,732
  Total 1,732
HOMEFIRST NYC 1,001
  Total 1,001
INDEP CARE SYSTEMS INC NYC 518
  Total 518
INDEP LIVING FOR SENIORS MONROE 301
  Total 301
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 220
  Total 220
PARTNERS IN COMMUNITY CARE ORANGE 102
  ROCKLAND 26
  Total 128
SENIOR HEALTH PARTNERS INC NYC 128
  Total 128
SENIOR NETWORK HEALTH HERKIMER 10
  ONEIDA 280
  Total 290
TOTAL AGING IN PLACE ERIE 35
  Total 35
VNS CHOICE NYC 3,043
  Total 3,043
 
  UPSTATE TOTALS: 1,652
  NEW YORK CITY TOTALS: 7,920
  GRAND TOTALS: 9,572

Note: The source of enrollment is based on the primary and secondary roster reports.