Managed Care

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

NYS December, 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: 17,688 14,727 2,154 1,209 19,842 15,936 80% 92% 87% 4,394 937 24,236 16,873 70%
Mandatory CDPHP   11,937   894   12,831 65%       804   13,635 56%
  Fidelis/NYS Catholic Hlth   1,750   225   1,975 10%       92   2,067 9%
  HealthNow/BlueShield of NENY   1   3   4 0%       0   4 0%
  Wellcare   1,039   87   1,126 6%       41   1,167 5%
Allegany TOTALS: 3,750 1,099 375 90 4,125 1,189 29% 90% 32% 979 194 5,104 1,383 27%
Voluntary Health Choice (Partial)   308   29   337 8%       148   485 10%
  HealthNow/BCBS-WNY/Community Blue   791   61   852 21%       46   898 18%
Broome TOTALS: 13,555 11,758 1,370 948 14,925 12,706 85% 90% 94% 3,597 996 18,522 13,702 74%
Mandatory Broome MC   4,663   310   4,973 33%       707   5,680 31%
  CDPHP   6,696   592   7,288 49%       269   7,557 41%
  Fidelis/NYS Catholic Hlth   399   46   445 3%       20   465 3%
Cattaraugus TOTALS: 6,400 4,908 412 314 6,812 5,222 77% 91% 84% 1,550 637 8,362 5,859 70%
Mandatory Fidelis/NYS Catholic Hlth   1,021   63   1,084 16%       78   1,162 14%
  HealthNow/BCBS-WNY/Community Blue   3,887   251   4,138 61%       559   4,697 56%
Cayuga Voluntary TOTALS: 5,469 0 374 0 5,843 0 0% 89% 0% 1,167 0 7,010 0 0%
Chautauqua TOTALS: 13,245 9,924 1,657 1,094 14,902 11,018 74% 85% 87% 2,726 1,143 17,628 12,161 69%
Mandatory Fidelis/NYS Catholic Hlth   5,611   573   6,184 41%       543   6,727 38%
  HealthNow/BCBS-WNY/Community Blue   3,711   406   4,117 28%       362   4,479 25%
  Primary Health   602   115   717 5%       238   955 5%
Chemung TOTALS: 8,763 3,760 851 236 9,614 3,996 42% 89% 47% 1,963 915 11,577 4,911 42%
Voluntary Southern Tier Pediatrics (Partial)   2,618       2,618 27%       256   2,874 25%
  Southern Tier Priority (Partial)   1,142   236   1,378 14%       659   2,037 18%
Chenango Voluntary TOTALS: 4,952 0 237 0 5,189 0 0% 92% 0% 1,001 0 6,190 0 0%
Clinton Voluntary TOTALS: 5,941 0 461 0 6,402 0 0% 86% 0% 1,571 0 7,973 0 0%
Columbia TOTALS: 3,355 2,659 275 171 3,630 2,830 78% 93% 83% 880 226 4,510 3,056 68%
Mandatory CDPHP   2,072   132   2,204 61%       191   2,395 53%
  Fidelis/NYS Catholic Hlth   188   12   200 6%       7   207 5%
  Wellcare   399   27   426 12%       28   454 10%
Cortland TOTALS: 4,296 432 297 17 4,593 449 10% 91% 11% 770 81 5,363 530 10%
Voluntary Fidelis/NYS Catholic Hlth   432   17   449 10%       81   530 10%
Delaware TOTALS: 3,000 0 221 0 3,221 0 0% 92% 0% 746 0 3,967 0 0%
Dutchess TOTALS: 9,827 2,334 892 101 10,719 2,435 23% 90% 25% 2,781 130 13,500 2,565 19%
Voluntary Wellcare   2,334   101   2,435 23%       130   2,565 19%
Erie TOTALS: 68,813 56,712 9,135 5,522 77,948 62,234 80% 93% 86% 17,303 7,701 95,251 69,935 73%
Mandatory Buffalo Community Health   9,203   768   9,971 13%       382   10,353 11%
  Fidelis/NYS Catholic Hlth   14,513   821   15,334 20%       1,380   16,714 18%
  HealthNow/BCBS-WNY/Community Blue   13,216   1,280   14,496 19%       1,014   15,510 16%
  Independent Health Assoc/IHA   19,109   1,484   20,593 26%       1,665   22,258 23%
  Total Full Risk   56,041   4,353   60,394 77%       4,441   64,835 68%
  PCMP II (Partial)   95   37   132 0%       262   394 0%
  PCMP III (Partial)   3   14   17 0%       266   283 0%
  PCMP II-A Special Care (Partial)   573   1,118   1,691 2%       2,732   4,423 5%
  Total Partial Risk   671   1,169   1,840 2%       3,260   5,100 5%
Essex Voluntary TOTALS: 2,132 0 165 0 2,297 0 0% 92% 0% 583 0 2,880 0 0%
Franklin Voluntary TOTALS: 3,539 0 315 0 3,854 0 0% 91% 0% 1,000 0 4,854 0 0%
Fulton TOTALS: 5,329 903 421 44 5,750 947 16% 92% 18% 1,078 48 6,828 995 15%
Voluntary CDPHP   903   44   947 16%       48   995 15%
Genesee TOTALS: 3,447 2,146 193 141 3,640 2,287 63% 89% 70% 643 136 4,283 2,423 57%
Voluntary HealthNow/BCBS-WNY/Community Blue   835   69   904 25%       25   929 22%
  Preferred Care   1,311   72   1,383 38%       111   1,494 35%
Greene TOTALS: 3,194 2,785 265 176 3,459 2,961 86% 93% 92% 695 263 4,154 3,224 78%
Mandatory CDPHP   1,843   115   1,958 57%       196   2,154 52%
  Fidelis/NYS Catholic Hlth   335   28   363 10%       15   378 9%
  Wellcare   607   33   640 19%       52   692 17%
Hamilton Voluntary TOTALS: 216 0 21 0 237 0 0% 91% 0% 45 0 282 0 0%
Herkimer TOTALS: 5,087 3,539 311 257 5,398 3,796 70% 92% 76% 898 91 6,296 3,887 62%
Mandatory Excellus   1,196   91   1,287 24%       34   1,321 21%
  Fidelis/NYS Catholic Hlth   1,525   115   1,640 30%       43   1,683 27%
  United Healthcare of Upstate   818   51   869 16%       14   883 14%
Jefferson Voluntary TOTALS: 8,667 0 705 0 9,372 0 0% 87% 0% 1,847 0 11,219 0 0%
Lewis Voluntary TOTALS: 2,418 0 116 0 2,534 0 0% 93% 0% 421 0 2,955 0 0%
Livingston TOTALS: 3,638 2,976 377 242 4,015 3,218 80% 92% 88% 690 211 4,705 3,429 73%
Mandatory Excellus   2,038   147   2,185 54%       105   2,290 49%
  Preferred Care   938   95   1,033 26%       106   1,139 24%
Madison Voluntary TOTALS: 4,176 0 241 0 4,417 0 0% 91% 0% 768 0 5,185 0 0%
Monroe TOTALS: 56,320 42,968 9,107 3,977 65,427 46,945 72% 91% 79% 12,618 3,274 78,045 50,219 64%
Mandatory Excellus   32,098   3,091   35,189 54%       2,587   37,776 48%
  Preferred Care   10,870   886   11,756 18%       687   12,443 16%
Montgomery TOTALS: 4,461 903 411 44 4,872 947 19% 92% 21% 809 78 5,681 1,025 18%
Voluntary CDPHP   903   44   947 19%       78   1,025 18%
Nassau TOTALS: 38,269 32,067 3,750 2,011 42,019 34,078 81% 92% 88% 10,297 1,709 52,316 35,787 68%
Mandatory Affinity Health Plan   6,443   250   6,693 16%       258   6,951 13%
  Fidelis/NYS Catholic Hlth   4,829   242   5,071 12%       196   5,267 10%
  HealthFirst PHSP   8,445   362   8,807 21%       336   9,143 17%
  HIP   5,876   619   6,495 15%       541   7,036 13%
  United Healthcare of NY   3,653   332   3,985 9%       204   4,189 8%
  Vytra   2,821   206   3,027 7%       174   3,201 6%
Niagara TOTALS: 14,025 12,927 1,665 1,144 15,690 14,071 90% 93% 97% 3,429 1,683 19,119 15,754 82%
Mandatory Fidelis/NYS Catholic Hlth   2,423   244   2,667 17%       297   2,964 16%
  HealthNow/BCBS-WNY/Community Blue   4,973   416   5,389 34%       505   5,894 31%
  Independent Health Assoc/IHA   5,531   484   6,015 38%       881   6,896 36%
Oneida TOTALS: 19,559 16,088 1,704 1,244 21,263 17,332 82% 92% 88% 5,328 1,621 26,591 18,953 71%
Mandatory Excellus   2,217   219   2,436 11%       84   2,520 9%
  Fidelis/NYS Catholic Hlth   8,998   720   9,718 46%       1,184   10,902 41%
  United Healthcare of Upstate   4,873   305   5,178 24%       353   5,531 21%
Onondaga TOTALS: 34,698 28,013 4,264 2,382 38,962 30,395 78% 89% 88% 8,049 2,499 47,011 32,894 70%
Mandatory Excellus   2,621   286   2,907 7%       120   3,027 6%
  Fidelis/NYS Catholic Hlth   6,211   518   6,729 17%       611   7,340 16%
  Total Care/Syracuse PHSP   10,557   943   11,500 30%       1,116   12,616 27%
  United Healthcare of Upstate   8,624   635   9,259 24%       652   9,911 25%
Ontario TOTALS: 5,017 4,040 456 208 5,473 4,248 78% 91% 85% 1,142 414 6,615 4,662 70%
Mandatory Excellus   3,346   158   3,504 64%       346   3,850 58%
  Preferred Care   694   50   744 14%       68   812 12%
Orange TOTALS: 28,197 8,842 2,161 448 30,358 9,290 31% 91% 34% 4,269 802 34,627 10,092 29%
Voluntary Affinity Health Plan   5,912   250   6,162 20%       635   6,797 20%
  Wellcare   1,671   71   1,742 6%       97   1,839 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   1,259   127   1,386 5%       70   1,456 4%
Orleans TOTALS: 3,565 2,309 354 220 3,919 2,529 65% 92% 70% 602 124 4,521 2,653 59%
Mandatory Excellus   773   71   844 22%       54   898 20%
  Fidelis/NYS Catholic Hlth   960   87   1,047 27%       52   1,099 24%
  HealthNow/BCBS-WNY/Community Blue   576   62   638 16%       18   656 15%
Oswego TOTALS: 11,619 9,868 856 582 12,475 10,450 84% 92% 91% 1,936 684 14,411 11,134 77%
Mandatory Excellus   280   26   306 2%       15   321 2%
  Fidelis/NYS Catholic Hlth   1,968   131   2,099 17%       117   2,216 15%
  Total Care/Syracuse PHSP   3,400   241   3,641 29%       281   3,922 27%
  United Healthcare of Upstate   4,220   184   4,404 35%       271   4,675 32%
Otsego TOTALS: 3,524 11 228 0 3,752 11 0% 91% 0% 864 0 4,616 11 0%
Voluntary Wellcare   11       11 0%           11 0%
Putnam TOTALS: 1,187 193 148 8 1,335 201 15% 88% 17% 564 29 1,899 230 12%
Voluntary Care Plus Health Plan   193   8   201 15%       29   230 12%
Rensselaer TOTALS: 9,287 8,251 979 743 10,266 8,994 88% 92% 95% 2,179 497 12,445 9,491 76%
Mandatory CDPHP   6,645   570   7,215 70%       422   7,637 61%
  Fidelis/NYS Catholic Hlth   710   52   762 7%       45   807 6%
  HealthNow/BlueShield of NENY   637   101   738 7%       20   758 6%
  Wellcare   259   20   279 3%       10   289 2%
Rockland TOTALS: 24,897 23,119 1,343 903 26,240 24,022 92% 92% 99% 2,635 590 28,875 24,612 85%
Mandatory Affinity Health Plan   1,690   149   1,839 7%       122   1,961 7%
  Community Choice Hlth Plan   143   27   170 1%       14   184 1%
  Fidelis/NYS Catholic Hlth   15,898   385   16,283 62%       259   16,542 57%
  Wellcare   1,946   107   2,053 8%       46   2,099 7%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,442   235   3,677 14%       149   3,826 13%
St Lawrence Voluntary TOTALS: 9,090 0 699 0 9,789 0 0% 91% 0% 2,556 0 12,345 0 0%
Saratoga TOTALS: 7,176 5,802 455 330 7,631 6,132 80% 92% 88% 1,903 281 9,534 6,413 67%
Mandatory CDPHP   4,814   247   5,061 66%       246   5,307 56%
  Fidelis/NYS Catholic Hlth   644   47   691 9%       28   719 8%
  HealthNow/BlueShield of NENY   344   36   380 5%       7   387 4%
Schenectady TOTALS: 10,827 6,057 1,021 296 11,848 6,353 54% 90% 60% 2,644 745 14,492 7,098 49%
Voluntary CDPHP   5,183   245   5,428 46%       680   6,108 42%
  Fidelis/NYS Catholic Hlth   874   51   925 8%       65   990 7%
Schoharie TOTALS: 2,149 62 162 9 2,311 71 3% 92% 3% 388 6 2,699 77 3%
Voluntary CDPHP   62   9   71 3%       6   77 3%
Schuyler TOTALS: 1,406 92 125 14 1,531 106 7% 92% 8% 308 4 1,839 110 6%
Voluntary Southern Tier Priority (Partial)   92   14   106 7%       4   110 6%
Seneca TOTALS: 2,160 1,401 138 55 2,298 1,456 63% 92% 69% 457 175 2,755 1,631 59%
Voluntary Excellus   1,401   55   1,456 63%       175   1,631 59%
Steuben TOTALS: 8,244 2,230 833 222 9,077 2,452 27% 91% 30% 2,054 668 11,131 3,120 28%
Voluntary Southern Tier Pediatrics (Partial)   105       105 1%       15   120 1%
  Southern Tier Priority (Partial)   2,125   222   2,347 26%       653   3,000 27%
Suffolk TOTALS: 58,599 48,830 5,835 3,624 64,434 52,454 81% 91% 89% 13,489 3,019 77,923 55,473 71%
Mandatory Affinity Health Plan   5,321   289   5,610 9%       203   5,813 7%
  Fidelis/NYS Catholic Hlth   4,737   335   5,072 8%       156   5,228 7%
  HealthFirst PHSP   7,892   445   8,337 13%       566   8,903 11%
  HIP   6,049   848   6,897 11%       325   7,222 9%
  Suffolk Health Plan   11,332   726   12,058 19%       1,159   13,217 17%
  United Healthcare of NY   8,939   509   9,448 15%       264   9,712 12%
  Vytra   4,560   472   5,032 8%       346   5,378 7%
Sullivan TOTALS: 6,478 2,902 313 60 6,791 2,962 44% 91% 48% 1,510 154 8,301 3,116 38%
Voluntary Wellcare   253   2   255 4%       32   287 3%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,649   58   2,707 40%       122   2,829 34%
Tioga TOTALS: 3,290 103 256 6 3,546 109 3% 92% 3% 725 0 4,271 109 3%
Voluntary CDPHP   103   6   109 3%           109 3%
Tompkins TOTALS: 4,800 449 527 40 5,327 489 9% 90% 10% 1,014 33 6,341 522 8%
Voluntary Total Care/Syracuse PHSP   449   40   489 9%       33   522 8%
Ulster TOTALS: 9,659 2,439 852 80 10,511 2,519 24% 91% 26% 2,601 203 13,112 2,722 21%
Voluntary Wellcare   2,439   80   2,519 24%       203   2,722 21%
Warren TOTALS: 3,503 2,155 241 21 3,744 2,176 58% 92% 63% 939 82 4,683 2,258 48%
Voluntary HealthNow/BlueShield of NENY   2,155   21   2,176 58%       82   2,258 48%
Washington TOTALS: 4,278 1,708 247 34 4,525 1,742 38% 91% 42% 954 139 5,479 1,881 34%
Voluntary CDPHP   562   3   565 12%       31   596 11%
  Fidelis/NYS Catholic Hlth   49   1   50 1%       1   51 1%
  HealthNow/BlueShield of NENY   1,097   30   1,127 25%       107   1,234 23%
Wayne TOTALS: 5,129 4,452 335 210 5,464 4,662 85% 92% 93% 1,212 343 6,676 5,005 75%
Mandatory Excellus   2,303   107   2,410 44%       157   2,567 38%
  Preferred Care   2,149   103   2,252 41%       186   2,438 37%
Westchester TOTALS: 51,454 36,219 6,984 3,170 58,438 39,389 67% 89% 76% 10,417 2,579 68,855 41,968 61%
Mandatory Affinity Health Plan   5,388   471   5,859 10%       418   6,277 9%
  Community Choice Hlth Plan   6,294   560   6,854 12%       443   7,297 11%
  Fidelis/NYS Catholic Hlth   3,334   413   3,747 6%       251   3,998 6%
  HIP   2,730   513   3,243 6%       333   3,576 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   18,473   1,213   19,686 34%       1,134   20,820 30%
Wyoming Voluntary TOTALS: 2,041 0 120 0 2,161 0 0% 91% 0% 431 0 2,592 0 0%
Yates TOTALS: 1,774 1,163 113 60 1,887 1,223 65% 93% 70% 290 96 2,177 1,319 61%
Voluntary Excellus   1,163   60   1,223 65%       96   1,319 61%
Upstate Total   657,579 426,325 68,523 32,707 726,102 459,032 63% 91% 70% 148,709 36,240 874,811 495,272 57%
NYC ABC Health Plan   6,586   1,513   8,099 0%       187   8,286 0%
Mandatory Affinity Health Plan   74,187   17,061   91,248 6%       3,039   94,287 5%
  AmeriChoice of New York/MHS   65,841   19,870   85,711 5%       3,239   88,950 5%
  Care Plus Health Plan   56,345   9,328   65,673 4%       1,161   66,834 4%
  Community Choice Hlth Plan   3,418   665   4,083 0%       77   4,160 0%
  Community Premier Plus   39,887   7,894   47,781 3%       1,271   49,052 3%
  Fidelis/NYS Catholic Hlth   64,028   12,420   76,448 5%       2,125   78,573 4%
  Fidelis Care HealthierLife SN                            
  HealthFirst PHSP   116,958   24,143   141,101 9%       5,211   146,312 8%
  HealthFirst PHSP SN   7   2   9 0%       4   13 0%
  Health Plus PHSP   128,530   27,055   155,585 10%       2,835   158,420 8%
  HIP   116,026   39,032   155,058 10%       7,570   162,628 9%
  Manhattan PHSP/CenterCare   55,253   11,382   66,635 4%       1,868   68,503 4%
  MetroPlus Health Plan   117,187   24,503   141,690 9%       4,679   146,369 8%
  MetroPlus Health Plan SN   44   43   87 0%       88   175 0%
  Neighborhood Health Providers   59,709   9,902   69,611 4%       1,905   71,516 4%
  NY Hospital Community PHSP   31,069   8,699   39,768 2%       950   40,718 2%
  NYPS Select Health SN   16   28   44 0%       55   99 0%
  NYS Catholic Health SN   3   1   4 0%       1   5 0%
  St Barnabas/Partners in Health   17,763   3,278   21,041 1%       1,112   22,153 1%
  United Healthcare of NY   21,608   8,889   30,497 2%       930   31,427 2%
  VidaCare Inc. SN   2   30   32 0%       40   72 0%
  Wellcare   21,072   5,396   26,468 2%       502   26,970 1%
  NYC Total 1,248,302 995,539 378,155 231,134 1,626,457 1,226,673 75% 90% 83% 252,281 38,849 1,878,738 1,265,522 67%
                               
  UPSTATE TOTALS: 657,579 426,325 68,523 32,707 726,102 459,032 63% 91% 70% 148,709 36,240 874,811 495,272 57%
  NEW YORK CITY TOTALS: 1,248,302 995,539 378,155 231,134 1,626,457 1,226,673 75% 90% 83% 252,281 38,849 1,878,738 1,265,522 67%
  GRAND TOTALS 1,905,881 1,421,864 446,678 263,841 2,352,559 1,685,705 72% 91% 79% 400,990 75,089 2,753,549 1,760,794 64%
NYC Boroughs Bronx 308,575 251,500 85,716 47,985 394,291 299,485 76%     65,069 10,218 459,360 309,702 67%
  Brooklyn 460,939 367,577 144,450 94,496 605,389 462,073 76%     86,429 14,150 691,818 476,223 69%
  Manhattan 176,233 133,102 70,978 35,905 247,211 169,007 68%     48,492 6,070 295,703 175,077 59%
  Queens 269,105 215,384 68,807 46,999 337,912 262,382 78%     44,455 6,595 382,367 268,977 70%
  Staten Island 33,450 27,977 8,204 5,749 41,654 33,726 81%     7,836 1,816 49,490 35,543 72%
  Borough Total 1,248,302 995,539 378,155 231,134 1,626,457 1,226,673 75% 90% 83% 252,281 38,849 1,878,738 1,265,522 67%

NOTES:

(1) The Managed Care eligible counts are based upon April, 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 : Albany County - HealthNow/BlueSheild of NENY

 

NYS December, 2003
PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 447
  Total 447
CO-OP CARE PLAN NYC 485
  Total 485
COMPREHENSIVE CARE MGT NYC 1,090
  WESTCHESTER 116
  Total 1,206
EDDY SENIORCARE SCHENECTADY 80
  Total 80
ELANT CHOICE ORANGE 76
  Total 76
GUILDNET NYC 1,867
  Total 1,867
HOMEFIRST NYC 1,026
  Total 1,026
INDEP CARE SYSTEMS INC NYC 531
  Total 531
INDEP LIVING FOR SENIORS MONROE 300
  Total 300
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 222
  Total 222
PARTNERS IN COMMUNITY CARE ORANGE 98
  ROCKLAND 23
  Total 121
SENIOR HEALTH PARTNERS INC NYC 146
  Total 146
SENIOR NETWORK HEALTH HERKIMER 16
  ONEIDA 309
  Total 325
TOTAL AGING IN PLACE ERIE 62
  Total 62
VNS CHOICE NYC 3,384
  Total 3,384
 
  UPSTATE TOTALS: 1,749
  NEW YORK CITY TOTALS: 8,529
  GRAND TOTALS: 10,278

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