Managed Care

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

NYS February 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: 16,227 13,102 1,972 1,062 18,199 14,164 78% 92% 85% 4,340 869 22,539 15,033 67%
  CDPHP   10,949   886   11,835 65%       763   12,598 56%
  Fidelis/NYS Catholic Hlth   1,149   110   1,259 7%       68   1,327 6%
  Wellcare   1,004   66   1,070 6%       38   1,108 5%
Allegany TOTALS: 3,491 976 300 67 3,791 400 11% 90% 12% 981 204 4,772 1,247 26%
  Health Choice (Partial)   373   27   400 11%       171   571 12%
  HealthNow/BCBS-WNY/Community Blue   603   40   643 17%       33   676 14%
Broome TOTALS: 12,725 10,578 1,339 848 14,064 11,426 81% 90% 90% 3,543 926 17,607 12,352 70%
  Broome MC   5,090   320   5,410 38%       698   6,108 35%
  Fidelis/NYS Catholic Hlth   419   44   463 3%       17   480 3%
  CDPHP   5,069   484   5,553 39%       211   5,764 33%
Cattauragus TOTALS: 5,930 4,590 387 270 6,317 4,860 77% 91% 84% 1,527 595 7,844 5,455 70%
  HealthNow/BCBS-WNY/Community Blue   3,533   214   3,747 59%       528   4,275 55%
  Fidelis/NYS Catholic Hlth   1,057   56   1,113 18%       67   1,180 15%
Cayuga TOTALS: 5,076 0 340 0 5,416 0 0% 89% 0% 1,151 0 6,567 0 0%
Chautauqua TOTALS: 11,916 8,872 1,490 951 13,406 9,823 73% 85% 86% 2,644 1,078 16,050 10,901 68%
  HealthNow/BCBS-WNY/Community Blue   2,963   259   3,222 24%       334   3,556 22%
  Primary Health   572   89   661 5%       226   887 6%
  Fidelis/NYS Catholic Hlth   5,337   603   5,940 44%       518   6,458 40%
Chemung TOTALS: 7,891 3,887 632 213 8,523 4,100 48% 89% 54% 1,934 983 10,457 5,083 49%
  Southern Tier Pediatrics (Partial)   2,691   0   2,691 32%       263   2,954 28%
  Southern Tier Priority (Partial)   1,196   213   1,409 17%       720   2,129 20%
Chenango TOTALS: 4,445 0 200 0 4,645 0 0% 92% 0% 988 0 5,633 0 0%
Clinton TOTALS: 5,479 0 414 0 5,893 0 0% 86% 0% 1,557 0 7,450 0 0%
Columbia TOTALS: 2,933 2,299 229 173 3,162 2,472 78% 93% 84% 847 206 4,009 2,678 67%
  CDPHP   1,815   136   1,951 62%       173   2,124 53%
  Wellcare   346   27   373 12%       25   398 10%
  Fidelis/NYS Catholic Hlth   138   10   148 5%       8   156 4%
Cortland TOTALS: 3,863 358 267 12 4,130 370 9% 91% 10% 773 87 4,903 457 9%
  Fidelis/NYS Catholic Hlth   358   12   370 9%       87   457 9%
Delaware TOTALS: 2,659 123 190 6 2,849 129 5% 92% 5% 763 4 3,612 133 4%
  Wellcare   123   6   129 5%       4   133 4%
Dutchess TOTALS: 8,829 1,485 766 43 9,595 1,528 16% 90% 18% 2,703 123 12,298 1,651 13%
  Wellcare   1,485   43   1,528 16%       123   1,651 13%
Erie TOTALS: 64,352 51,847 8,709 4,652 73,061 56,499 77% 93% 84% 17,099 7,284 90,160 63,783 71%
  Buffalo Community Health   7,327   475   7,802 11%       288   8,090 9%
  HealthNow/BCBS-WNY/Community Blue   10,741   911   11,652 16%       908   12,560 14%
  Independent Health Assoc/IHA   18,722   1,434   20,156 28%       1451   21,607 24%
  Fidelis/NYS Catholic Hlth   14,403   796   15,199 21%       1290   16,489 18%
  Total Full Risk   51,193   3,616   54,809 75%       3,937   58,746 65%
  PCMP II (Partial)   111   37   148 0%       284   432 0%
  PCMP III (Partial)   7   21   28 0%       303   331 0%
  PCMP II-A Special Care (Partial)   536   978   1,514 2%       2760   4,274 5%
  Total Partial Risk   654   1,036   1,690 2%       3,347   5,037 6%
Essex TOTALS: 1,888 0 123 0 2,011 0 0% 92% 0% 589 0 2,600 0 0%
Franklin TOTALS: 3,244 0 249 0 3,493 0 0% 91% 0% 983 0 4,476 0 0%
Fulton TOTALS: 4,750 933 309 40 5,059 973 19% 92% 21% 1,066 41 6,125 1,014 17%
  CDPHP   933   40   973 19%       41   1,014 17%
Genesee TOTALS: 3,099 1,535 142 95 3,241 1,630 50% 89% 56% 628 97 3,869 1,727 45%
  HealthNow/BCBS-WNY/Community Blue   300   23   323 10%       5   328 8%
  Preferred Care   1,235   72   1,307 40%       92   1,399 36%
Greene TOTALS: 2,859 2,447 245 152 3,104 2,599 84% 93% 90% 673 206 3,777 2,805 74%
  CDPHP   1,607   105   1,712 55%       150   1,862 49%
  Wellcare   590   30   620 20%       45   665 18%
  Fidelis/NYS Catholic Hlth   250   17   267 9%       11   278 7%
Hamilton TOTALS: 160 0 12 0 172 0 0% 91% 0% 48 0 220 0 0%
Herkimer TOTALS: 4,511 1,369 276 101 4,787 1,470 31% 92% 33% 892 54 5,679 1,524 27%
  Fidelis/NYS Catholic Hlth   701   62   763 16%       36   799 14%
  United Healthcare of Upstate   668   39   707 15%       18   725 13%
Jefferson TOTALS: 7,942 0 584 0 8,526 0 0% 87% 0% 1,832 0 10,358 0 0%
Lewis TOTALS: 2,105 0 102 0 2,207 0 0% 93% 0% 421 0 2,628 0 0%
Livingston TOTALS: 3,266 2,433 299 165 3,565 2,598 73% 92% 80% 680 179 4,245 2,777 65%
  Excellus   1,579   120   1,699 48%       82   1,781 42%
  Preferred Care   854   45   899 25%       97   996 23%
Madison TOTALS: 3,591 0 208 0 3,799 0 0% 91% 0% 764 0 4,563 0 0%
Monroe TOTALS: 52,867 41,158 8,524 3,692 61,391 44,850 73% 91% 80% 12,323 3,086 73,714 47,936 65%
  Excellus   30,646   2,855   33,501 55%       2460   35,961 49%
  Preferred Care   10,512   837   11,349 18%       626   11,975 16%
Montgomery TOTALS: 4,148 915 377 34 4,525 949 21% 92% 23% 809 63 5,334 1,012 19%
  CDPHP   915   34   949 21%       63   1,012 19%
Nassau TOTALS: 32,952 24,068 3,304 1,569 36,256 25,637 71% 92% 76% 10,201 1,434 46,457 27,071 58%
  Vytra   2,454   105   2,559 7%       141   2,700 6%
  HIP   4,742   492   5,234 14%       474   5,708 12%
  HealthFirst PHSP   5,880   325   6,205 17%       286   6,491 14%
  Affinity Health Plan   5,012   184   5,196 14%       227   5,423 12%
  Fidelis/NYS Catholic Hlth   3,697   230   3,927 11%       171   4,098 9%
  United Healthcare of NY   2,283   233   2,516 7%       135   2,651 6%
Niagara TOTALS: 12,903 11,550 1,502 855 14,405 12,405 86% 93% 93% 3,343 1,545 17,748 13,950 79%
  Independent Health Assoc/IHA   5,396   413   5,809 40%       821   6,630 37%
  Fidelis/NYS Catholic Hlth   2,058   165   2,223 15%       305   2,528 14%
  HealthNow/BCBS-WNY/Community Blue   4,096   277   4,373 30%       419   4,792 27%
Oneida TOTALS: 18,057 14,795 1,718 1,101 19,775 15,896 80% 92% 87% 5,240 1,465 25,015 17,361 69%
  Fidelis/NYS Catholic Hlth   8,180   625   8,805 45%       1036   9,841 39%
  United Healthcare of Upstate   5,052   324   5,376 27%       374   5,750 23%
  Excellus   1,563   152   1,715 9%       55   1,770 7%
Onondaga TOTALS: 32,370 25,276 3,479 1,757 35,849 27,033 75% 89% 85% 7,974 2,332 43,823 29,365 67%
  Fidelis/NYS Catholic Hlth   5,562   387   5,949 17%       564   6,513 15%
  Total Care/Syracuse PHSP   9,884   694   10,578 30%       1066   11,644 27%
  United Healthcare of Upstate   7,596   508   8,104 23%       627   8,731 20%
  Excellus   2,234   168   2,402 7%       75   2,477 7%
Ontario TOTALS: 4,343 3,630 343 188 4,686 3,818 81% 91% 89% 1,155 386 5,841 4,204 72%
  Excellus   2,925   147   3,072 66%       323   3,395 58%
  Preferred Care   705   41   746 16%       63   809 14%
Orange TOTALS: 24,841 6,538 2,527 315 27,368 6,853 25% 91% 28% 4,235 708 31,603 7,561 24%
  Affinity Health Plan   4,736   211   4,947 18%       597   5,544 18%
  Wellcare   1,372   48   1,420 5%       92   1,512 5%
  Westchester PHSP   430   56   486 2%       19   505 2%
Orleans TOTALS: 3,314 1,370 280 84 3,594 1,454 40% 92% 44% 596 85 4,190 1,539 37%
  Excellus   543   38   581 16%       45   626 15%
  Fidelis/NYS Catholic Hlth   533   22   555 15%       24   579 14%
  HealthNow/BCBS-WNY/Community Blue   294   24   318 9%       16   334 8%
Oswego TOTALS: 10,206 8,658 697 521 10,903 9,179 84% 92% 91% 1,919 618 12,822 9,797 76%
  Fidelis/NYS Catholic Hlth   1,725   119   1,844 17%       103   1,947 15%
  Total Care/Syracuse PHSP   2,953   226   3,179 29%       261   3,440 27%
  United Healthcare of Upstate   3,895   165   4,060 37%       251   4,311 34%
  Excellus   85   11   96 1%       3   99 1%
Otsego TOTALS: 3,061 18 188 0 3,249 18 1% 91% 1% 843 1 4,092 19 0%
  Wellcare   18   0   18 1%       1   19 0%
Putnam TOTALS: 1,027 153 136 8 1,163 161 14% 88% 16% 549 30 1,712 191 11%
  Care Plus Health Plan   153   8   161 14%       30   191 11%
Rensselaer TOTALS: 8,655 7,628 902 685 9,557 8,313 87% 92% 95% 2,182 450 11,739 8,763 75%
  CDPHP   6,532   579   7,111 74%       382   7,493 64%
  Fidelis/NYS Catholic Hlth   659   47   706 7%       48   754 6%
  Wellcare   257   20   277 3%       16   293 2%
  HealthNow/BlueShield of NENY   180   39   219 2%       4   223 2%
Rockland TOTALS: 22,114 20,967 1,283 761 23,397 21,728 93% 92% 101% 2,660 547 26,057 22,275 85%
  Affinity Health Plan   1,566   109   1,675 7%       107   1,782 7%
  Fidelis/NYS Catholic Hlth   14,377   353   14,730 63%       243   14,973 57%
  Wellcare   2,048   88   2,136 9%       57   2,193 8%
  Westchester PHSP   2,869   194   3,063 13%       122   3,185 12%
  Community Choice Hlth Plan   107   17   124 1%       18   142 1%
St. Lawrence TOTALS: 8,323 0 648 0 8,971 0 0% 91% 0% 2,519 0 11,490 0 0%
Saratoga TOTALS: 5,913 4,732 381 246 6,294 4,978 79% 92% 86% 1,876 232 8,170 5,210 64%
  Wellcare   49   5   54 1%       0   54 1%
  CDPHP   4,031   206   4,237 67%       208   4,445 54%
  Fidelis/NYS Catholic Hlth   652   35   687 11%       24   711 9%
Schenectady TOTALS: 9,307 6,495 834 382 10,141 6,877 68% 90% 75% 2,526 738 12,667 7,615 60%
  CDPHP   5,842   336   6,178 61%       672   6,850 54%
  Fidelis/NYS Catholic Hlth   653   46   699 7%       66   765 6%
Schoharie TOTALS: 1,975 71 118 4 2,093 75 4% 92% 4% 385 5 2,478 80 3%
  CDPHP   71   4   75 4%       5   80 3%
Schuyler TOTALS: 1,259 0 111 0 1,370 0 0% 92% 0% 318 0 1,688 0 0%
Seneca TOTALS: 1,901 1,304 124 47 2,025 1,351 67% 92% 72% 452 170 2,477 1,521 61%
  Excellus   1,304   47   1,351 67%       170   1,521 61%
Steuben TOTALS: 7,438 2,008 598 171 8,036 2,179 27% 91% 30% 2,046 624 10,082 2,803 28%
  Southern Tier Pediatrics (Partial)   99   0   99 1%       14   113 1%
  Southern Tier Priority (Partial)   1,909   171   2,080 26%       610   2,690 27%
Suffolk TOTALS: 46,833 37,705 4,332 2,387 51,165 40,092 78% 91% 86% 13,291 2,813 64,456 42,905 67%
  Vytra   3,058   106   3,164 6%       294   3,458 5%
  HIP   4,808   628   5,436 11%       279   5,715 9%
  HealthFirst PHSP   5,685   269   5,954 12%       543   6,497 10%
  Suffolk Plan HMO   10,013   578   10,591 21%       1187   11,778 18%
  Affinity Health Plan   4,373   207   4,580 9%       172   4,752 7%
  United Healthcare of NY   6,448   366   6,814 13%       201   7,015 11%
  Fidelis/NYS Catholic Hlth   3,320   233   3,553 7%       137   3,690 6%
Sullivan TOTALS: 5,386 1,935 267 46 5,653 1,981 35% 91% 39% 1,485 127 7,138 2,108 30%
  Wellcare   441   6   447 8%       47   494 7%
  Westchester PHSP   1,494   40   1,534 27%       80   1,614 23%
Tioga TOTALS: 2,846 68 187 3 3,033 71 2% 92% 3% 743 0 3,776 71 2%
  CDPHP   68   3   71 2%       0   71 2%
Tompkins TOTALS: 4,376 76 495 5 4,871 81 2% 90% 2% 999 9 5,870 90 2%
  Total Care/Syracuse PHSP   76   5   81 2%       9   90 2%
Ulster TOTALS: 9,085 2,426 799 108 9,884 2,534 26% 91% 28% 2,581 192 12,465 2,726 22%
  Wellcare   2,426   108   2,534 26%       192   2,726 22%
Warren TOTALS: 2,960 1,929 171 20 3,131 1,949 62% 92% 68% 897 75 4,028 2,024 50%
  HealthNow/BlueShield of NENY   1,929   20   1,949 62%       75   2,024 50%
Washington TOTALS: 3,647 1,418 193 39 3,840 1,457 38% 91% 42% 944 137 4,784 1,594 33%
  HealthNow/BlueShield of NENY   912   29   941 25%       111   1,052 22%
  CDPHP   506   10   516 13%       26   542 11%
Wayne TOTALS: 4,442 3,491 235 151 4,677 3,642 78% 92% 85% 1,162 295 5,839 3,937 67%
  Excellus   1,223   54   1,277 27%       104   1,381 24%
  Preferred Care   2,268   97   2,365 51%       191   2,556 44%
Westchester TOTALS: 48,076 32,455 6,489 2,422 54,565 34,877 64% 89% 72% 10,199 2,477 64,764 37,354 58%
  HIP   2,547   402   2,949 5%       322   3,271 5%
  Westchester PHSP   16,568   883   17,451 32%       1067   18,518 29%
  Affinity Health Plan   5,137   397   5,534 10%       436   5,970 9%
  Community Choice Hlth Plan   5,421   466   5,887 11%       446   6,333 10%
  Fidelis/NYS Catholic Hlth   2,782   274   3,056 6%       206   3,262 5%
Wyoming TOTALS: 1,831 0 111 0 1,942 0 0% 91% 0% 413 0 2,355 0 0%
Yates TOTALS: 1,534 1,126 92 47 1,626 1,173 72% 93% 78% 290 77 1,916 1,250 65%
  Excellus   1,126   47   1,173 72%       77   1,250 65%
Upstate Total   591,221 370,797 61,229 26,498 652,450 396,652 61% 91% 67% 146,581 33,657 799,031 430,952 54%
NYC Affinity Health Plan   66,420   9,537   75,957 5%       2,965   78,922 5%
  Fidelis/NYS Catholic Hlth   55,897   8,740   64,637 5%       1,883   66,520 4%
  HealthFirst PHSP   88,543   14,946   103,489 7%       5,238   108,727 7%
  HIP   101,844   30,482   132,326 9%       8,040   140,366 8%
  Health Plus PHSP   99,162   16,250   115,412 8%       2,442   117,854 7%
  AmeriChoice of New York/MHS   59,435   15,937   75,372 5%       3,529   78,901 5%
  Manhattan PHSP/Center Care   49,481   8,381   57,862 4%       1,748   59,610 4%
  MetroPlus Health Plan   88,662   14,889   103,551 7%       4,288   107,839 7%
  United Healthcare of NY   14,863   5,438   20,301 1%       586   20,887 1%
  St Barnabas/Partners in Health   17,878   2,771   20,649 1%       1,122   21,771 1%
  Neighborhood Health Providers   54,408   6,086   60,494 4%       1,811   62,305 4%
  Wellcare   16,140   3,172   19,312 1%       440   19,752 1%
  ABC Health Plan   6,775   1,175   7,950 1%       176   8,126 0%
  Community Choice Hlth Plan   3,489   594   4,083 0%       74   4,157 0%
  Community Premier Plus   21,921   3,293   25,214 2%       1,070   26,284 2%
  NY Hospital Community PHSP   24,190   5,203   29,393 2%       828   30,221 2%
  Care Plus Health Plan   44,973   5,728   50,701 4%       1,042   51,743 3%
  NYC Total 1,103,464 814,081 299,166 152,622 1,402,630 966,703 69% 90% 76% 250,782 37,282 1,653,412 1,003,985 61%
                               
  UPSTATE TOTALS: 591,221 370,797 61,229 26,498 652,450 396,652 61% 91% 67% 146,581 33,657 799,031 430,952 54%
  NEW YORK CITY TOTALS: 1,103,464 814,081 299,166 152,622 1,402,630 966,703 69% 90% 76% 250,782 37,282 1,653,412 1,003,985 61%
  GRAND TOTALS 1,694,685 1,184,878 360,395 179,120 2,055,080 1,363,355 66% 91% 73% 397,363 70,939 2,452,443 1,434,937 59%
NYC Boroughs Bronx 282,570 226,721 71,506 35,495 354,076 262,217 74%     64,106 9,625 418,182 271,841 65%
  Brooklyn 407,895 308,045 114,963 66,713 522,858 374,758 72%     86,635 13,836 609,493 388,594 64%
  Manhattan 160,665 82,687 57,598 17,625 218,263 100,313 46%     48,326 5,530 266,589 105,842 40%
  Queens 223,604 171,565 48,807 28,629 272,411 200,194 73%     43,984 6,440 316,395 206,634 65%
  Staten Island 28,730 25,063 6,292 4,159 35,022 29,222 83%     7,731 1,852 42,753 31,074 73%
  Borough Total 1,103,464 814,081 299,166 152,622 1,402,630 966,703 69% 90% 76% 250,782 37,282 1,653,412 1,003,985 61%

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