Managed Care

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

NYS January 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: 15,427 12,939 1,856 1,015 17,283 13,954 81% 92% 88% 4,299 847 21,582 14,801 69%
  CDPHP   10,816   855   11,671 68%       741   12,412 58%
  Fidelis/NYS Catholic Hlth   1,126   100   1,226 7%       67   1,293 6%
  Wellcare   997   60   1,057 6%       39   1,096 5%
Allegany TOTALS: 3,523 942 331 68 3,854 414 11% 90% 12% 1,005 203 4,859 1,213 25%
  Health Choice (Partial)   384   30   414 11%       172   586 12%
  HealthNow/BCBS-WNY/Community Blue   558   38   596 15%       31   627 13%
Broome TOTALS: 11,751 10,469 1,234 818 12,985 11,287 87% 90% 96% 3,461 918 16,446 12,205 74%
  Broome MC   5,110   306   5,416 42%       694   6,110 37%
  Fidelis/NYS Catholic Hlth   408   45   453 3%       18   471 3%
  CDPHP   4,951   467   5,418 42%       206   5,624 34%
Cattauragus TOTALS: 5,652 4,525 352 269 6,004 4,794 80% 91% 87% 1,568 582 7,572 5,376 71%
  HealthNow/BCBS-WNY/Community Blue   3,469   217   3,686 61%       517   4,203 56%
  Fidelis/NYS Catholic Hlth   1,056   52   1,108 18%       65   1,173 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 8,762 1,446 913 12,595 9,675 77% 85% 90% 2,619 1,069 15,214 10,744 71%
  HealthNow/BCBS-WNY/Community Blue   2,897   246   3,143 25%       333   3,476 23%
  Primary Health   584   85   669 5%       229   898 6%
  Fidelis/NYS Catholic Hlth   5,281   582   5,863 47%       507   6,370 42%
Chemung TOTALS: 7,521 3,764 593 197 8,114 3,961 49% 89% 55% 1,918 984 10,032 4,945 49%
  Southern Tier Pediatrics (Partial)   2,620   0   2,620 32%       262   2,882 29%
  Southern Tier Priority (Partial)   1,144   197   1,341 17%       722   2,063 21%
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 2,288 239 160 3,122 2,448 78% 93% 84% 856 204 3,978 2,652 67%
  CDPHP   1,786   125   1,911 61%       170   2,081 52%
  Wellcare   350   26   376 12%       27   403 10%
  Fidelis/NYS Catholic Hlth   152   9   161 5%       7   168 4%
Cortland TOTALS: 3,729 353 259 10 3,988 363 9% 91% 10% 779 87 4,767 450 9%
  Fidelis/NYS Catholic Hlth   353   10   363 9%       87   450 9%
Delaware TOTALS: 2,468 116 217 6 2,685 122 5% 92% 5% 755 4 3,440 126 4%
  Wellcare   116   6   122 5%       4   126 4%
Dutchess TOTALS: 8,117 1,420 700 35 8,817 1,455 17% 90% 18% 2,593 114 11,410 1,569 14%
  Wellcare   1,420   35   1,455 17%       114   1,569 14%
Erie TOTALS: 61,532 50,945 8,341 4,585 69,873 55,530 79% 93% 86% 17,191 7,244 87,064 62,774 72%
  Buffalo Community Health   7,101   475   7,576 11%       276   7,852 9%
  HealthNow/BCBS-WNY/Community Blue   10,433   882   11,315 16%       908   12,223 14%
  Independent Health Assoc/IHA   18,531   1,412   19,943 29%       1428   21,371 25%
  Fidelis/NYS Catholic Hlth   14,250   798   15,048 22%       1288   16,336 19%
  Total Full Risk   50,315   3,567   53,882 77%       3,900   57,782 66%
  PCMP II (Partial)   108   37   145 0%       287   432 0%
  PCMP III (Partial)   7   21   28 0%       308   336 0%
  PCMP II-A Special Care (Partial)   515   960   1,475 2%       2749   4,224 5%
  Total Partial Risk   630   1,018   1,648 2%       3,344   4,992 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: 4,617 929 390 36 5,007 965 19% 92% 21% 1,080 43 6,087 1,008 17%
  CDPHP   929   36   965 19%       43   1,008 17%
Genesee TOTALS: 2,791 1,450 134 90 2,925 1,540 53% 89% 59% 615 101 3,540 1,641 46%
  HealthNow/BCBS-WNY/Community Blue   210   14   224 8%       4   228 6%
  Preferred Care   1,240   76   1,316 45%       97   1,413 40%
Greene TOTALS: 2,834 2,396 274 142 3,108 2,538 82% 93% 87% 683 210 3,791 2,748 72%
  CDPHP   1,574   95   1,669 54%       152   1,821 48%
  Wellcare   587   29   616 20%       46   662 17%
  Fidelis/NYS Catholic Hlth   235   18   253 8%       12   265 7%
Hamilton TOTALS: 131 0 13 0 144 0 0% 91% 0% 47 0 191 0 0%
Herkimer TOTALS: 4,188 1,318 269 99 4,457 1,417 32% 92% 35% 882 54 5,339 1,471 28%
  Fidelis/NYS Catholic Hlth   671   58   729 16%       36   765 14%
  United Healthcare of Upstate   647   41   688 15%       18   706 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 2,371 274 157 3,328 2,528 76% 92% 83% 676 179 4,004 2,707 68%
  Excellus   1,547   118   1,665 50%       80   1,745 44%
  Preferred Care   824   39   863 26%       99   962 24%
Madison TOTALS: 3,208 0 168 0 3,376 0 0% 91% 0% 754 0 4,130 0 0%
Monroe TOTALS: 49,621 40,383 7,667 3,791 57,288 44,174 77% 91% 84% 12,204 3,037 69,492 47,211 68%
  Excellus   29,839   2,917   32,756 57%       2409   35,165 51%
  Preferred Care   10,544   874   11,418 20%       628   12,046 17%
Montgomery TOTALS: 3,957 880 400 30 4,357 910 21% 92% 23% 793 65 5,150 975 19%
  CDPHP   880   30   910 21%       65   975 19%
Nassau TOTALS: 31,402 23,791 3,147 1,566 34,549 25,357 73% 92% 79% 10,096 1,414 44,645 26,771 60%
  Vytra   2,524   110   2,634 8%       143   2,777 6%
  HIP   4,667   482   5,149 15%       469   5,618 13%
  HealthFirst PHSP   5,811   335   6,146 18%       278   6,424 14%
  Affinity Health Plan   4,977   192   5,169 15%       230   5,399 12%
  Fidelis/NYS Catholic Hlth   3,622   234   3,856 11%       170   4,026 9%
  United Healthcare of NY   2,190   213   2,403 7%       124   2,527 6%
Niagara TOTALS: 12,180 11,475 1,423 844 13,603 12,319 91% 93% 98% 3,363 1,524 16,966 13,843 82%
  Independent Health Assoc/IHA   5,364   410   5,774 42%       809   6,583 39%
  Fidelis/NYS Catholic Hlth   2,062   165   2,227 16%       302   2,529 15%
  HealthNow/BCBS-WNY/Community Blue   4,049   269   4,318 32%       413   4,731 28%
Oneida TOTALS: 16,722 14,342 1,678 1,059 18,400 15,401 84% 92% 91% 5,139 1,437 23,539 16,838 72%
  Fidelis/NYS Catholic Hlth   7,894   608   8,502 46%       1014   9,516 40%
  United Healthcare of Upstate   4,954   310   5,264 29%       374   5,638 24%
  Excellus   1,494   141   1,635 9%       49   1,684 7%
Onondaga TOTALS: 30,565 24,752 3,121 1,651 33,686 26,403 78% 89% 88% 7,805 2,299 41,491 28,702 69%
  Fidelis/NYS Catholic Hlth   5,497   354   5,851 17%       556   6,407 15%
  Total Care/Syracuse PHSP   9,738   652   10,390 31%       1050   11,440 28%
  United Healthcare of Upstate   7,347   487   7,834 23%       619   8,453 20%
  Excellus   2,170   158   2,328 7%       74   2,402 7%
Ontario TOTALS: 4,100 3,584 347 161 4,447 3,745 84% 91% 92% 1,090 375 5,537 4,120 74%
  Excellus   2,889   123   3,012 68%       314   3,326 60%
  Preferred Care   695   38   733 16%       61   794 14%
Orange TOTALS: 22,281 6,424 3,563 301 25,844 6,725 26% 91% 29% 4,116 702 29,960 7,427 25%
  Affinity Health Plan   4,680   206   4,886 19%       597   5,483 18%
  Wellcare   1,372   50   1,422 6%       89   1,511 5%
  Westchester PHSP   372   45   417 2%       16   433 1%
Orleans TOTALS: 3,101 1,274 300 78 3,401 1,352 40% 92% 43% 612 87 4,013 1,439 36%
  Excellus   496   32   528 16%       48   576 14%
  Fidelis/NYS Catholic Hlth   531   23   554 16%       25   579 14%
  HealthNow/BCBS-WNY/Community Blue   247   23   270 8%       14   284 7%
Oswego TOTALS: 9,386 8,310 706 497 10,092 8,807 87% 92% 94% 1,943 607 12,035 9,414 78%
  Fidelis/NYS Catholic Hlth   1,648   123   1,771 18%       103   1,874 16%
  Total Care/Syracuse PHSP   2,856   213   3,069 30%       252   3,321 28%
  United Healthcare of Upstate   3,745   153   3,898 39%       251   4,149 34%
  Excellus   61   8   69 1%       1   70 1%
Otsego TOTALS: 2,857 22 154 0 3,011 22 1% 91% 1% 831 1 3,842 23 1%
  Wellcare   22   0   22 1%       1   23 1%
Putnam TOTALS: 938 151 157 10 1,095 161 15% 88% 17% 548 32 1,643 193 12%
  Care Plus Health Plan   151   10   161 15%       32   193 12%
Rensselaer TOTALS: 8,122 7,603 895 659 9,017 8,262 92% 92% 100% 2,160 454 11,177 8,716 78%
  CDPHP   6,539   561   7,100 79%       389   7,489 67%
  Fidelis/NYS Catholic Hlth   656   48   704 8%       46   750 7%
  Wellcare   263   21   284 3%       16   300 3%
  HealthNow/BlueShield of NENY   145   29   174 2%       3   177 2%
Rockland TOTALS: 20,437 20,640 1,364 748 21,801 21,388 98% 92% 106% 2,644 541 24,445 21,929 90%
  Affinity Health Plan   1,509   111   1,620 7%       114   1,734 7%
  Fidelis/NYS Catholic Hlth   14,175   359   14,534 67%       242   14,776 60%
  Wellcare   2,083   82   2,165 10%       56   2,221 9%
  Westchester PHSP   2,754   180   2,934 13%       113   3,047 12%
  Community Choice Hlth Plan   119   16   135 1%       16   151 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 4,588 370 235 5,585 4,823 86% 92% 94% 1,897 229 7,482 5,052 68%
  Wellcare   49   5   54 1%       0   54 1%
  CDPHP   3,890   194   4,084 73%       206   4,290 57%
  Fidelis/NYS Catholic Hlth   649   36   685 12%       23   708 9%
Schenectady TOTALS: 8,665 6,361 773 373 9,438 6,734 71% 90% 79% 2,520 718 11,958 7,452 62%
  CDPHP   5,725   328   6,053 64%       654   6,707 56%
  Fidelis/NYS Catholic Hlth   636   45   681 7%       64   745 6%
Schoharie TOTALS: 1,868 72 111 3 1,979 75 4% 92% 4% 384 4 2,363 79 3%
  CDPHP   72   3   75 4%       4   79 3%
Schuyler TOTALS: 1,199 0 118 0 1,317 0 0% 92% 0% 330 0 1,647 0 0%
Seneca TOTALS: 1,720 1,249 131 46 1,851 1,295 70% 92% 76% 450 167 2,301 1,462 64%
  Excellus   1,249   46   1,295 70%       167   1,462 64%
Steuben TOTALS: 6,960 1,974 582 176 7,542 2,150 29% 91% 31% 2,080 621 9,622 2,771 29%
  Southern Tier Pediatrics (Partial)   103   0   103 1%       13   116 1%
  Southern Tier Priority (Partial)   1,871   176   2,047 27%       608   2,655 28%
Suffolk TOTALS: 41,557 36,413 3,716 2,241 45,273 38,654 85% 91% 94% 13,281 2,782 58,554 41,436 71%
  Vytra   3,122   113   3,235 7%       296   3,531 6%
  HIP   4,598   569   5,167 11%       270   5,437 9%
  HealthFirst PHSP   5,623   259   5,882 13%       534   6,416 11%
  Suffolk Plan HMO   9,882   561   10,443 23%       1184   11,627 20%
  Affinity Health Plan   4,037   193   4,230 9%       172   4,402 8%
  United Healthcare of NY   6,026   325   6,351 14%       187   6,538 11%
  Fidelis/NYS Catholic Hlth   3,125   221   3,346 7%       139   3,485 6%
Sullivan TOTALS: 5,080 1,858 285 48 5,365 1,906 36% 91% 39% 1,442 127 6,807 2,033 30%
  Wellcare   458   7   465 9%       49   514 8%
  Westchester PHSP   1,400   41   1,441 27%       78   1,519 22%
Tioga TOTALS: 2,631 62 175 3 2,806 65 2% 92% 3% 714 0 3,520 65 2%
  CDPHP   62   3   65 2%       0   65 2%
Tompkins TOTALS: 4,137 45 496 2 4,633 47 1% 90% 1% 982 4 5,615 51 1%
  Total Care/Syracuse PHSP   45   2   47 1%       4   51 1%
Ulster TOTALS: 8,568 2,441 783 103 9,351 2,544 27% 91% 30% 2,566 188 11,917 2,732 23%
  Wellcare   2,441   103   2,544 27%       188   2,732 23%
Warren TOTALS: 2,723 1,858 173 14 2,896 1,872 65% 92% 71% 883 71 3,779 1,943 51%
  HealthNow/BlueShield of NENY   1,858   14   1,872 65%       71   1,943 51%
Washington TOTALS: 3,255 1,392 215 36 3,470 1,428 41% 91% 45% 933 131 4,403 1,559 35%
  HealthNow/BlueShield of NENY   891   26   917 26%       107   1,024 23%
  CDPHP   501   10   511 15%       24   535 12%
Wayne TOTALS: 3,877 3,300 218 132 4,095 3,432 84% 92% 91% 1,205 297 5,300 3,729 70%
  Excellus   1,076   41   1,117 27%       103   1,220 23%
  Preferred Care   2,224   91   2,315 57%       194   2,509 47%
Westchester TOTALS: 44,491 32,969 5,916 2,472 50,407 35,441 70% 89% 79% 9,969 2,495 60,376 37,936 63%
  HIP   2,600   446   3,046 6%       318   3,364 6%
  Westchester PHSP   16,897   884   17,781 35%       1075   18,856 31%
  Affinity Health Plan   5,147   408   5,555 11%       448   6,003 10%
  Community Choice Hlth Plan   5,539   476   6,015 12%       448   6,463 11%
  Fidelis/NYS Catholic Hlth   2,786   258   3,044 6%       206   3,250 5%
Wyoming TOTALS: 1,652 0 120 0 1,772 0 0% 91% 0% 416 0 2,188 0 0%
Yates TOTALS: 1,314 1,096 72 40 1,386 1,136 82% 93% 88% 284 75 1,670 1,211 73%
  Excellus   1,096   40   1,136 82%       75   1,211 73%
Upstate Total   551,659 364,296 59,092 25,919 610,751 389,619 64% 91% 70% 145,443 33,327 756,194 423,542 56%
NYC Affinity Health Plan   64,619   9,002   73,621 6%       2,979   76,600 5%
  Fidelis/NYS Catholic Hlth   53,798   8,403   62,201 5%       1,900   64,101 4%
  HealthFirst PHSP   86,323   14,357   100,680 8%       5,241   105,921 7%
  HIP   98,704   28,915   127,619 10%       8,006   135,625 9%
  Health Plus PHSP   98,053   15,381   113,434 9%       2,439   115,873 8%
  AmeriChoice of New York/MHS   58,975   15,603   74,578 6%       3,532   78,110 5%
  Manhattan PHSP/Center Care   48,545   8,238   56,783 5%       1,757   58,540 4%
  MetroPlus Health Plan   84,808   13,829   98,637 8%       4,308   102,945 7%
  United Healthcare of NY   14,258   5,103   19,361 2%       570   19,931 1%
  St Barnabas/Partners in Health   17,830   2,781   20,611 2%       1,137   21,748 1%
  Neighborhood Health Providers   52,406   5,867   58,273 5%       1,802   60,075 4%
  Wellcare   15,779   3,133   18,912 2%       444   19,356 1%
  ABC Health Plan   6,785   1,191   7,976 1%       176   8,152 1%
  Community Choice Hlth Plan   3,586   633   4,219 0%       76   4,295 0%
  Community Premier Plus   20,044   2,905   22,949 2%       1,050   23,999 2%
  NY Hospital Community PHSP   23,599   5,012   28,611 2%       887   29,498 2%
  Care Plus Health Plan   42,011   5,453   47,464 4%       1,029   48,493 3%
  NYC Total 1,017,540 790,123 238,069 145,806 1,255,609 935,929 75% 90% 82% 253,686 37,333 1,509,295 973,262 64%
                               
  UPSTATE TOTALS: 551,659 364,296 59,092 25,919 610,751 389,619 64% 91% 70% 145,443 33,327 756,194 423,542 56%
  NEW YORK CITY TOTALS: 1,017,540 790,123 238,069 145,806 1,255,609 935,929 75% 90% 82% 253,686 37,333 1,509,295 973,262 64%
  GRAND TOTALS 1,569,199 1,154,419 297,161 171,725 1,866,360 1,325,548 71% 91% 78% 399,129 70,660 2,265,489 1,396,804 62%
NYC Boroughs Bronx 268,951 223,874 58,468 34,753 327,419 258,627 79%     64,258 9,681 391,677 268,308 69%
  Brooklyn 374,235 300,111 91,460 64,060 465,695 364,171 78%     88,334 13,835 554,029 378,006 68%
  Manhattan 150,392 76,052 46,471 15,989 196,863 92,041 47%     48,934 5,487 245,797 97,528 40%
  Queens 197,848 165,024 36,673 26,933 234,521 191,957 82%     44,340 6,460 278,861 198,417 71%
  Staten Island 26,114 25,062 4,997 4,072 31,111 29,134 94%     7,820 1,869 38,931 31,002 80%
  Borough Total 1,017,540 790,123 238,069 145,806 1,255,609 935,929 75% 90% 82% 253,686 37,333 1,509,295 973,262 64%

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