Managed Care

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

NYS July 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 13,741 2,020 1,076 19,077 14,817 78% 92% 84% 4,370 890 23,447 15,707 67%
Mandatory CDPHP   11,381   840   12,221 64%       778   12,999 55%
  Fidelis/NYS Catholic Hlth   1,406   169   1,575 8%       74   1,649 7%
  Wellcare   954   67   1,021 5%       38   1,059 5%
Allegany TOTALS: 3,620 1,071 348 78 3,968 359 9% 90% 10% 987 191 4,955 1,340 27%
Voluntary Health Choice (Partial)   327   32   359 9%       158   517 10%
  HealthNow/BCBS-WNY/Community Blue   744   46   790 20%       33   823 17%
Broome TOTALS: 13,263 11,247 1,325 940 14,588 12,187 84% 90% 92% 3,561 960 18,149 13,147 72%
Mandatory Broome MC   4,924   330   5,254 36%       703   5,957 33%
  CDPHP   5,931   573   6,504 45%       233   6,737 37%
  Fidelis/NYS Catholic Hlth   392   37   429 3%       24   453 2%
Cattauragus TOTALS: 6,269 4,890 422 303 6,691 5,193 78% 91% 85% 1,525 633 8,216 5,826 71%
Mandatory Fidelis/NYS Catholic Hlth   1,069   75   1,144 17%       78   1,222 15%
  HealthNow/BCBS-WNY/Community Blue   3,821   228   4,049 61%       555   4,604 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 9,567 1,554 1,088 14,397 10,655 74% 85% 87% 2,709 1,146 17,106 11,801 69%
Mandatory Fidelis/NYS Catholic Hlth   5,583   636   6,219 43%       554   6,773 40%
  HealthNow/BCBS-WNY/Community Blue   3,415   335   3,750 26%       356   4,106 24%
  Primary Health   569   117   686 5%       236   922 5%
Chemung TOTALS: 8,486 3,913 780 234 9,266 4,147 45% 89% 50% 1,955 945 11,221 5,092 45%
Voluntary Southern Tier Pediatrics (Partial)   2,700   0   2,700 29%       267   2,967 26%
  Southern Tier Priority (Partial)   1,213   234   1,447 16%       678   2,125 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 2,510 263 175 3,423 2,685 78% 93% 84% 869 219 4,292 2,904 68%
Mandatory CDPHP   1,970   132   2,102 61%       181   2,283 53%
  Fidelis/NYS Catholic Hlth   189   17   206 6%       8   214 5%
  Wellcare   351   26   377 11%       30   407 9%
Cortland TOTALS: 4,220 395 282 18 4,502 413 9% 91% 10% 766 81 5,268 494 9%
Voluntary Fidelis/NYS Catholic Hlth   395   18   413 9%       81   494 9%
Delaware TOTALS: 2,870 114 219 6 3,089 120 4% 92% 4% 743 3 3,832 123 3%
Voluntary Wellcare   114   6   120 4%       3   123 3%
Dutchess TOTALS: 9,392 1,906 790 81 10,182 1,987 20% 90% 22% 2,764 121 12,946 2,108 16%
Voluntary Wellcare   1,906   81   1,987 20%       121   2,108 16%
Erie TOTALS: 66,731 54,193 8,821 5,151 75,552 59,344 79% 93% 85% 17,135 7,519 92,687 66,863 72%
Mandatory Buffalo Community Health   7,906   572   8,478 11%       336   8,814 10%
  Fidelis/NYS Catholic Hlth   14,295   813   15,108 20%       1346   16,454 18%
  HealthNow/BCBS-WNY/Community Blue   12,159   1,111   13,270 18%       983   14,253 15%
  Independent Health Assoc/IHA   19,150   1,494   20,644 27%       1565   22,209 24%
  Total Full Risk   53,510   3,990   57,500 76%       4,230   61,730 67%
  PCMP II (Partial)   104   36   140 0%       267   407 0%
  PCMP III (Partial)   5   21   26 0%       284   310 0%
  PCMP II-A Special Care (Partial)   574   1,104   1,678 2%       2738   4,416 5%
  Total Partial Risk   683   1,161   1,844 2%       3,289   5,133 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: 5,207 970 372 61 5,579 1,031 18% 92% 20% 1,080 41 6,659 1,072 16%
Voluntary CDPHP   970   61   1,031 18%       41   1,072 16%
Genesee TOTALS: 3,347 1,862 185 138 3,532 2,000 57% 89% 63% 617 118 4,149 2,118 51%
Voluntary HealthNow/BCBS-WNY/Community Blue   611   56   667 19%       14   681 16%
  Preferred Care   1,251   82   1,333 38%       104   1,437 35%
Greene TOTALS: 3,080 2,594 257 167 3,337 2,761 83% 93% 89% 669 242 4,006 3,003 75%
Mandatory CDPHP   1,737   124   1,861 56%       176   2,037 51%
  Fidelis/NYS Catholic Hlth   298   19   317 9%       15   332 8%
  Wellcare   559   24   583 17%       51   634 16%
Hamilton Voluntary TOTALS: 211 0 14 0 225 0 0% 91% 0% 47 0 272 0 0%
Herkimer TOTALS: 4,918 2,062 314 143 5,232 2,205 42% 92% 46% 898 63 6,130 2,268 37%
Mandatory Excellus   399   31   430 8%       11   441 7%
  Fidelis/NYS Catholic Hlth   962   75   1,037 20%       38   1,075 18%
  United Healthcare of Upstate   701   37   738 14%       14   752 12%
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 2,797 346 192 3,921 2,989 76% 92% 83% 675 189 4,596 3,178 69%
Mandatory Excellus   1,932   120   2,052 52%       93   2,145 47%
  Preferred Care   865   72   937 24%       96   1,033 22%
Madison Voluntary TOTALS: 3,969 0 220 0 4,189 0 0% 91% 0% 769 0 4,958 0 0%
Monroe TOTALS: 54,874 41,163 8,702 3,902 63,576 45,065 71% 91% 78% 12,472 2,995 76,048 48,060 63%
Mandatory Excellus   31,017   2,998   34,015 54%       2368   36,383 48%
  Preferred Care   10,146   904   11,050 17%       627   11,677 15%
Montgomery TOTALS: 4,274 916 386 39 4,660 955 20% 92% 22% 816 74 5,476 1,029 19%
Voluntary CDPHP   916   39   955 20%       74   1,029 19%
Nassau TOTALS: 34,739 26,671 3,380 1,735 38,119 28,406 75% 92% 81% 10,221 1,531 48,340 29,937 62%
Mandatory Affinity Health Plan   5,500   206   5,706 15%       246   5,952 12%
  Fidelis/NYS Catholic Hlth   4,000   230   4,230 11%       176   4,406 9%
  HealthFirst PHSP   6,765   314   7,079 19%       279   7,358 15%
  HIP   5,147   568   5,715 15%       508   6,223 13%
  United Healthcare of NY   2,824   292   3,116 8%       172   3,288 7%
  Vytra   2,435   125   2,560 7%       150   2,710 6%
Niagara TOTALS: 13,849 12,326 1,559 1,049 15,408 13,375 87% 93% 93% 3,394 1,633 18,802 15,008 80%
Mandatory Fidelis/NYS Catholic Hlth   2,232   217   2,449 16%       327   2,776 15%
  HealthNow/BCBS-WNY/Community Blue   4,582   381   4,963 32%       449   5,412 29%
  Independent Health Assoc/IHA   5,512   451   5,963 39%       857   6,820 36%
Oneida TOTALS: 18,945 15,341 1,652 1,198 20,597 16,539 80% 92% 87% 5,309 1,543 25,906 18,082 70%
Mandatory Excellus   1,791   190   1,981 10%       68   2,049 8%
  Fidelis/NYS Catholic Hlth   8,493   698   9,191 45%       1118   10,309 40%
  United Healthcare of Upstate   5,057   310   5,367 26%       357   5,724 22%
Onondaga TOTALS: 33,876 26,486 3,883 2,116 37,759 28,602 76% 89% 85% 7,987 2,324 45,746 30,926 68%
Mandatory Excellus   2,390   228   2,618 7%       95   2,713 6%
  Fidelis/NYS Catholic Hlth   5,811   474   6,285 17%       578   6,863 15%
  Total Care/Syracuse PHSP   10,163   848   11,011 29%       1058   12,069 26%
  United Healthcare of Upstate   8,122   566   8,688 23%       593   9,281 25%
Ontario TOTALS: 4,735 3,955 426 218 5,161 4,173 81% 91% 88% 1,142 392 6,303 4,565 72%
Mandatory Excellus   3,206   175   3,381 66%       328   3,709 59%
  Preferred Care   749   43   792 15%       64   856 14%
Orange TOTALS: 27,083 8,053 2,122 451 29,205 8,504 29% 91% 32% 4,243 744 33,448 9,248 28%
Voluntary Affinity Health Plan   5,658   265   5,923 20%       612   6,535 20%
  Wellcare   1,476   80   1,556 5%       91   1,647 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   919   106   1,025 4%       41   1,066 3%
Orleans TOTALS: 3,439 1,737 329 116 3,768 1,853 49% 92% 53% 591 109 4,359 1,962 45%
Voluntary Excellus   623   45   668 18%       55   723 17%
  Fidelis/NYS Catholic Hlth   709   41   750 20%       42   792 18%
  HealthNow/BCBS-WNY/Community Blue   405   30   435 12%       12   447 10%
Oswego TOTALS: 11,117 9,413 803 605 11,920 10,018 84% 92% 91% 1,926 638 13,846 10,656 77%
Mandatory Excellus   168   32   200 2%       5   205 1%
  Fidelis/NYS Catholic Hlth   1,867   133   2,000 17%       112   2,112 15%
  Total Care/Syracuse PHSP   3,218   242   3,460 29%       268   3,728 27%
  United Healthcare of Upstate   4,160   198   4,358 37%       253   4,611 33%
Otsego TOTALS: 3,346 13 204 0 3,550 13 0% 91% 0% 849 0 4,399 13 0%
Voluntary Wellcare   13   0   13 0%       0   13 0%
Putnam TOTALS: 1,113 169 132 7 1,245 176 14% 88% 16% 563 31 1,808 207 11%
Voluntary Care Plus Health Plan   169   7   176 14%       31   207 11%
Rensselaer TOTALS: 9,173 7,908 961 705 10,134 8,613 85% 92% 92% 2,159 472 12,293 9,085 74%
Mandatory CDPHP   6,514   577   7,091 70%       404   7,495 61%
  Fidelis/NYS Catholic Hlth   692   33   725 7%       47   772 6%
  HealthNow/BlueShield of NENY   453   77   530 5%       9   539 4%
  Wellcare   249   18   267 3%       12   279 2%
Rockland TOTALS: 24,094 22,027 1,302 809 25,396 22,836 90% 92% 98% 2,645 586 28,041 23,422 84%
Mandatory Affinity Health Plan   1,681   115   1,796 7%       119   1,915 7%
  Community Choice Hlth Plan   109   13   122 0%       11   133 0%
  Fidelis/NYS Catholic Hlth   15,062   351   15,413 61%       254   15,667 56%
  Wellcare   2,020   106   2,126 8%       54   2,180 8%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,155   224   3,379 13%       148   3,527 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 5,358 429 305 7,166 5,663 79% 92% 86% 1,889 260 9,055 5,923 65%
Mandatory CDPHP   4,590   235   4,825 67%       230   5,055 56%
  Fidelis/NYS Catholic Hlth   676   54   730 10%       28   758 8%
  HealthNow/BlueShield of NENY   42   11   53 1%       1   54 1%
  Wellcare   50   5   55 1%       1   56 1%
Schenectady TOTALS: 10,345 6,353 939 334 11,284 6,687 59% 90% 66% 2,599 734 13,883 7,421 53%
Voluntary CDPHP   5,572   286   5,858 52%       674   6,532 47%
  Fidelis/NYS Catholic Hlth   781   48   829 7%       60   889 6%
Schoharie TOTALS: 2,039 65 147 6 2,186 71 3% 92% 4% 381 5 2,567 76 3%
Voluntary CDPHP   65   6   71 3%       5   76 3%
Schuyler TOTALS: 1,423 50 116 4 1,539 54 4% 92% 4% 310 0 1,849 54 3%
Voluntary Southern Tier Priority (Partial)   50   4   54 4%       0   54 3%
Seneca TOTALS: 2,122 1,446 144 58 2,266 1,504 66% 92% 72% 463 181 2,729 1,685 62%
Voluntary Excellus   1,446   58   1,504 66%       181   1,685 62%
Steuben TOTALS: 8,070 2,152 769 213 8,839 2,365 27% 91% 29% 2,070 625 10,909 2,990 27%
Voluntary Southern Tier Pediatrics (Partial)   110   0   110 1%       14   124 1%
  Southern Tier Priority (Partial)   2,042   213   2,255 26%       611   2,866 26%
Suffolk TOTALS: 53,946 44,707 5,076 3,194 59,022 47,901 81% 91% 89% 13,448 2,903 72,470 50,804 70%
Mandatory Affinity Health Plan   5,101   265   5,366 9%       179   5,545 8%
  Fidelis/NYS Catholic Hlth   4,331   287   4,618 8%       153   4,771 7%
  HealthFirst PHSP   6,831   362   7,193 12%       545   7,738 11%
  HIP   5,684   841   6,525 11%       310   6,835 9%
  Suffolk Plan HMO   10,972   691   11,663 20%       1171   12,834 18%
  United Healthcare of NY   7,983   481   8,464 14%       234   8,698 12%
  Vytra   3,805   267   4,072 7%       311   4,383 6%
Sullivan TOTALS: 6,184 2,492 309 58 6,493 2,550 39% 91% 43% 1,493 151 7,986 2,701 34%
Voluntary Wellcare   328   3   331 5%       39   370 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,164   55   2,219 34%       112   2,331 29%
Tioga TOTALS: 3,130 78 218 5 3,348 83 2% 92% 3% 731 1 4,079 84 2%
Voluntary CDPHP   78   5   83 2%       1   84 2%
Tompkins TOTALS: 4,653 266 516 30 5,169 296 6% 90% 6% 1,005 21 6,174 317 5%
Voluntary Total Care/Syracuse PHSP   266   30   296 6%       21   317 5%
Ulster TOTALS: 9,395 2,316 852 86 10,247 2,402 23% 91% 26% 2,587 197 12,834 2,599 20%
Voluntary Wellcare   2,316   86   2,402 23%       197   2,599 20%
Warren TOTALS: 3,312 2,098 216 24 3,528 2,122 60% 92% 66% 922 76 4,450 2,198 49%
Voluntary HealthNow/BlueShield of NENY   2,098   24   2,122 60%       76   2,198 49%
Washington TOTALS: 3,942 1,651 213 44 4,155 1,695 41% 91% 45% 949 132 5,104 1,827 36%
Voluntary CDPHP   576   6   582 14%       29   611 12%
  Fidelis/NYS Catholic Hlth   6   0   6 0%       0   6 0%
  HealthNow/BlueShield of NENY   1,069   38   1,107 27%       103   1,210 24%
Wayne TOTALS: 4,943 4,166 292 200 5,235 4,366 83% 92% 91% 1,201 339 6,436 4,705 73%
Mandatory Excellus   1,881   101   1,982 38%       140   2,122 33%
  Preferred Care   2,285   99   2,384 46%       199   2,583 40%
Westchester TOTALS: 49,427 33,468 6,706 2,770 56,133 36,238 65% 89% 73% 10,325 2,511 66,458 38,749 58%
Mandatory Affinity Health Plan   5,073   411   5,484 10%       432   5,916 9%
  Community Choice Hlth Plan   5,701   502   6,203 11%       439   6,642 10%
  Fidelis/NYS Catholic Hlth   2,971   358   3,329 6%       219   3,548 5%
  HIP   2,499   445   2,944 5%       319   3,263 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   17,224   1,054   18,278 33%       1102   19,380 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 1,179 96 54 1,809 1,233 68% 93% 73% 288 91 2,097 1,324 63%
Voluntary Excellus   1,179   54   1,233 68%       91   1,324 63%
Upstate Total   631,165 397,855 64,497 30,186 695,662 427,251 61% 91% 68% 147,644 34,660 843,306 462,701 55%
NYC ABC Health Plan   7,138   1,379   8,517 1%       176   8,693 0%
Mandatory Affinity Health Plan   71,774   13,498   85,272 5%       2,897   88,169 5%
  AmeriChoice of New York/MHS   63,446   18,372   81,818 5%       3,185   85,003 5%
  Care Plus Health Plan   52,110   7,905   60,015 4%       1,056   61,071 3%
  Community Choice Hlth Plan   3,344   618   3,962 0%       72   4,034 0%
  Community Premier Plus   32,529   5,662   38,191 2%       1,110   39,301 2%
  Fidelis/NYS Catholic Hlth   61,913   10,945   72,858 5%       1,980   74,838 4%
  Fidelis Care HealthierLife SN                            
  HealthFirst PHSP   103,504   19,286   122,790 8%       4,903   127,693 7%
  HealthFirst PHSP SN   5   3   8 0%       1   9 0%
  Health Plus PHSP   119,064   22,576   141,640 9%       2,474   144,114 8%
  HIP   112,667   36,993   149,660 9%       7,148   156,808 8%
  Manhattan PHSP/Center Care   53,999   10,233   64,232 4%       1,768 66,000 4%
  MetroPlus Health Plan   106,411   20,736   127,147 8%       4,378   131,525 7%
  MetroPlus Health Plan SN   9   6   15 0%       16   31 0%
  Neighborhood Health Providers   58,956   8,107   67,063 4%       1,829   68,892 4%
  NY Hospital Community PHSP   28,155   6,963   35,118 2%       840   35,958 2%
  NYPS Select Health SN                            
  St Barnabas/Partners in Health   17,702   3,069   20,771 1%       1,098   21,869 1%
  United Healthcare of NY   19,022   7,644   26,666 2%       728   27,394 1%
  VidaCare Inc. SN   0   0   0 0%       1   1 0%
  Wellcare   18,061   4,074   22,135 1%       452   22,587 1%
NYC Total 1,232,048 929,809 365,179 198,069 1,597,227 1,127,878 71% 90% 78% 251,856 36,112 1,849,083 1,163,990 63%
                               
  UPSTATE TOTALS: 631,165 397,855 64,497 30,186 695,662 427,251 61% 91% 68% 147,644 34,660 843,306 462,701 55%
  NEW YORK CITY TOTALS: 1,232,048 929,809 365,179 198,069 1,597,227 1,127,878 71% 90% 78% 251,856 36,112 1,849,083 1,163,990 63%
  GRAND TOTALS 1,863,213 1,327,664 429,676 228,255 2,292,889 1,555,129 68% 91% 75% 399,500 70,772 2,692,389 1,626,691 60%
NYC Boroughs Bronx 305,681 240,218 83,283 42,314 388,964 282,531 73%     64,760 9,581 453,724 292,112 64%
  Brooklyn 456,460 346,432 140,056 83,380 596,516 429,812 72%     86,314 13,181 682,830 442,993 65%
  Manhattan 175,007 115,165 69,160 27,877 244,167 143,043 59%     48,437 5,501 292,604 148,544 51%
  Queens 261,844 201,395 64,935 39,503 326,779 240,898 74%     44,510 6,127 371,289 247,025 67%
  Staten Island 33,056 26,599 7,745 4,995 40,801 31,594 77%     7,835 1,722 48,636 33,316 69%
  Borough Total 1,232,048 929,809 365,179 198,069 1,597,227 1,127,878 71% 90% 78% 251,856 36,112 1,849,083 1,163,990 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 - HealthFirst PHSP SN, MetroPlus Health Plan SN, VidaCare Inc. SN Washington County - Fidelis/ NYS Catholic Health

MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS July, 2003

PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 420
  Total 420
CO-OP CARE PLAN NYC 526
  Total 526
COMPREHENSIVE CARE MGT NYC 983
  WESTCHESTER 105
  Total 1,088
EDDY SENIORCARE SCHENECTADY 88
  Total 88
ELANT CHOICE ORANGE 74
  Total 74
GUILDNET NYC 1,724
  Total 1,724
HOMEFIRST NYC 973
  Total 973
INDEP CARE SYSTEMS INC NYC 503
  Total 503
INDEP LIVING FOR SENIORS MONROE 300
  Total 300
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 223
  Total 223
PARTNERS IN COMMUNITY CARE ORANGE 101
  ROCKLAND 25
  Total 126
SENIOR HEALTH PARTNERS INC NYC 125
  Total 125
SENIOR NETWORK HEALTH HERKIMER 8
  ONEIDA 272
  Total 280
TOTAL AGING IN PLACE ERIE 29
  Total 29
VNS CHOICE NYC 2,963
  Total 2,963
     
  UPSTATE TOTALS: 1,645
  NEW YORK CITY TOTALS: 7,797
  GRAND TOTALS: 9,442

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