Managed Care

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

NYS June 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 13,955 1,972 1,068 18,199 15,023 83% 92% 90% 4,340 893 22,539 15,916 71%
  CDPHP   11,596   850   12,446 68%       780   13,226 59%
  Fidelis/NYS Catholic Hlth   1,365   153   1,518 8%       74   1,592 7%
  Wellcare   994   65   1,059 6%       39   1,098 5%
Allegany TOTALS: 3,491 1,115 300 88 3,791 400 11% 90% 12% 981 200 4,772 1,403 29%
  Health Choice (Partial)   362   38   400 11%       165   565 12%
  HealthNow/BCBS-WNY/Community Blue   753   50   803 21%       35   838 18%
Broome TOTALS: 12,725 11,325 1,339 923 14,064 12,248 87% 90% 96% 3,543 968 17,607 13,216 75%
  Broome MC   5,067   331   5,398 38%       707   6,105 35%
  CDPHP   5,864   558   6,422 46%       236   6,658 38%
  Fidelis/NYS Catholic Hlth   394   34   428 3%       25   453 3%
Cattauragus TOTALS: 5,930 4,845 387 285 6,317 5,130 81% 91% 89% 1,527 630 7,844 5,760 73%
  Fidelis/NYS Catholic Hlth   1,071   70   1,141 18%       77   1,218 16%
  HealthNow/BCBS-WNY/Community Blue   3,774   215   3,989 63%       553   4,542 58%
Cayuga TOTALS: 5,076 0 340 0 5,416 0 0% 89% 0% 1,151 0 6,567 0 0%
Chautauqua TOTALS: 11,916 9,534 1,490 1,063 13,406 10,597 79% 85% 93% 2,644 1,145 16,050 11,742 73%
  Fidelis/NYS Catholic Hlth   5,564   629   6,193 46%       553   6,746 42%
  HealthNow/BCBS-WNY/Community Blue   3,375   331   3,706 28%       359   4,065 25%
  Primary Health   595   103   698 5%       233   931 6%
Chemung TOTALS: 7,891 4,010 632 227 8,523 4,237 50% 89% 56% 1,934 961 10,457 5,198 50%
  Southern Tier Pediatrics (Partial)   2,786   0   2,786 33%       275   3,061 29%
  Southern Tier Priority (Partial)   1,224   227   1,451 17%       686   2,137 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 2,525 229 178 3,162 2,703 85% 93% 91% 847 223 4,009 2,926 73%
  CDPHP   1,986   137   2,123 67%       184   2,307 58%
  Fidelis/NYS Catholic Hlth   183   17   200 6%       8   208 5%
  Wellcare   356   24   380 12%       31   411 10%
Cortland TOTALS: 3,863 396 267 17 4,130 413 10% 91% 11% 773 82 4,903 495 10%
  Fidelis/NYS Catholic Hlth   396   17   413 10%       82   495 10%
Delaware TOTALS: 2,659 116 190 6 2,849 122 4% 92% 5% 763 3 3,612 125 3%
  Wellcare   116   6   122 4%       3   125 3%
Dutchess TOTALS: 8,829 1,858 766 80 9,595 1,938 20% 90% 22% 2,703 120 12,298 2,058 17%
  Wellcare   1,858   80   1,938 20%       120   2,058 17%
Erie TOTALS: 64,352 53,718 8,709 5,046 73,061 58,764 80% 93% 87% 17,099 7,521 90,160 66,285 74%
  Buffalo Community Health   7,719   549   8,268 11%       338   8,606 10%
  Fidelis/NYS Catholic Hlth   14,411   827   15,238 21%       1339   16,577 18%
  HealthNow/BCBS-WNY/Community Blue   11,898   1,064   12,962 18%       974   13,936 15%
  Independent Health Assoc/IHA   18,995   1,472   20,467 28%       1566   22,033 24%
  Total Full Risk   53,023   3,912   56,935 78%       4,217   61,152 68%
  PCMP II (Partial)   109   36   145 0%       268   413 0%
  PCMP III (Partial)   6   22   28 0%       288   316 0%
  PCMP II-A Special Care (Partial)   580   1,076   1,656 2%       2748   4,404 5%
  Total Partial Risk   695   1,134   1,829 3%       3,304   5,133 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: 4,750 975 309 62 5,059 1,037 20% 92% 22% 1,066 40 6,125 1,077 18%
  CDPHP   975   62   1,037 20%       40   1,077 18%
Genesee TOTALS: 3,099 1,778 142 131 3,241 1,909 59% 89% 66% 628 120 3,869 2,029 52%
  HealthNow/BCBS-WNY/Community Blue   551   49   600 19%       13   613 16%
  Preferred Care   1,227   82   1,309 40%       107   1,416 37%
Greene TOTALS: 2,859 2,578 245 167 3,104 2,745 88% 93% 95% 673 240 3,777 2,985 79%
  CDPHP   1,719   123   1,842 59%       177   2,019 53%
  Fidelis/NYS Catholic Hlth   288   19   307 10%       15   322 9%
  Wellcare   571   25   596 19%       48   644 17%
Hamilton TOTALS: 160 0 12 0 172 0 0% 91% 0% 48 0 220 0 0%
Herkimer TOTALS: 4,511 1,820 276 128 4,787 1,948 41% 92% 44% 892 62 5,679 2,010 35%
  Excellus   226   14   240 5%       8   248 4%
  Fidelis/NYS Catholic Hlth   885   71   956 20%       38   994 18%
  United Healthcare of Upstate   709   43   752 16%       16   768 14%
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 2,789 299 186 3,565 2,975 83% 92% 91% 680 195 4,245 3,170 75%
  Excellus   1,900   121   2,021 57%       98   2,119 50%
  Preferred Care   889   65   954 27%       97   1,051 25%
Madison TOTALS: 3,591 0 208 0 3,799 0 0% 91% 0% 764 0 4,563 0 0%
Monroe TOTALS: 52,867 41,830 8,524 3,992 61,391 45,822 75% 91% 82% 12,323 3,066 73,714 48,888 66%
  Excellus   31,404   3,063   34,467 56%       2425   36,892 50%
  Preferred Care   10,426   929   11,355 18%       641   11,996 16%
Montgomery TOTALS: 4,148 905 377 36 4,525 941 21% 92% 23% 809 71 5,334 1,012 19%
  CDPHP   905   36   941 21%       71   1,012 19%
Nassau TOTALS: 32,952 26,483 3,304 1,724 36,256 28,207 78% 92% 84% 10,201 1,552 46,457 29,759 64%
  Affinity Health Plan   5,493   206   5,699 16%       242   5,941 13%
  Fidelis/NYS Catholic Hlth   3,965   239   4,204 12%       186   4,390 9%
  HealthFirst PHSP   6,634   329   6,963 19%       292   7,255 16%
  HIP   5,136   544   5,680 16%       510   6,190 13%
  United Healthcare of NY   2,789   293   3,082 9%       170   3,252 7%
  Vytra   2,466   113   2,579 7%       152   2,731 6%
Niagara TOTALS: 12,903 12,156 1,502 1,025 14,405 13,181 92% 93% 99% 3,343 1,651 17,748 14,832 84%
  Fidelis/NYS Catholic Hlth   2,176   223   2,399 17%       327   2,726 15%
  HealthNow/BCBS-WNY/Community Blue   4,495   362   4,857 34%       453   5,310 30%
  Independent Health Assoc/IHA   5,485   440   5,925 41%       871   6,796 38%
Oneida TOTALS: 18,057 15,422 1,718 1,181 19,775 16,603 84% 92% 91% 5,240 1,543 25,015 18,146 73%
  Excellus   1,724   177   1,901 10%       66   1,967 8%
  Fidelis/NYS Catholic Hlth   8,505   691   9,196 47%       1112   10,308 41%
  United Healthcare of Upstate   5,193   313   5,506 28%       365   5,871 23%
Onondaga TOTALS: 32,370 26,521 3,479 2,094 35,849 28,615 80% 89% 90% 7,974 2,327 43,823 30,942 71%
  Excellus   2,395   222   2,617 7%       88   2,705 6%
  Fidelis/NYS Catholic Hlth   5,814   471   6,285 18%       579   6,864 16%
  Total Care/Syracuse PHSP   10,193   843   11,036 31%       1064   12,100 28%
  United Healthcare of Upstate   8,119   558   8,677 24%       596   9,273 26%
Ontario TOTALS: 4,343 3,952 343 228 4,686 4,180 89% 91% 98% 1,155 392 5,841 4,572 78%
  Excellus   3,193   181   3,374 72%       328   3,702 63%
  Preferred Care   759   47   806 17%       64   870 15%
Orange TOTALS: 24,841 7,802 2,527 430 27,368 8,232 30% 91% 33% 4,235 744 31,603 8,976 28%
  Affinity Health Plan   5,485   249   5,734 21%       615   6,349 20%
  Wellcare   1,487   80   1,567 6%       93   1,660 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   830   101   931 3%       36   967 3%
Orleans TOTALS: 3,314 1,656 280 113 3,594 1,769 49% 92% 54% 596 96 4,190 1,865 45%
  Excellus   617   44   661 18%       52   713 17%
  Fidelis/NYS Catholic Hlth   634   35   669 19%       31   700 17%
  HealthNow/BCBS-WNY/Community Blue   405   34   439 12%       13   452 11%
Oswego TOTALS: 10,206 9,340 697 602 10,903 9,942 91% 92% 99% 1,919 639 12,822 10,581 83%
  Excellus   159   32   191 2%       3   194 2%
  Fidelis/NYS Catholic Hlth   1,859   132   1,991 18%       112   2,103 16%
  Total Care/Syracuse PHSP   3,175   247   3,422 31%       271   3,693 29%
  United Healthcare of Upstate   4,147   191   4,338 40%       253   4,591 36%
Otsego TOTALS: 3,061 13 188 0 3,249 13 0% 91% 0% 843 1 4,092 14 0%
  Wellcare   13   0   13 0%       1   14 0%
Putnam TOTALS: 1,027 178 136 10 1,163 188 16% 88% 18% 549 32 1,712 220 13%
  Care Plus Health Plan   178   10   188 16%       32   220 13%
Rensselaer TOTALS: 8,655 7,845 902 676 9,557 8,521 89% 92% 97% 2,182 477 11,739 8,998 77%
  CDPHP   6,519   554   7,073 74%       411   7,484 64%
  Fidelis/NYS Catholic Hlth   691   34   725 8%       45   770 7%
  HealthNow/BlueShield of NENY   397   70   467 5%       6   473 4%
  Wellcare   238   18   256 3%       15   271 2%
Rockland TOTALS: 22,114 21,912 1,283 794 23,397 22,706 97% 92% 105% 2,660 587 26,057 23,293 89%
  Affinity Health Plan   1,647   111   1,758 8%       119   1,877 7%
  Community Choice Hlth Plan   111   14   125 1%       14   139 1%
  Fidelis/NYS Catholic Hlth   14,950   354   15,304 65%       256   15,560 60%
  Wellcare   2,061   101   2,162 9%       57   2,219 9%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,143   214   3,357 14%       141   3,498 13%
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 5,205 381 289 6,294 5,494 87% 92% 95% 1,876 259 8,170 5,753 70%
  CDPHP   4,467   232   4,699 75%       229   4,928 60%
  Fidelis/NYS Catholic Hlth   670   48   718 11%       28   746 9%
  HealthNow/BlueShield of NENY   15   4   19 0%       1   20 0%
  Wellcare   53   5   58 1%       1   59 1%
Schenectady TOTALS: 9,307 6,787 834 378 10,141 7,165 71% 90% 79% 2,526 758 12,667 7,923 63%
  CDPHP   6,023   330   6,353 63%       696   7,049 56%
  Fidelis/NYS Catholic Hlth   764   48   812 8%       62   874 7%
Schoharie TOTALS: 1,975 69 118 6 2,093 75 4% 92% 4% 385 5 2,478 80 3%
  CDPHP   69   6   75 4%       5   80 3%
Schuyler TOTALS: 1,259 48 111 2 1,370 50 4% 92% 4% 318 0 1,688 50 3%
  Southern Tier Priority (Partial)   48   2   50 4%       0   50 3%
Seneca TOTALS: 1,901 1,423 124 58 2,025 1,481 73% 92% 79% 452 181 2,477 1,662 67%
  Excellus   1,423   58   1,481 73%       181   1,662 67%
Steuben TOTALS: 7,438 2,143 598 212 8,036 2,355 29% 91% 32% 2,046 624 10,082 2,979 30%
  Southern Tier Pediatrics (Partial)   108   0   108 1%       13   121 1%
  Southern Tier Priority (Partial)   2,035   212   2,247 28%       611   2,858 28%
Suffolk TOTALS: 46,833 43,778 4,332 3,078 51,165 46,856 92% 91% 100% 13,291 2,923 64,456 49,779 77%
  Affinity Health Plan   4,992   261   5,253 10%       185   5,438 8%
  Fidelis/NYS Catholic Hlth   4,214   288   4,502 9%       148   4,650 7%
  HealthFirst PHSP   6,695   350   7,045 14%       547   7,592 12%
  HIP   5,649   817   6,466 13%       311   6,777 11%
  Suffolk Plan HMO   10,849   670   11,519 23%       1185   12,704 20%
  United Healthcare of NY   7,799   468   8,267 16%       238   8,505 13%
  Vytra   3,580   224   3,804 7%       309   4,113 6%
Sullivan TOTALS: 5,386 2,501 267 56 5,653 2,557 45% 91% 50% 1,485 143 7,138 2,700 38%
  Wellcare   348   3   351 6%       42   393 6%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,153   53   2,206 39%       101   2,307 32%
Tioga TOTALS: 2,846 76 187 5 3,033 81 3% 92% 3% 743 1 3,776 82 2%
  CDPHP   76   5   81 3%       1   82 2%
Tompkins TOTALS: 4,376 230 495 29 4,871 259 5% 90% 6% 999 18 5,870 277 5%
  Total Care/Syracuse PHSP   230   29   259 5%       18   277 5%
Ulster TOTALS: 9,085 2,324 799 91 9,884 2,415 24% 91% 27% 2,581 192 12,465 2,607 21%
  Wellcare   2,324   91   2,415 24%       192   2,607 21%
Warren TOTALS: 2,960 2,090 171 26 3,131 2,116 68% 92% 74% 897 77 4,028 2,193 54%
  HealthNow/BlueShield of NENY   2,090   26   2,116 68%       77   2,193 54%
Washington TOTALS: 3,647 1,615 193 46 3,840 1,661 43% 91% 48% 944 128 4,784 1,789 37%
  CDPHP   565   9   574 15%       28   602 13%
  HealthNow/BlueShield of NENY   1,050   37   1,087 28%       100   1,187 25%
Wayne TOTALS: 4,442 4,145 235 196 4,677 4,341 93% 92% 101% 1,162 336 5,839 4,677 80%
  Excellus   1,823   99   1,922 41%       134   2,056 35%
  Preferred Care   2,322   97   2,419 52%       202   2,621 45%
Westchester TOTALS: 48,076 34,002 6,489 2,815 54,565 36,817 67% 89% 76% 10,199 2,526 64,764 39,343 61%
  Affinity Health Plan   5,229   432   5,661 10%       435   6,096 9%
  Community Choice Hlth Plan   5,721   527   6,248 11%       448   6,696 10%
  Fidelis/NYS Catholic Hlth   3,017   333   3,350 6%       218   3,568 6%
  HIP   2,626   455   3,081 6%       320   3,401 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   17,409   1,068   18,477 34%       1105   19,582 30%
Wyoming TOTALS: 1,831 0 111 0 1,942 0 0% 91% 0% 413 0 2,355 0 0%
Yates TOTALS: 1,534 1,214 92 58 1,626 1,272 78% 93% 84% 290 89 1,916 1,361 71%
  Excellus   1,214   58   1,272 78%       89   1,361 71%
Upstate Total   591,221 397,002 61,229 29,905 652,450 426,104 65% 91% 72% 146,581 34,841 799,031 461,748 58%
NYC ABC Health Plan   7,201   1,387   8,588 1%       185   8,773 1%
  Affinity Health Plan   72,134   13,239   85,373 6%       2,952   88,325 5%
  AmeriChoice of New York/MHS   63,184   18,150   81,334 6%       3,233   84,567 5%
  Care Plus Health Plan   52,417   7,714   60,131 4%       1,059   61,190 4%
  Community Choice Hlth Plan   3,361   610   3,971 0%       74   4,045 0%
  Community Premier Plus   30,844   5,139   35,983 3%       1,105   37,088 2%
  Fidelis/NYS Catholic Hlth   61,844   10,759   72,603 5%       2,021   74,624 5%
  HealthFirst PHSP   101,891   18,807   120,698 9%       4,996   125,694 8%
  Health Plus PHSP   117,221   22,154   139,375 10%       2,519   141,894 9%
  HIP   112,596   36,509   149,105 11%       7,260   156,365 9%
  Manhattan PHSP/Center Care   54,250   10,166   64,416 5%       1,827 66,243 4%
  MetroPlus Health Plan   104,732   20,290   125,022 9%       4,445   129,467 8%
  Neighborhood Health Providers   59,287   7,918   67,205 5%       1,842   69,047 4%
  NY Hospital Community PHSP   27,668   6,712   34,380 2%       866   35,246 2%
  St Barnabas/Partners in Health   17,966   3,093   21,059 2%       1,131   22,190 1%
  United Healthcare of NY   18,589   7,406   25,995 2%       746   26,741 2%
  Wellcare   17,861   3,925   21,786 2%       435   22,221 1%
  NYC Total 1,103,464 923,046 299,166 193,978 1,402,630 1,117,024 80% 90% 88% 250,782 36,696 1,653,412 1,153,720 70%
                               
  UPSTATE TOTALS: 591,221 397,002 61,229 29,905 652,450 426,104 65% 91% 72% 146,581 34,841 799,031 461,748 58%
  NEW YORK CITY TOTALS: 1,103,464 923,046 299,166 193,978 1,402,630 1,117,024 80% 90% 88% 250,782 36,696 1,653,412 1,153,720 70%
  GRAND TOTALS 1,694,685 1,320,048 360,395 223,883 2,055,080 1,543,128 75% 91% 83% 397,363 71,537 2,452,443 1,615,468 66%
NYC Boroughs Bronx 282,570 241,107 71,506 41,984 354,076 283,092 80%     64,106 9,762 418,182 292,853 70%
  Brooklyn 407,895 344,299 114,963 82,275 522,858 426,574 82%     86,635 13,383 609,493 439,956 72%
  Manhattan 160,665 110,468 57,598 26,250 218,263 136,717 63%     48,326 5,569 266,589 142,287 53%
  Queens 223,604 200,271 48,807 38,448 272,411 238,719 88%     43,984 6,245 316,395 244,964 77%
  Staten Island 28,730 26,901 6,292 5,022 35,022 31,923 91%     7,731 1,737 42,753 33,660 79%
  Borough Total 1,103,464 923,046 299,166 193,978 1,402,630 1,117,024 80% 90% 88% 250,782 36,696 1,653,412 1,153,720 70%

NOTES:

  1. The Managed Care eligible counts are based upon July, 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: Excellus - None

MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS June, 2003

PROVIDER COUNTY TOTAL ENROLLMENT
Broadlawn Health Partners Nassau 414
  Total 414
Co-Op Care Plan Nyc 528
  Total 528
Comprehensive Care Mgt Nyc 975
  Westchester 105
  Total 1,080
Eddy Seniorcare Schenectady 85
  Total 85
Elant Choice Orange 69
  Total 69
Guildnet Nyc 1,693
  Total 1,693
Homefirst Nyc 929
  Total 929
Indep Care Systems Inc Nyc 497
  Total 497
Indep Living For Seniors Monroe 304
  Total 304
Loretto/Independent Living Services Onondaga 233
  Total 233
Partners In Community Care Orange 106
  Rockland 24
  Total 130
Senior Health Partners Inc Nyc 121
  Total 121
Senior Network Health Herkimer 5
  Oneida 266
  Total 271
Total Aging In Place Erie 18
  Total 18
Vns Choice Nyc 2,905
  Total 2,905
 
  Upstate Totals: 1,629
  New York City Totals: 7,648
  Grand Totals: 9,277

Note: The source of enrollment is based on the MEDS database.