Managed Care

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

NYS March 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 16,227 13,215 1,972 1,014 18,199 14,229 78% 92% 85% 4,340 868 22,539 15,097 67%
  CDPHP   11,012   845   11,857 65%       760   12,617 56%
  Fidelis/NYS Catholic Hlth   1,210   104   1,314 7%       66   1,380 6%
  Wellcare   993   65   1,058 6%       42   1,100 5%
Allegany 3,491 987 300 76 3,791 394 10% 90% 11% 981 200 4,772 1,263 26%
  Health Choice (Partial)   365   29   394 10%       168   562 12%
  HealthNow/BCBS-WNY/Community Blue   622   47   669 18%       32   701 15%
Broome 12,725 10,686 1,339 856 14,064 11,542 82% 90% 91% 3,543 952 17,607 12,494 71%
  Broome MC   5,048   314   5,362 38%       710   6,072 34%
  Fidelis/NYS Catholic Hlth   411   39   450 3%       20   470 3%
  CDPHP   5,227   503   5,730 41%       222   5,952 34%
Cattauragus 5,930 4,598 387 261 6,317 4,859 77% 91% 84% 1,527 610 7,844 5,469 70%
  HealthNow/BCBS-WNY/Community Blue   3,571   201   3,772 60%       539   4,311 55%
  Fidelis/NYS Catholic Hlth   1,027   60   1,087 17%       71   1,158 15%
Cayuga 5,076 0 340 0 5,416 0 0% 89% 0% 1,151 0 6,567 0 0%
Chautauqua 11,916 9,053 1,490 957 13,406 10,010 75% 85% 88% 2,644 1,102 16,050 11,112 69%
  HealthNow/BCBS-WNY/Community Blue   3,051   278   3,329 25%       342   3,671 23%
  Primary Health   583   87   670 5%       226   896 6%
  Fidelis/NYS Catholic Hlth   5,419   592   6,011 45%       534   6,545 41%
Chemung 7,891 3,947 632 210 8,523 4,157 49% 89% 55% 1,934 962 10,457 5,119 49%
  Southern Tier Pediatrics (Partial)   2,725   0   2,725 32%       266   2,991 29%
  Southern Tier Priority (Partial)   1,222   210   1,432 17%       696   2,128 20%
Chenango 4,445 0 200 0 4,645 0 0% 92% 0% 988 0 5,633 0 0%
Clinton 5,479 0 414 0 5,893 0 0% 86% 0% 1,557 0 7,450 0 0%
Columbia 2,933 2,349 229 170 3,162 2,519 80% 93% 85% 847 208 4,009 2,727 68%
  CDPHP   1,858   136   1,994 63%       173   2,167 54%
  Wellcare   353   27   380 12%       26   406 10%
  Fidelis/NYS Catholic Hlth   138   7   145 5%       9   154 4%
Cortland 3,863 365 267 16 4,130 381 9% 91% 10% 773 84 4,903 465 9%
  Fidelis/NYS Catholic Hlth   365   16   381 9%       84   465 9%
Delaware 2,659 122 190 6 2,849 128 4% 92% 5% 763 3 3,612 131 4%
  Wellcare   122   6   128 4%       3   131 4%
Dutchess 8,829 1,571 766 55 9,595 1,626 17% 90% 19% 2,703 117 12,298 1,743 14%
  Wellcare   1,571   55   1,626 17%       117   1,743 14%
Erie 64,352 52,487 8,709 4,688 73,061 57,175 78% 93% 85% 17,099 7,356 90,160 64,531 72%
  Buffalo Community Health   7,451   472   7,923 11%       292   8,215 9%
  HealthNow/BCBS-WNY/Community Blue   11,094   946   12,040 16%       934   12,974 14%
  Independent Health Assoc/IHA   18,780   1,436   20,216 28%       1490   21,706 24%
  Fidelis/NYS Catholic Hlth   14,502   786   15,288 21%       1304   16,592 18%
    51,827   3,640   55,467 76%       4,020   59,487 66%
  PCMP II (Partial)   108   38   146 0%       280   426 0%
  PCMP III (Partial)   8   22   30 0%       301   331 0%
  PCMP II-A Special Care (Partial)   544   988   1,532 2%       2755   4,287 5%
    660   1,048   1,708 2%       3,336   5,044 6%
Essex 1,888 0 123 0 2,011 0 0% 92% 0% 589 0 2,600 0 0%
Franklin 3,244 0 249 0 3,493 0 0% 91% 0% 983 0 4,476 0 0%
Fulton 4,750 935 309 49 5,059 984 19% 92% 21% 1,066 42 6,125 1,026 17%
  CDPHP   935   49   984 19%       42   1,026 17%
Genesee 3,099 1,569 142 106 3,241 1,675 52% 89% 58% 628 102 3,869 1,777 46%
  HealthNow/BCBS-WNY/Community Blue   364   27   391 12%       6   397 10%
  Preferred Care   1,205   79   1,284 40%       96   1,380 36%
Greene 2,859 2,498 245 156 3,104 2,654 86% 93% 92% 673 218 3,777 2,872 76%
  CDPHP   1,639   107   1,746 56%       159   1,905 50%
  Wellcare   582   31   613 20%       48   661 18%
  Fidelis/NYS Catholic Hlth   277   18   295 10%       11   306 8%
Hamilton 160 0 12 0 172 0 0% 91% 0% 48 0 220 0 0%
Herkimer 4,511 1,457 276 109 4,787 1,566 33% 92% 36% 892 52 5,679 1,618 28%
  Fidelis/NYS Catholic Hlth   763   72   835 17%       38   873 15%
  United Healthcare of Upstate   694   37   731 15%       14   745 13%
Jefferson 7,942 0 584 0 8,526 0 0% 87% 0% 1,832 0 10,358 0 0%
Lewis 2,105 0 102 0 2,207 0 0% 93% 0% 421 0 2,628 0 0%
Livingston 3,266 2,555 299 171 3,565 2,726 76% 92% 84% 680 187 4,245 2,913 69%
  Excellus   1,686   122   1,808 51%       88   1,896 45%
  Preferred Care   869   49   918 26%       99   1,017 24%
Madison 3,591 0 208 0 3,799 0 0% 91% 0% 764 0 4,563 0 0%
Monroe 52,867 40,747 8,524 3,560 61,391 44,307 72% 91% 79% 12,323 3,144 73,714 47,451 64%
  Excellus   30,356   2,753   33,109 54%       2495   35,604 48%
  Preferred Care   10,391   807   11,198 18%       649   11,847 16%
Montgomery 4,148 916 377 38 4,525 954 21% 92% 23% 809 64 5,334 1,018 19%
  CDPHP   916   38   954 21%       64   1,018 19%
Nassau 32,952 24,369 3,304 1,588 36,256 25,957 72% 92% 77% 10,201 1,456 46,457 27,413 59%
  Vytra   2,411   99   2,510 7%       137   2,647 6%
  HIP   4,780   495   5,275 15%       475   5,750 12%
  HealthFirst PHSP   5,978   326   6,304 17%       292   6,596 14%
  Affinity Health Plan   5,103   190   5,293 15%       238   5,531 12%
  Fidelis/NYS Catholic Hlth   3,732   228   3,960 11%       171   4,131 9%
  United Healthcare of NY   2,365   250   2,615 7%       143   2,758 6%
Niagara 12,903 11,704 1,502 910 14,405 12,614 88% 93% 94% 3,343 1,587 17,748 14,201 80%
  Independent Health Assoc/IHA   5,428   429   5,857 41%       839   6,696 38%
  Fidelis/NYS Catholic Hlth   2,040   173   2,213 15%       314   2,527 14%
  HealthNow/BCBS-WNY/Community Blue   4,236   308   4,544 32%       434   4,978 28%
Oneida 18,057 15,097 1,718 1,119 19,775 16,216 82% 92% 89% 5,240 1,489 25,015 17,705 71%
  Fidelis/NYS Catholic Hlth   8,357   635   8,992 45%       1056   10,048 40%
  United Healthcare of Upstate   5,120   327   5,447 28%       376   5,823 23%
  Excellus   1,620   157   1,777 9%       57   1,834 7%
Onondaga 32,370 25,419 3,479 1,808 35,849 27,227 76% 89% 85% 7,974 2,371 43,823 29,598 68%
  Fidelis/NYS Catholic Hlth   5,567   387   5,954 17%       568   6,522 15%
  Total Care/Syracuse PHSP   9,896   721   10,617 30%       1091   11,708 27%
  United Healthcare of Upstate   7,702   521   8,223 23%       635   8,858 20%
  Excellus   2,254   179   2,433 7%       77   2,510 7%
Ontario 4,343 3,713 343 189 4,686 3,902 83% 91% 91% 1,155 391 5,841 4,293 73%
  Excellus   3,002   145   3,147 67%       328   3,475 59%
  Preferred Care   711   44   755 16%       63   818 14%
Orange 24,841 6,812 2,527 340 27,368 7,152 26% 91% 29% 4,235 712 31,603 7,864 25%
  Affinity Health Plan   4,884   224   5,108 19%       598   5,706 18%
  Wellcare   1,392   50   1,442 5%       91   1,533 5%
  Westchester PHSP   536   66   602 2%       23   625 2%
Orleans 3,314 1,418 280 92 3,594 1,510 42% 92% 46% 596 82 4,190 1,592 38%
  Excellus   555   43   598 17%       45   643 15%
  Fidelis/NYS Catholic Hlth   557   21   578 16%       25   603 14%
  HealthNow/BCBS-WNY/Community Blue   306   28   334 9%       12   346 8%
Oswego 10,206 8,759 697 529 10,903 9,288 85% 92% 92% 1,919 618 12,822 9,906 77%
  Fidelis/NYS Catholic Hlth   1,759   111   1,870 17%       107   1,977 15%
  Total Care/Syracuse PHSP   2,993   231   3,224 30%       255   3,479 27%
  United Healthcare of Upstate   3,910   173   4,083 37%       253   4,336 34%
  Excellus   97   14   111 1%       3   114 1%
Otsego 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 1,027 162 136 11 1,163 173 15% 88% 17% 549 31 1,712 204 12%
  Care Plus Health Plan   162   11   173 15%       31   204 12%
Rensselaer 8,655 7,650 902 678 9,557 8,328 87% 92% 95% 2,182 457 11,739 8,785 75%
  CDPHP   6,521   569   7,090 74%       388   7,478 64%
  Fidelis/NYS Catholic Hlth   658   43   701 7%       46   747 6%
  Wellcare   243   18   261 3%       18   279 2%
  HealthNow/BlueShield of NENY   228   48   276 3%       5   281 2%
Rockland 22,114 21,353 1,283 765 23,397 22,118 95% 92% 103% 2,660 561 26,057 22,679 87%
  Affinity Health Plan   1,596   106   1,702 7%       114   1,816 7%
  Fidelis/NYS Catholic Hlth   14,619   357   14,976 64%       247   15,223 58%
  Wellcare   2,050   93   2,143 9%       55   2,198 8%
  Westchester PHSP   2,976   191   3,167 14%       128   3,295 13%
  Community Choice Hlth Plan   112   18   130 1%       17   147 1%
St. Lawrence 8,323 0 648 0 8,971 0 0% 91% 0% 2,519 0 11,490 0 0%
Saratoga 5,913 4,820 381 236 6,294 5,056 80% 92% 88% 1,876 248 8,170 5,304 65%
  Wellcare   52   3   55 1%       0   55 1%
  CDPHP   4,115   194   4,309 68%       219   4,528 55%
  Fidelis/NYS Catholic Hlth   653   39   692 11%       29   721 9%
Schenectady 9,307 6,561 834 382 10,141 6,943 68% 90% 76% 2,526 738 12,667 7,681 61%
  CDPHP   5,879   339   6,218 61%       671   6,889 54%
  Fidelis/NYS Catholic Hlth   682   43   725 7%       67   792 6%
Schoharie 1,975 68 118 5 2,093 73 3% 92% 4% 385 4 2,478 77 3%
  CDPHP   68   5   73 3%       4   77 3%
Schuyler 1,259 0 111 0 1,370 0 0% 92% 0% 318 0 1,688 0 0%
Seneca 1,901 1,310 124 46 2,025 1,356 67% 92% 73% 452 175 2,477 1,531 62%
  Excellus   1,310   46   1,356 67%       175   1,531 62%
Steuben 7,438 2,048 598 191 8,036 2,239 28% 91% 31% 2,046 627 10,082 2,866 28%
  Southern Tier Pediatrics (Partial)   100   0   100 1%       14   114 1%
  Southern Tier Priority (Partial)   1,948   191   2,139 27%       613   2,752 27%
Suffolk 46,833 38,941 4,332 2,540 51,165 41,481 81% 91% 89% 13,291 2,840 64,456 44,321 69%
  Vytra   3,016   102   3,118 6%       299   3,417 5%
  HIP   5,020   681   5,701 11%       290   5,991 9%
  HealthFirst PHSP   5,854   295   6,149 12%       540   6,689 10%
  Suffolk Plan HMO   10,191   581   10,772 21%       1187   11,959 19%
  Affinity Health Plan   4,503   232   4,735 9%       177   4,912 8%
  United Healthcare of NY   6,746   396   7,142 14%       209   7,351 11%
  Fidelis/NYS Catholic Hlth   3,611   253   3,864 8%       138   4,002 6%
Sullivan 5,386 2,084 267 48 5,653 2,132 38% 91% 42% 1,485 128 7,138 2,260 32%
  Wellcare   413   6   419 7%       45   464 7%
  Westchester PHSP   1,671   42   1,713 30%       83   1,796 25%
Tioga 2,846 64 187 5 3,033 69 2% 92% 2% 743 0 3,776 69 2%
  CDPHP   64   5   69 2%       0   69 2%
Tompkins 4,376 121 495 15 4,871 136 3% 90% 3% 999 14 5,870 150 3%
  Total Care/Syracuse PHSP   121   15   136 3%       14   150 3%
Ulster 9,085 2,448 799 106 9,884 2,554 26% 91% 28% 2,581 181 12,465 2,735 22%
  Wellcare   2,448   106   2,554 26%       181   2,735 22%
Warren 2,960 1,963 171 21 3,131 1,984 63% 92% 69% 897 76 4,028 2,060 51%
  HealthNow/BlueShield of NENY   1,963   21   1,984 63%       76   2,060 51%
Washington 3,647 1,464 193 40 3,840 1,504 39% 91% 43% 944 137 4,784 1,641 34%
  HealthNow/BlueShield of NENY   940   32   972 25%       111   1,083 23%
  CDPHP   524   8   532 14%       26   558 12%
Wayne 4,442 3,674 235 166 4,677 3,840 82% 92% 89% 1,162 310 5,839 4,150 71%
  Excellus   1,353   67   1,420 30%       111   1,531 26%
  Preferred Care   2,321   99   2,420 52%       199   2,619 45%
Westchester 48,076 33,307 6,489 2,485 54,565 35,792 66% 89% 74% 10,199 2,499 64,764 38,291 59%
  HIP   2,560   413   2,973 5%       325   3,298 5%
  Westchester PHSP   17,046   918   17,964 33%       1082   19,046 29%
  Affinity Health Plan   5,183   391   5,574 10%       433   6,007 9%
  Community Choice Hlth Plan   5,644   478   6,122 11%       446   6,568 10%
  Fidelis/NYS Catholic Hlth   2,874   285   3,159 6%       213   3,372 5%
Wyoming 1,831 0 111 0 1,942 0 0% 91% 0% 413 0 2,355 0 0%
Yates 1,534 1,116 92 48 1,626 1,164 72% 93% 77% 290 79 1,916 1,243 65%
  Excellus   1,116   48   1,164 72%       79   1,243 65%
  591,221 376,520 61,229 26,861 652,450 402,712 62% 91% 68% 146,581 34,083 799,031 437,464 55%
NYC Affinity Health Plan   67,901   10,332   78,233 6%       2,984   81,217 5%
  Fidelis/NYS Catholic Hlth   57,650   9,267   66,917 5%       1,921   68,838 4%
  HealthFirst PHSP   91,532   15,886   107,418 8%       5,299   112,717 7%
  HIP   104,175   32,042   136,217 10%       8,117   144,334 9%
  Health Plus PHSP   101,586   17,533   119,119 8%       2,497   121,616 7%
  AmeriChoice of New York/MHS   60,268   16,529   76,797 5%       3,529   80,326 5%
  Manhattan PHSP/Center Care   51,085   8,882   59,967 4%       1,747   61,714 4%
  MetroPlus Health Plan   91,909   16,289   108,198 8%       4,283   112,481 7%
  United Healthcare of NY   15,794   5,920   21,714 2%       619   22,333 1%
  St Barnabas/Partners in Health   17,890   2,861   20,751 1%       1,119   21,870 1%
  Neighborhood Health Providers   55,864   6,637   62,501 4%       1,840   64,341 4%
  Wellcare   16,750   3,411   20,161 1%       440   20,601 1%
  ABC Health Plan   7,205   1,276   8,481 1%       181   8,662 1%
  Community Choice Hlth Plan   3,396   587   3,983 0%       71   4,054 0%
  Community Premier Plus   24,123   3,699   27,822 2%       1,084   28,906 2%
  NY Hospital Community PHSP   25,211   5,539   30,750 2%       813   31,563 2%
  Care Plus Health Plan   47,596   6,176   53,772 4%       1,047   54,819 3%
<  1,103,464 839,935 299,166 162,866 1,402,630 1,002,801 71% 90% 79% 250,782 37,591 1,653,412 1,040,392 63%
                               
  591,221 376,520 61,229 26,861 652,450 402,712 62% 91% 68% 146,581 34,083 799,031 437,464 55%
  1,103,464 839,935 299,166 162,866 1,402,630 1,002,801 71% 90% 79% 250,782 37,591 1,653,412 1,040,392 63%
  1,694,685 1,216,455 360,395 189,727 2,055,080 1,405,513 68% 91% 76% 397,363 71,674 2,452,443 1,477,856 60%
NYC Boroughs Bronx 282,570 230,278 71,506 37,289 354,076 267,567 76%     64,106 9,718 418,182 277,285 66%
  Brooklyn 407,895 316,099 114,963 70,655 522,858 386,754 74%     86,635 13,927 609,493 400,681 66%
  Manhattan 160,665 90,060 57,598 19,784 218,263 109,844 50%     48,326 5,595 266,589 115,440 43%
  Queens 223,604 178,222 48,807 30,796 272,411 209,017 77%     43,984 6,514 316,395 215,531 68%
  Staten Island 28,730 25,277 6,292 4,341 35,022 29,618 85%     7,731 1,837 42,753 31,455 74%
  1,103,464 839,935 299,166 162,866 1,402,630 1,002,801 71% 90% 79% 250,782 37,591 1,653,412 1,040,392 63%

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