Managed Care

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

NYS May 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 13,417 1,972 1,026 18,199 14,443 79% 92% 86% 4,340 892 22,539 15,335 68%
  CDPHP   11,230   855   12,085 66%       787   12,872 57%
  Fidelis/NYS Catholic Hlth   1,237   112   1,349 7%       66   1,415 6%
  Wellcare   950   59   1,009 6%       39   1,048 5%
Allegany TOTALS: 3,491 1,031 300 74 3,791 393 10% 90% 11% 981 201 4,772 1,306 27%
  Health Choice (Partial)   366   27   393 10%       169   562 12%
  HealthNow/BCBS-WNY/Community Blue   665   47   712 19%       32   744 16%
Broome TOTALS: 12,725 10,829 1,339 881 14,064 11,710 83% 90% 92% 3,543 970 17,607 12,680 72%
  Broome MC   5,001   314   5,315 38%       716   6,031 34%
  Fidelis/NYS Catholic Hlth   375   36   411 3%       22   433 2%
  CDPHP   5,453   531   5,984 43%       232   6,216 35%
Cattauragus TOTALS: 5,930 4,678 387 263 6,317 4,941 78% 91% 86% 1,527 610 7,844 5,551 71%
  HealthNow/BCBS-WNY/Community Blue   3,636   200   3,836 61%       540   4,376 56%
  Fidelis/NYS Catholic Hlth   1,042   63   1,105 17%       70   1,175 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 9,104 1,490 973 13,406 10,077 75% 85% 88% 2,644 1,116 16,050 11,193 70%
  HealthNow/BCBS-WNY/Community Blue   3,113   287   3,400 25%       352   3,752 23%
  Primary Health   587   87   674 5%       226   900 6%
  Fidelis/NYS Catholic Hlth   5,404   599   6,003 45%       538   6,541 41%
Chemung TOTALS: 7,891 3,970 632 205 8,523 4,175 49% 89% 55% 1,934 964 10,457 5,139 49%
  Southern Tier Pediatrics (Partial)   2,752   0   2,752 32%       272   3,024 29%
  Southern Tier Priority (Partial)   1,218   205   1,423 17%       692   2,115 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 2,406 229 177 3,162 2,583 82% 93% 87% 847 208 4,009 2,791 70%
  CDPHP   1,885   142   2,027 64%       174   2,201 55%
  Wellcare   355   24   379 12%       26   405 10%
  Fidelis/NYS Catholic Hlth   166   11   177 6%       8   185 5%
Cortland TOTALS: 3,863 383 267 14 4,130 397 10% 91% 11% 773 83 4,903 480 10%
  Fidelis/NYS Catholic Hlth   383   14   397 10%       83   480 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 1,675 766 63 9,595 1,738 18% 90% 20% 2,703 114 12,298 1,852 15%
  Wellcare   1,675   63   1,738 18%       114   1,852 15%
Erie TOTALS: 64,352 52,408 8,709 4,725 73,061 57,133 78% 93% 85% 17,099 7,401 90,160 64,534 72%
  Buffalo Community Health   7,391   485   7,876 11%       308   8,184 9%
  HealthNow/BCBS-WNY/Community Blue   11,246   963   12,209 17%       948   13,157 15%
  Independent Health Assoc/IHA   18,770   1,423   20,193 28%       1510   21,703 24%
  Fidelis/NYS Catholic Hlth   14,335   783   15,118 21%       1320   16,438 18%
  Total Full Risk   51,742   3,654   55,396 76%       4,086   59,482 66%
  PCMP II (Partial)   107   39   146 0%       272   418 0%
  PCMP III (Partial)   7   23   30 0%       298   328 0%
  PCMP II-A Special Care (Partial)   552   1,009   1,561 2%       2745   4,306 5%
  Total Partial Risk   666   1,071   1,737 2%       3,315   5,052 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: 4,750 949 309 60 5,059 1,009 20% 92% 22% 1,066 40 6,125 1,049 17%
  CDPHP   949   60   1,009 20%       40   1,049 17%
Genesee TOTALS: 3,099 1,638 142 116 3,241 1,754 54% 89% 61% 628 108 3,869 1,862 48%
  HealthNow/BCBS-WNY/Community Blue   413   35   448 14%       10   458 12%
  Preferred Care   1,225   81   1,306 40%       98   1,404 36%
Greene TOTALS: 2,859 2,496 245 154 3,104 2,650 85% 93% 91% 673 227 3,777 2,877 76%
  CDPHP   1,634   107   1,741 56%       167   1,908 51%
  Wellcare   585   28   613 20%       47   660 17%
  Fidelis/NYS Catholic Hlth   277   19   296 10%       13   309 8%
Hamilton TOTALS: 160 0 12 0 172 0 0% 91% 0% 48 0 220 0 0%
Herkimer TOTALS: 4,511 1,515 276 115 4,787 1,630 34% 92% 37% 892 53 5,679 1,683 30%
  Excellus   26   0   26 1%       0   26 0%
  Fidelis/NYS Catholic Hlth   783   76   859 18%       39   898 16%
  United Healthcare of Upstate   706   39   745 16%       14   759 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 2,598 299 173 3,565 2,771 78% 92% 85% 680 187 4,245 2,958 70%
  Excellus   1,749   119   1,868 52%       90   1,958 46%
  Preferred Care   849   54   903 25%       97   1,000 24%
Madison TOTALS: 3,591 0 208 0 3,799 0 0% 91% 0% 764 0 4,563 0 0%
Monroe TOTALS: 52,867 41,136 8,524 3,837 61,391 44,973 73% 91% 80% 12,323 3,231 73,714 48,204 65%
  Excellus   30,698   2,937   33,635 55%       2559   36,194 49%
  Preferred Care   10,438   900   11,338 18%       672   12,010 16%
Montgomery TOTALS: 4,148 880 377 38 4,525 918 20% 92% 22% 809 64 5,334 982 18%
  CDPHP   880   38   918 20%       64   982 18%
Nassau TOTALS: 32,952 24,851 3,304 1,589 36,256 26,440 73% 92% 79% 10,201 1,479 46,457 27,919 60%
  Vytra   2,346   103   2,449 7%       141   2,590 6%
  HIP   4,853   494   5,347 15%       478   5,825 13%
  HealthFirst PHSP   6,146   318   6,464 18%       294   6,758 15%
  Affinity Health Plan   5,240   194   5,434 15%       242   5,676 12%
  Fidelis/NYS Catholic Hlth   3,767   218   3,985 11%       179   4,164 9%
  United Healthcare of NY   2,499   262   2,761 8%       145   2,906 6%
Niagara TOTALS: 12,903 11,861 1,502 935 14,405 12,796 89% 93% 96% 3,343 1,588 17,748 14,384 81%
  Independent Health Assoc/IHA   5,437   426   5,863 41%       848   6,711 38%
  Fidelis/NYS Catholic Hlth   2,073   185   2,258 16%       313   2,571 14%
  HealthNow/BCBS-WNY/Community Blue   4,351   324   4,675 32%       427   5,102 29%
Oneida TOTALS: 18,057 15,110 1,718 1,140 19,775 16,250 82% 92% 89% 5,240 1,483 25,015 17,733 71%
  Fidelis/NYS Catholic Hlth   8,371   649   9,020 46%       1070   10,090 40%
  United Healthcare of Upstate   5,095   322   5,417 27%       360   5,777 23%
  Excellus   1,644   169   1,813 9%       53   1,866 7%
Onondaga TOTALS: 32,370 25,726 3,479 1,895 35,849 27,621 77% 89% 87% 7,974 2,379 43,823 30,000 68%
  Fidelis/NYS Catholic Hlth   5,688   412   6,100 17%       570   6,670 15%
  Total Care/Syracuse PHSP   9,986   762   10,748 30%       1098   11,846 27%
  United Healthcare of Upstate   7,796   534   8,330 23%       625   8,955 20%
  Excellus   2,256   187   2,443 7%       86   2,529 7%
Ontario TOTALS: 4,343 3,782 343 200 4,686 3,982 85% 91% 93% 1,155 391 5,841 4,373 75%
  Excellus   3,044   157   3,201 68%       330   3,531 60%
  Preferred Care   738   43   781 17%       61   842 14%
Orange TOTALS: 24,841 7,130 2,527 365 27,368 7,495 27% 91% 30% 4,235 716 31,603 8,211 26%
  Affinity Health Plan   5,093   233   5,326 19%       602   5,928 19%
  Wellcare   1,401   50   1,451 5%       86   1,537 5%
  Westchester PHSP   636   82   718 3%       28   746 2%
Orleans TOTALS: 3,314 1,484 280 105 3,594 1,589 44% 92% 48% 596 83 4,190 1,672 40%
  Excellus   582   47   629 18%       45   674 16%
  Fidelis/NYS Catholic Hlth   566   25   591 16%       26   617 15%
  HealthNow/BCBS-WNY/Community Blue   336   33   369 10%       12   381 9%
Oswego TOTALS: 10,206 9,002 697 553 10,903 9,555 88% 92% 95% 1,919 624 12,822 10,179 79%
  Fidelis/NYS Catholic Hlth   1,790   124   1,914 18%       107   2,021 16%
  Total Care/Syracuse PHSP   3,072   233   3,305 30%       260   3,565 28%
  United Healthcare of Upstate   4,025   178   4,203 39%       254   4,457 35%
  Excellus   115   18   133 1%       3   136 1%
Otsego TOTALS: 3,061 15 188 0 3,249 15 0% 91% 1% 843 1 4,092 16 0%
  Wellcare   15   0   15 0%       1   16 0%
Putnam TOTALS: 1,027 173 136 12 1,163 185 16% 88% 18% 549 29 1,712 214 13%
  Care Plus Health Plan   173   12   185 16%       29   214 13%
Rensselaer TOTALS: 8,655 7,663 902 673 9,557 8,336 87% 92% 95% 2,182 458 11,739 8,794 75%
  CDPHP   6,469   556   7,025 74%       391   7,416 63%
  Fidelis/NYS Catholic Hlth   663   44   707 7%       46   753 6%
  Wellcare   246   17   263 3%       17   280 2%
  HealthNow/BlueShield of NENY   285   56   341 4%       4   345 3%
Rockland TOTALS: 22,114 21,452 1,283 759 23,397 22,211 95% 92% 103% 2,660 562 26,057 22,773 87%
  Affinity Health Plan   1,603   106   1,709 7%       114   1,823 7%
  Fidelis/NYS Catholic Hlth   14,681   358   15,039 64%       248   15,287 59%
  Wellcare   2,041   93   2,134 9%       57   2,191 8%
  Westchester PHSP   3,037   189   3,226 14%       128   3,354 13%
  Community Choice Hlth Plan   90   13   103 0%       15   118 0%
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 4,932 381 246 6,294 5,178 82% 92% 90% 1,876 247 8,170 5,425 66%
  Wellcare   52   3   55 1%       0   55 1%
  CDPHP   4,216   206   4,422 70%       218   4,640 57%
  Fidelis/NYS Catholic Hlth   662   37   699 11%       29   728 9%
  HealthNow/BlueShield of NENY   2   0   2 0%       0   2 0%
Schenectady TOTALS: 9,307 6,633 834 355 10,141 6,988 69% 90% 77% 2,526 748 12,667 7,736 61%
  CDPHP   5,923   313   6,236 61%       685   6,921 55%
  Fidelis/NYS Catholic Hlth   710   42   752 7%       63   815 6%
Schoharie TOTALS: 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 TOTALS: 1,259 0 111 0 1,370 0 0% 92% 0% 318 0 1,688 0 0%
Seneca TOTALS: 1,901 1,325 124 55 2,025 1,380 68% 92% 74% 452 179 2,477 1,559 63%
  Excellus   1,325   55   1,380 68%       179   1,559 63%
Steuben TOTALS: 7,438 2,049 598 195 8,036 2,244 28% 91% 31% 2,046 615 10,082 2,859 28%
  Southern Tier Pediatrics (Partial)   97   0   97 1%       14   111 1%
  Southern Tier Priority (Partial)   1,952   195   2,147 27%       601   2,748 27%
Suffolk TOTALS: 46,833 40,118 4,332 2,751 51,165 42,869 84% 91% 92% 13,291 2,865 64,456 45,734 71%
  Vytra   3,094   120   3,214 6%       300   3,514 5%
  HIP   5,279   755   6,034 12%       303   6,337 10%
  HealthFirst PHSP   5,986   322   6,308 12%       553   6,861 11%
  Suffolk Plan HMO   10,265   607   10,872 21%       1176   12,048 19%
  Affinity Health Plan   4,617   255   4,872 10%       177   5,049 8%
  United Healthcare of NY   7,060   423   7,483 15%       216   7,699 12%
  Fidelis/NYS Catholic Hlth   3,817   269   4,086 8%       140   4,226 7%
Sullivan TOTALS: 5,386 2,193 267 51 5,653 2,244 40% 91% 44% 1,485 137 7,138 2,381 33%
  Wellcare   367   4   371 7%       45   416 6%
  Westchester PHSP   1,826   47   1,873 33%       92   1,965 28%
Tioga TOTALS: 2,846 70 187 3 3,033 73 2% 92% 3% 743 0 3,776 73 2%
  CDPHP   70   3   73 2%       0   73 2%
Tompkins TOTALS: 4,376 147 495 19 4,871 166 3% 90% 4% 999 17 5,870 183 3%
  Total Care/Syracuse PHSP   147   19   166 3%       17   183 3%
Ulster TOTALS: 9,085 2,416 799 93 9,884 2,509 25% 91% 28% 2,581 182 12,465 2,691 22%
  Wellcare   2,416   93   2,509 25%       182   2,691 22%
Warren TOTALS: 2,960 2,017 171 21 3,131 2,038 65% 92% 71% 897 75 4,028 2,113 52%
  HealthNow/BlueShield of NENY   2,017   21   2,038 65%       75   2,113 52%
Washington TOTALS: 3,647 1,503 193 44 3,840 1,547 40% 91% 44% 944 130 4,784 1,677 35%
  HealthNow/BlueShield of NENY   962   35   997 26%       104   1,101 23%
  CDPHP   541   9   550 14%       26   576 12%
Wayne TOTALS: 4,442 3,822 235 176 4,677 3,998 85% 92% 93% 1,162 325 5,839 4,323 74%
  Excellus   1,523   77   1,600 34%       122   1,722 29%
  Preferred Care   2,299   99   2,398 51%       203   2,601 45%
Westchester TOTALS: 48,076 32,817 6,489 2,439 54,565 35,256 65% 89% 73% 10,199 2,510 64,764 37,766 58%
  HIP   2,533   407   2,940 5%       325   3,265 5%
  Westchester PHSP   16,738   878   17,616 32%       1088   18,704 29%
  Affinity Health Plan   5,050   400   5,450 10%       436   5,886 9%
  Community Choice Hlth Plan   5,559   469   6,028 11%       447   6,475 10%
  Fidelis/NYS Catholic Hlth   2,937   285   3,222 6%       214   3,436 5%
Wyoming TOTALS: 1,831 0 111 0 1,942 0 0% 91% 0% 413 0 2,355 0 0%
Yates TOTALS: 1,534 1,172 92 54 1,626 1,226 75% 93% 81% 290 84 1,916 1,310 68%
  Excellus   1,172   54   1,226 75%       84   1,310 68%
Upstate Total   591,221 380,760 61,229 27,633 652,450 407,681 62% 91% 69% 146,581 34,383 799,031 442,776 55%
NYC Affinity Health Plan   70,773   11,436   82,209 6%       3,074   85,283 5%
  Fidelis/NYS Catholic Hlth   59,979   9,943   69,922 5%       1,984   71,906 4%
  HealthFirst PHSP   95,468   16,914   112,382 8%       5,405   117,787 7%
  HIP   107,707   33,827   141,534 10%       8,210   149,744 9%
  Health Plus PHSP   107,806   19,003   126,809 9%       2,595   129,404 8%
  AmeriChoice of New York/MHS   61,454   17,232   78,686 6%       3,553   82,239 5%
  Manhattan PHSP/Center Care   53,270   9,605   62,875 4%       1,798   64,673 4%
  MetroPlus Health Plan   97,637   18,106   115,743 8%       4,398   120,141 7%
  United Healthcare of NY   16,935   6,450   23,385 2%       680   24,065 1%
  St Barnabas/Partners in Health   18,022   2,995   21,017 1%       1,158   22,175 1%
  Neighborhood Health Providers   58,405   7,298   65,703 5%       1,902   67,605 4%
  Wellcare   17,516   3,696   21,212 2%       451   21,663 1%
  ABC Health Plan   7,524   1,382   8,906 1%       191   9,097 1%
  Community Choice Hlth Plan   3,421   590   4,011 0%       77   4,088 0%
  Community Premier Plus   26,465   4,147   30,612 2%       1,119   31,731 2%
  NY Hospital Community PHSP   26,732   6,119   32,851 2%       852   33,703 2%
  Care Plus Health Plan   49,774   6,856   56,630 4%       1,093   57,723 3%
  NYC Total 1,103,464 878,888 299,166 175,599 1,402,630 1,054,487 75% 90% 83% 250,782 38,540 1,653,412 1,093,027 66%
                               
  UPSTATE TOTALS: 591,221 380,760 61,229 27,633 652,450 407,681 62% 91% 69% 146,581 34,383 799,031 442,776 55%
  NEW YORK CITY TOTALS: 1,103,464 878,888 299,166 175,599 1,402,630 1,054,487 75% 90% 83% 250,782 38,540 1,653,412 1,093,027 66%
  GRAND TOTALS 1,694,685 1,259,648 360,395 203,232 2,055,080 1,462,168 71% 91% 79% 397,363 72,923 2,452,443 1,535,803 63%
NYC Boroughs Bronx 282,570 236,307 71,506 39,419 354,076 275,727 78%     64,106 10,028 418,182 285,754 68%
  Brooklyn 407,895 329,228 114,963 75,304 522,858 404,532 77%     86,635 14,216 609,493 418,748 69%
  Manhattan 160,665 99,034 57,598 22,467 218,263 121,501 56%     48,326 5,733 266,589 127,234 48%
  Queens 223,604 188,239 48,807 33,859 272,411 222,098 82%     43,984 6,694 316,395 228,792 72%
  Staten Island 28,730 26,080 6,292 4,549 35,022 30,629 87%     7,731 1,870 42,753 32,499 76%
  Borough Total 1,103,464 878,888 299,166 175,599 1,402,630 1,054,487 75% 90% 83% 250,782 38,540 1,653,412 1,093,027 66%

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 - Herkimer County
    HealthNow/BlueShield of NENY - Saratoga County


MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS May, 2003

PROVIDER COUNTY TOTAL ENROLLMENT
Broadlawn Health Partners Nassau 388
Total 388
Co-Op Care Plan NYC 520
Total 520
Comprehensive Care Mgt NYC 972
Westchester 105
Total 1,077
Eddy Seniorcare Schenectady 84
Total 84
Elant Choice Orange 64
Total 64
Guildnet NYC 1,659
Total 1,659
Homefirst NYC 881
Total 881
Indep Care Systems Inc NYC 490
Total 490
Indep Living For Seniors Monroe 311
Total 311
Loretto/Independent Living Services Onondaga 228
Total 228
Partners In Community Care Orange 101
Rockland 21
Total 122
Senior Health Partners Inc NYC 116
Total 116
Senior Network Health Herkimer* 5
Oneida 261
Total 266
Total Aging In Place Erie 12
Total 12
VNS Choice NYC 2,860
Total 2,860
 
Upstate Totals: 1,580
New York City Totals: 7,498
Grand Totals: 9,078

*Senior Network Health was added this month to Herkimer County.
NOTE: The source of enrollment is based on the MEDS Database.