Managed Care

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

NYS November, 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: 17,688 14,649 2,154 1,190 19,842 15,839 80% 92% 87% 4,394 973 24,236 16,812 69%
Mandatory CDPHP   11,927   878   12,805 65%       852   13,657 56%
  Fidelis/NYS Catholic Hlth   1,704   229   1,933 10%       84   2,017 8%
  Wellcare   1,018   83   1,101 6%       37   1,138 5%
Allegany TOTALS: 3,750 1,089 375 84 4,125 1,173 28% 90% 31% 979 196 5,104 1,369 27%
Voluntary Health Choice (Partial)   298   30   328 8%       151   479 9%
  HealthNow/BCBS-WNY/Community Blue   791   54   845 20%       45   890 17%
Broome TOTALS: 13,555 11,644 1,370 948 14,925 12,592 84% 90% 93% 3,597 992 18,522 13,584 73%
Mandatory Broome MC   4,682   312   4,994 33%       704   5,698 31%
  CDPHP   6,569   590   7,159 48%       268   7,427 40%
  Fidelis/NYS Catholic Hlth   393   46   439 3%       20   459 2%
Cattaraugus TOTALS: 6,400 4,948 412 319 6,812 5,267 77% 91% 85% 1,550 647 8,362 5,914 71%
Mandatory Fidelis/NYS Catholic Hlth   1,012   66   1,078 16%       84   1,162 14%
  HealthNow/BCBS-WNY/Community Blue   3,936   253   4,189 61%       563   4,752 57%
Cayuga Voluntary TOTALS: 5,469 0 374 0 5,843 0 0% 89% 0% 1,167 0 7,010 0 0%
Chautauqua TOTALS: 13,245 9,959 1,657 1,105 14,902 11,064 74% 85% 87% 2,726 1,149 17,628 12,213 69%
Mandatory Fidelis/NYS Catholic Hlth   5,662   589   6,251 42%       548   6,799 39%
  HealthNow/BCBS-WNY/Community Blue   3,684   399   4,083 27%       361   4,444 25%
  Primary Health   613   117   730 5%       240   970 6%
Chemung TOTALS: 8,763 3,682 851 245 9,614 3,927 41% 89% 46% 1,963 923 11,577 4,850 42%
Voluntary Southern Tier Pediatrics (Partial)   2,545       2,545 26%       260   2,805 24%
  Southern Tier Priority (Partial)   1,137   245   1,382 14%       663   2,045 18%
Chenango Voluntary TOTALS: 4,952 0 237 0 5,189 0 0% 92% 0% 1,001 0 6,190 0 0%
Clinton Voluntary TOTALS: 5,941 0 461 0 6,402 0 0% 86% 0% 1,571 0 7,973 0 0%
Columbia TOTALS: 3,355 2,636 275 172 3,630 2,808 77% 93% 83% 880 220 4,510 3,028 67%
Mandatory CDPHP   2,058   131   2,189 60%       186   2,375 53%
  Fidelis/NYS Catholic Hlth   184   14   198 5%       7   205 5%
  Wellcare   394   27   421 12%       27   448 10%
Cortland TOTALS: 4,296 428 297 19 4,593 447 10% 91% 11% 770 80 5,363 527 10%
Voluntary Fidelis/NYS Catholic Hlth   428   19   447 10%       80   527 10%
Delaware TOTALS: 3,000 0 221 0 3,221 0 0% 92% 0% 746 0 3,967 0 0%
Dutchess TOTALS: 9,827 2,243 892 97 10,719 2,340 22% 90% 24% 2,781 129 13,500 2,469 18%
Voluntary Wellcare   2,243   97   2,340 22%       129   2,469 18%
Erie TOTALS: 68,813 56,267 9,135 5,513 77,948 61,780 79% 93% 86% 17,303 7,681 95,251 69,461 73%
Mandatory Buffalo Community Health   8,973   756   9,729 12%       383   10,112 11%
  Fidelis/NYS Catholic Hlth   14,504   820   15,324 20%       1,357   16,681 18%
  HealthNow/BCBS-WNY/Community Blue   13,075   1,258   14,333 18%       1,013   15,346 16%
  Independent Health Assoc/IHA   19,033   1,508   20,541 26%       1,658   22,199 23%
  Total Full Risk   55,585   4,342   59,927 77%       4,411   64,338 68%
  PCMP II (Partial)   99   37   136 0%       265   401 0%
  PCMP III (Partial)   3   16   19 0%       273   292 0%
  PCMP II-A Special Care (Partial)   580   1,118   1,698 2%       2,732   4,430 5%
  Total Partial Risk   682   1,171   1,853 2%       3,270   5,123 5%
Essex Voluntary TOTALS: 2,132 0 165 0 2,297 0 0% 92% 0% 583 0 2,880 0 0%
Franklin Voluntary TOTALS: 3,539 0 315 0 3,854 0 0% 91% 0% 1,000 0 4,854 0 0%
Fulton TOTALS: 5,329 915 421 46 5,750 961 17% 92% 18% 1,078 43 6,828 1,004 15%
Voluntary CDPHP   915   46   961 17%       43   1,004 15%
Genesee TOTALS: 3,447 2,087 193 144 3,640 2,231 61% 89% 69% 643 136 4,283 2,367 55%
Voluntary HealthNow/BCBS-WNY/Community Blue   786   69   855 23%       22   877 20%
  Preferred Care   1,301   75   1,376 38%       114   1,490 35%
Greene TOTALS: 3,194 2,791 265 172 3,459 2,963 86% 93% 92% 695 261 4,154 3,224 78%
Mandatory CDPHP   1,874   114   1,988 57%       196   2,184 53%
  Fidelis/NYS Catholic Hlth   329   25   354 10%       16   370 9%
  Wellcare   588   33   621 18%       49   670 16%
Hamilton Voluntary TOTALS: 216 0 21 0 237 0 0% 91% 0% 45 0 282 0 0%
Herkimer TOTALS: 5,087 3,421 311 234 5,398 3,655 68% 92% 74% 898 83 6,296 3,738 59%
Mandatory Excellus   1,136   77   1,213 22%       31   1,244 20%
  Fidelis/NYS Catholic Hlth   1,452   107   1,559 29%       40   1,599 25%
  United Healthcare of Upstate   833   50   883 16%       12   895 14%
Jefferson Voluntary TOTALS: 8,667 0 705 0 9,372 0 0% 87% 0% 1,847 0 11,219 0 0%
Lewis Voluntary TOTALS: 2,418 0 116 0 2,534 0 0% 93% 0% 421 0 2,955 0 0%
Livingston TOTALS: 3,638 2,993 377 238 4,015 3,231 80% 92% 88% 690 201 4,705 3,432 73%
Mandatory Excellus   2,039   143   2,182 54%       96   2,278 48%
  Preferred Care   954   95   1,049 26%       105   1,154 25%
Madison Voluntary TOTALS: 4,176 0 241 0 4,417 0 0% 91% 0% 768 0 5,185 0 0%
Monroe TOTALS: 56,320 42,475 9,107 3,872 65,427 46,347 71% 91% 78% 12,618 3,248 78,045 49,595 64%
Mandatory Excellus   31,697   3,020   34,717 53%       2,569   37,286 48%
  Preferred Care   10,778   852   11,630 18%       679   12,309 16%
Montgomery TOTALS: 4,461 896 411 40 4,872 936 19% 92% 21% 809 76 5,681 1,012 18%
Voluntary CDPHP   896   40   936 19%       76   1,012 18%
Nassau TOTALS: 38,269 31,169 3,750 1,945 42,019 33,114 79% 92% 85% 10,297 1,673 52,316 34,787 66%
Mandatory Affinity Health Plan   6,164   236   6,400 15%       256   6,656 13%
  Fidelis/NYS Catholic Hlth   4,750   246   4,996 12%       199   5,195 10%
  HealthFirst PHSP   8,260   352   8,612 20%       329   8,941 17%
  HIP   5,762   600   6,362 15%       522   6,884 13%
  United Healthcare of NY   3,514   319   3,833 9%       199   4,032 8%
  Vytra   2,719   192   2,911 7%       168   3,079 6%
Niagara TOTALS: 14,025 12,830 1,665 1,121 15,690 13,951 89% 93% 96% 3,429 1,667 19,119 15,618 82%
Mandatory Fidelis/NYS Catholic Hlth   2,393   235   2,628 17%       302   2,930 15%
  HealthNow/BCBS-WNY/Community Blue   4,909   410   5,319 34%       491   5,810 30%
  Independent Health Assoc/IHA   5,528   476   6,004 38%       874   6,878 36%
Oneida TOTALS: 19,559 16,121 1,704 1,243 21,263 17,364 82% 92% 88% 5,328 1,620 26,591 18,984 71%
Mandatory Excellus   2,119   211   2,330 11%       76   2,406 9%
  Fidelis/NYS Catholic Hlth   9,049   723   9,772 46%       1,184   10,956 41%
  United Healthcare of Upstate   4,953   309   5,262 25%       360   5,622 21%
Onondaga TOTALS: 34,698 27,655 4,264 2,373 38,962 30,028 77% 89% 87% 8,049 2,463 47,011 32,491 69%
Mandatory Excellus   2,571   283   2,854 7%       112   2,966 6%
  Fidelis/NYS Catholic Hlth   6,088   529   6,617 17%       604   7,221 15%
  Total Care/Syracuse PHSP   10,424   947   11,371 29%       1,100   12,471 27%
  United Healthcare of Upstate   8,572   614   9,186 24%       647   9,833 25%
Ontario TOTALS: 5,017 4,071 456 208 5,473 4,279 78% 91% 86% 1,142 407 6,615 4,686 71%
Mandatory Excellus   3,351   159   3,510 64%       339   3,849 58%
  Preferred Care   720   49   769 14%       68   837 13%
Orange TOTALS: 28,197 8,742 2,161 444 30,358 9,186 30% 91% 33% 4,269 788 34,627 9,974 29%
Voluntary Affinity Health Plan   5,876   255   6,131 20%       628   6,759 20%
  Wellcare   1,685   73   1,758 6%       96   1,854 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   1,181   116   1,297 4%       64   1,361 4%
Orleans TOTALS: 3,565 2,211 354 182 3,919 2,393 61% 92% 66% 602 119 4,521 2,512 56%
Mandatory Excellus   768   59   827 21%       50   877 19%
  Fidelis/NYS Catholic Hlth   921   75   996 25%       53   1,049 23%
  HealthNow/BCBS-WNY/Community Blue   522   48   570 15%       16   586 13%
Oswego TOTALS: 11,619 9,816 856 589 12,475 10,405 83% 92% 90% 1,936 691 14,411 11,096 77%
Mandatory Excellus   272   31   303 2%       19   322 2%
  Fidelis/NYS Catholic Hlth   1,937   130   2,067 17%       123   2,190 15%
  Total Care/Syracuse PHSP   3,360   237   3,597 29%       279   3,876 27%
  United Healthcare of Upstate   4,247   191   4,438 36%       270   4,708 33%
Otsego TOTALS: 3,524 11 228 0 3,752 11 0% 91% 0% 864 0 4,616 11 0%
Voluntary Wellcare   11       11 0%           11 0%
Putnam TOTALS: 1,187 193 148 7 1,335 200 15% 88% 17% 564 30 1,899 230 12%
Voluntary Care Plus Health Plan   193   7   200 15%       30   230 12%
Rensselaer TOTALS: 9,287 8,248 979 748 10,266 8,996 88% 92% 95% 2,179 497 12,445 9,493 76%
Mandatory CDPHP   6,669   576   7,245 71%       424   7,669 62%
  Fidelis/NYS Catholic Hlth   698   48   746 7%       45   791 6%
  HealthNow/BlueShield of NENY   612   107   719 7%       16   735 6%
  Wellcare   269   17   286 3%       12   298 2%
Rockland TOTALS: 24,897 22,815 1,343 878 26,240 23,693 90% 92% 98% 2,635 588 28,875 24,281 84%
Mandatory Affinity Health Plan   1,695   139   1,834 7%       121   1,955 7%
  Community Choice Hlth Plan   128   24   152 1%       16   168 1%
  Fidelis/NYS Catholic Hlth   15,715   374   16,089 61%       256   16,345 57%
  Wellcare   1,959   104   2,063 8%       42   2,105 7%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,318   237   3,555 14%       153   3,708 13%
St Lawrence Voluntary TOTALS: 9,090 0 699 0 9,789 0 0% 91% 0% 2,556 0 12,345 0 0%
Saratoga TOTALS: 7,176 5,714 455 323 7,631 6,037 79% 92% 86% 1,903 284 9,534 6,321 66%
Mandatory CDPHP   4,783   245   5,028 66%       251   5,279 55%
  Fidelis/NYS Catholic Hlth   649   49   698 9%       27   725 8%
  HealthNow/BlueShield of NENY   282   29   311 4%       6   317 3%
Schenectady TOTALS: 10,827 6,177 1,021 308 11,848 6,485 55% 90% 61% 2,644 742 14,492 7,227 50%
Voluntary CDPHP   5,316   264   5,580 47%       677   6,257 43%
  Fidelis/NYS Catholic Hlth   861   44   905 8%       65   970 7%
Schoharie TOTALS: 2,149 54 162 8 2,311 62 3% 92% 3% 388 5 2,699 67 2%
Voluntary CDPHP   54   8   62 3%       5   67 2%
Schuyler TOTALS: 1,406 76 125 7 1,531 83 5% 92% 6% 308 4 1,839 87 5%
Voluntary Southern Tier Priority (Partial)   76   7   83 5%       4   87 5%
Seneca TOTALS: 2,160 1,411 138 57 2,298 1,468 64% 92% 69% 457 177 2,755 1,645 60%
Voluntary Excellus   1,411   57   1,468 64%       177   1,645 60%
Steuben TOTALS: 8,244 2,220 833 230 9,077 2,450 27% 91% 30% 2,054 671 11,131 3,121 28%
Voluntary Southern Tier Pediatrics (Partial)   107       107 1%       15   122 1%
  Southern Tier Priority (Partial)   2,113   230   2,343 26%       656   2,999 27%
Suffolk TOTALS: 58,599 48,336 5,835 3,548 64,434 51,884 81% 91% 88% 13,489 3,007 77,923 54,891 70%
Mandatory Affinity Health Plan   5,297   287   5,584 9%       200   5,784 7%
  Fidelis/NYS Catholic Hlth   4,702   330   5,032 8%       161   5,193 7%
  HealthFirst PHSP   7,736   438   8,174 13%       569   8,743 11%
  HIP   5,953   860   6,813 11%       315   7,128 9%
  Suffolk Health Plan   11,319   702   12,021 19%       1,163   13,184 17%
  United Healthcare of NY   8,860   499   9,359 15%       263   9,622 12%
  Vytra   4,469   432   4,901 8%       336   5,237 7%
Sullivan TOTALS: 6,478 2,794 313 53 6,791 2,847 42% 91% 46% 1,510 151 8,301 2,998 36%
Voluntary Wellcare   254   2   256 4%       34   290 3%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,540   51   2,591 38%       117   2,708 33%
Tioga TOTALS: 3,290 91 256 4 3,546 95 3% 92% 3% 725 0 4,271 95 2%
Voluntary CDPHP   91   4   95 3%           95 2%
Tompkins TOTALS: 4,800 412 527 40 5,327 452 8% 90% 9% 1,014 32 6,341 484 8%
Voluntary Total Care/Syracuse PHSP   412   40   452 8%       32   484 8%
Ulster TOTALS: 9,659 2,367 852 78 10,511 2,445 23% 91% 26% 2,601 195 13,112 2,640 20%
Voluntary Wellcare   2,367   78   2,445 23%       195   2,640 20%
Warren TOTALS: 3,503 2,136 241 22 3,744 2,158 58% 92% 63% 939 84 4,683 2,242 48%
Voluntary HealthNow/BlueShield of NENY   2,136   22   2,158 58%       84   2,242 48%
Washington TOTALS: 4,278 1,720 247 36 4,525 1,756 39% 91% 43% 954 136 5,479 1,892 35%
Voluntary CDPHP   564   6   570 13%       27   597 11%
  Fidelis/NYS Catholic Hlth   31   1   32 1%       1   33 1%
  HealthNow/BlueShield of NENY   1,125   29   1,154 26%       108   1,262 23%
Wayne TOTALS: 5,129 4,408 335 206 5,464 4,614 84% 92% 92% 1,212 344 6,676 4,958 74%
Mandatory Excellus   2,236   105   2,341 43%       157   2,498 37%
  Preferred Care   2,172   101   2,273 42%       187   2,460 37%
Westchester TOTALS: 51,454 34,509 6,984 2,894 58,438 37,403 64% 89% 72% 10,417 2,559 68,855 39,962 58%
Mandatory Affinity Health Plan   5,087   413   5,500 9%       424   5,924 9%
  Community Choice Hlth Plan   6,035   516   6,551 11%       441   6,992 10%
  Fidelis/NYS Catholic Hlth   3,085   377   3,462 6%       241   3,703 5%
  HIP   2,641   468   3,109 5%       324   3,433 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   17,661   1,120   18,781 32%       1,129   19,910 29%
Wyoming Voluntary TOTALS: 2,041 0 120 0 2,161 0 0% 91% 0% 431 0 2,592 0 0%
Yates TOTALS: 1,774 1,183 113 60 1,887 1,243 66% 93% 71% 290 98 2,177 1,341 62%
Voluntary Excellus   1,183   60   1,243 66%       98   1,341 62%
Upstate Total   657,579 420,613 68,523 32,050 726,102 452,663 62% 91% 69% 148,709 36,070 874,811 488,733 56%
NYC ABC Health Plan   6,851   1,533   8,384 1%       188   8,572 0%
Mandatory Affinity Health Plan   73,858   16,507   90,365 6%       2,965   93,330 5%
  AmeriChoice of New York/MHS   65,558   19,640   85,198 5%       3,226   88,424 5%
  Care Plus Health Plan   55,488   9,137   64,625 4%       1,139   65,764 4%
  Community Choice Hlth Plan   3,478   680   4,158 0%       75   4,233 0%
  Community Premier Plus   38,788   7,580   46,368 3%       1,216   47,584 3%
  Fidelis/NYS Catholic Hlth   64,117   12,104   76,221 5%       2,089   78,310 4%
  Fidelis Care HealthierLife SN                            
  HealthFirst PHSP   115,412   23,200   138,612 9%       5,079   143,691 8%
  HealthFirst PHSP SN   8   2   10 0%       4   14 0%
  Health Plus PHSP   127,272   26,097   153,369 9%       2,737   156,106 8%
  HIP   116,323   38,830   155,153 10%       7,415   162,568 9%
  Manhattan PHSP/CenterCare   55,527   11,315   66,842 4%       1,827   68,669 4%
  MetroPlus Health Plan   116,070   23,861   139,931 9%       4,590   144,521 8%
  MetroPlus Health Plan SN   43   41   84 0%       81   165 0%
  Neighborhood Health Providers   60,221   9,538   69,759 4%       1,863   71,622 4%
  NY Hospital Community PHSP   30,712   8,434   39,146 2%       895   40,041 2%
  NYPS Select Health SN   12   20   32 0%       35   67 0%
  NYS Catholic Health SN   3   0   3 0%       1   4 0%
  St Barnabas/Partners in Health   17,768   3,225   20,993 1%       1,100   22,093 1%
  United Healthcare of NY   21,171   8,646   29,817 2%       859   30,676 2%
  VidaCare Inc. SN   1   29   30 0%       37   67 0%
  Wellcare   20,468   5,035   25,503 2%       476   25,979 1%
  NYC Total 1,248,302 989,149 378,155 225,454 1,626,457 1,214,603 75% 90% 83% 252,281 37,897 1,878,738 1,252,500 67%
 
  UPSTATE TOTALS: 657,579 420,613 68,523 32,050 726,102 452,663 62% 91% 69% 148,709 36,070 874,811 488,733 56%
  NEW YORK CITY TOTALS: 1,248,302 989,149 378,155 225,454 1,626,457 1,214,603 75% 90% 83% 252,281 37,897 1,878,738 1,252,500 67%
  GRAND TOTALS 1,905,881 1,409,762 446,678 257,504 2,352,559 1,667,266 71% 91% 78% 400,990 73,967 2,753,549 1,741,233 63%
NYC Boroughs Bronx 308,575 249,683 85,716 46,862 394,291 296,545 75%     65,069 9,982 459,360 306,527 67%
  Brooklyn 460,939 366,014 144,450 92,442 605,389 458,456 76%     86,429 13,751 691,818 472,207 68%
  Manhattan 176,233 131,269 70,978 34,653 247,211 165,921 67%     48,492 5,919 295,703 171,840 58%
  Queens 269,105 214,406 68,807 45,914 337,912 260,320 77%     44,455 6,430 382,367 266,750 70%
  Staten Island 33,450 27,777 8,204 5,584 41,654 33,361 80%     7,836 1,815 49,490 35,176 71%
  Borough Total 1,248,302 989,149 378,155 225,454 1,626,457 1,214,603 75% 90% 83% 252,281 37,897 1,878,738 1,252,500 67%

NOTES:

(1) The Managed Care eligible counts are based upon April, 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 : None

 

NYS November, 2003
PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 443
Total 443
CO-OP CARE PLAN NYC 495
Total 495
COMPREHENSIVE CARE MGT NYC 1,067
WESTCHESTER 106
Total 1,173
EDDY SENIORCARE SCHENECTADY 83
Total 83
ELANT CHOICE ORANGE 76
Total 76
GUILDNET NYC 1,856
Total 1,856
HOMEFIRST NYC 1,024
Total 1,024
INDEP CARE SYSTEMS INC NYC 534
Total 534
INDEP LIVING FOR SENIORS MONROE 291
Total 291
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 224
Total 224
PARTNERS IN COMMUNITY CARE ORANGE 102
ROCKLAND 23
Total 125
SENIOR HEALTH PARTNERS INC NYC 141
Total 141
SENIOR NETWORK HEALTH HERKIMER 14
ONEIDA 296
Total 310
TOTAL AGING IN PLACE ERIE 52
Total 52
VNS CHOICE NYC 3,298
Total 3,298
 
  UPSTATE TOTALS: 1,710
NEW YORK CITY TOTALS: 8,415
GRAND TOTALS: 10,125

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