Managed Care

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

NYS October 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 14,643 2,020 1,224 19,077 15,867 83% 92% 90% 4,370 965 23,447 16,832 72%
Mandatory CDPHP   11,932   922   12,854 67%       843   13,697 58%
  Fidelis/NYS Catholic Hlth   1,691   222   1,913 10%       81   1,994 9%
  Wellcare   1,020   80   1,100 6%       41   1,141 5%
Allegany TOTALS: 3,620 1,070 348 78 3,968 1,148 29% 90% 32% 987 196 4,955 1,344 27%
Voluntary Health Choice (Partial)   310   31   341 9%       154   495 10%
  HealthNow/BCBS-WNY/Community Blue   760   47   807 20%       42   849 17%
Broome TOTALS: 13,263 11,584 1,325 938 14,588 12,522 86% 90% 95% 3,561 999 18,149 13,521 74%
Mandatory Broome MC   4,824   324   5,148 35%       708   5,856 32%
  CDPHP   6,365   569   6,934 48%       270   7,204 40%
  Fidelis/NYS Catholic Hlth   395   45   440 3%       21   461 3%
Cattaraugus TOTALS: 6,269 4,878 422 317 6,691 5,195 78% 91% 85% 1,525 646 8,216 5,841 71%
Mandatory Fidelis/NYS Catholic Hlth   1,016   71   1,087 16%       83   1,170 14%
  HealthNow/BCBS-WNY/Community Blue   3,862   246   4,108 61%       563   4,671 57%
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 9,814 1,554 1,108 14,397 10,922 76% 85% 89% 2,709 1,146 17,106 12,068 71%
Mandatory Fidelis/NYS Catholic Hlth   5,634   610   6,244 43%       544   6,788 40%
  HealthNow/BCBS-WNY/Community Blue   3,572   382   3,954 27%       361   4,315 25%
  Primary Health   608   116   724 5%       241   965 6%
Chemung TOTALS: 8,486 3,719 780 245 9,266 3,964 43% 89% 48% 1,955 919 11,221 4,883 44%
Voluntary Southern Tier Pediatrics (Partial)   2,577       2,577 28%       261   2,838 25%
  Southern Tier Priority (Partial)   1,142   245   1,387 15%       658   2,045 18%
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 2,592 263 179 3,423 2,771 81% 93% 87% 869 212 4,292 2,983 70%
Mandatory CDPHP   2,024   140   2,164 63%       179   2,343 55%
  Fidelis/NYS Catholic Hlth   192   13   205 6%       7   212 5%
  Wellcare   376   26   402 12%       26   428 10%
Cortland TOTALS: 4,220 412 282 21 4,502 433 10% 91% 11% 766 80 5,268 513 10%
Voluntary Fidelis/NYS Catholic Hlth   412   21   433 10%       80   513 10%
Delaware TOTALS: 2,870 0 219 0 3,089 0 0% 92% 0% 743 0 3,832 0 0%
Dutchess TOTALS: 9,392 2,100 790 85 10,182 2,185 21% 90% 24% 2,764 125 12,946 2,310 18%
Voluntary Wellcare   2,100   85   2,185 21%       125   2,310 18%
Erie TOTALS: 66,731 55,220 8,821 5,390 75,552 60,610 80% 93% 87% 17,135 7,635 92,687 68,245 74%
Mandatory Buffalo Community Health   8,441   682   9,123 12%       362   9,485 10%
  Fidelis/NYS Catholic Hlth   14,346   818   15,164 20%       1,347   16,511 18%
  HealthNow/BCBS-WNY/Community Blue   12,782   1,216   13,998 19%       1,008   15,006 16%
  Independent Health Assoc/IHA   18,975   1,514   20,489 27%       1,643   22,132 24%
  Total Full Risk   54,544   4,230   58,774 78%       4,360   63,134 68%
  PCMP II (Partial)   100   35   135 0%       265   400 0%
  PCMP III (Partial)   5   15   20 0%       276   296 0%
  PCMP II-A Special Care (Partial)   571   1,110   1,681 2%       2,734   4,415 5%
  Total Partial Risk   676   1,160   1,836 2%       3,275   5,111 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: 5,207 907 372 52 5,579 959 17% 92% 19% 1,080 43 6,659 1,002 15%
Voluntary CDPHP   907   52   959 17%       43   1,002 15%
Genesee TOTALS: 3,347 2,011 185 127 3,532 2,138 61% 89% 68% 617 130 4,149 2,268 55%
Voluntary HealthNow/BCBS-WNY/Community Blue   722   57   779 22%       15   794 19%
  Preferred Care   1,289   70   1,359 38%       115   1,474 36%
Greene TOTALS: 3,080 2,719 257 177 3,337 2,896 87% 93% 93% 669 254 4,006 3,150 79%
Mandatory CDPHP   1,826   122   1,948 58%       189   2,137 53%
  Fidelis/NYS Catholic Hlth   322   21   343 10%       17   360 9%
  Wellcare   571   34   605 18%       48   653 16%
Hamilton Voluntary TOTALS: 211 0 14 0 225 0 0% 91% 0% 47 0 272 0 0%
Herkimer TOTALS: 4,918 3,058 314 204 5,232 3,262 62% 92% 68% 898 72 6,130 3,334 54%
Mandatory Excellus   952   66   1,018 19%       24   1,042 17%
  Fidelis/NYS Catholic Hlth   1,314   94   1,408 27%       36   1,444 24%
  United Healthcare of Upstate   792   44   836 16%       12   848 14%
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 2,938 346 233 3,921 3,171 81% 92% 88% 675 194 4,596 3,365 73%
Mandatory Excellus   2,011   143   2,154 55%       93   2,247 49%
  Preferred Care   927   90   1,017 26%       101   1,118 24%
Madison Voluntary TOTALS: 3,969 0 220 0 4,189 0 0% 91% 0% 769 0 4,958 0 0%
Monroe TOTALS: 54,874 43,492 8,702 4,036 63,576 47,528 75% 91% 82% 12,472 3,185 76,048 50,713 67%
Mandatory Excellus   32,374   3,136   35,510 56%       2,517   38,027 50%
  Preferred Care   11,118   900   12,018 19%       668   12,686 17%
Montgomery TOTALS: 4,274 907 386 40 4,660 947 20% 92% 22% 816 71 5,476 1,018 19%
Voluntary CDPHP   907   40   947 20%       71   1,018 19%
Nassau TOTALS: 34,739 30,057 3,380 1,886 38,119 31,943 84% 92% 91% 10,221 1,650 48,340 33,593 69%
Mandatory Affinity Health Plan   5,995   219   6,214 16%       254   6,468 13%
  Fidelis/NYS Catholic Hlth   4,505   234   4,739 12%       204   4,943 10%
  HealthFirst PHSP   7,893   347   8,240 22%       317   8,557 18%
  HIP   5,654   602   6,256 16%       511   6,767 14%
  United Healthcare of NY   3,326   318   3,644 10%       197   3,841 8%
  Vytra   2,684   166   2,850 7%       167   3,017 6%
Niagara TOTALS: 13,849 12,661 1,559 1,085 15,408 13,746 89% 93% 96% 3,394 1,655 18,802 15,401 82%
Mandatory Fidelis/NYS Catholic Hlth   2,359   235   2,594 17%       306   2,900 15%
  HealthNow/BCBS-WNY/Community Blue   4,762   394   5,156 33%       477   5,633 30%
  Independent Health Assoc/IHA   5,540   456   5,996 39%       872   6,868 37%
Oneida TOTALS: 18,945 15,985 1,652 1,217 20,597 17,202 84% 92% 90% 5,309 1,592 25,906 18,794 73%
Mandatory Excellus   2,035   203   2,238 11%       80   2,318 9%
  Fidelis/NYS Catholic Hlth   8,911   710   9,621 47%       1,155   10,776 42%
  United Healthcare of Upstate   5,039   304   5,343 26%       357   5,700 22%
Onondaga TOTALS: 33,876 27,168 3,883 2,327 37,759 29,495 78% 89% 88% 7,987 2,424 45,746 31,919 70%
Mandatory Excellus   2,515   284   2,799 7%       111   2,910 6%
  Fidelis/NYS Catholic Hlth   5,910   506   6,416 17%       591   7,007 15%
  Total Care/Syracuse PHSP   10,331   928   11,259 30%       1,098   12,357 27%
  United Healthcare of Upstate   8,412   609   9,021 24%       624   9,645 26%
Ontario TOTALS: 4,735 4,048 426 213 5,161 4,261 83% 91% 90% 1,142 405 6,303 4,666 74%
Mandatory Excellus   3,338   159   3,497 68%       341   3,838 61%
  Preferred Care   710   54   764 15%       64   828 13%
Orange TOTALS: 27,083 8,614 2,122 448 29,205 9,062 31% 91% 34% 4,243 768 33,448 9,830 29%
Voluntary Affinity Health Plan   5,901   269   6,170 21%       612   6,782 20%
  Wellcare   1,577   75   1,652 6%       97   1,749 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   1,136   104   1,240 4%       59   1,299 4%
Orleans TOTALS: 3,439 2,016 329 159 3,768 2,175 58% 92% 63% 591 122 4,359 2,297 53%
Mandatory Excellus   699   49   748 20%       55   803 18%
  Fidelis/NYS Catholic Hlth   862   66   928 25%       52   980 22%
  HealthNow/BCBS-WNY/Community Blue   455   44   499 13%       15   514 12%
Oswego TOTALS: 11,117 9,595 803 602 11,920 10,197 86% 92% 93% 1,926 674 13,846 10,871 79%
Mandatory Excellus   242   31   273 2%       17   290 2%
  Fidelis/NYS Catholic Hlth   1,892   135   2,027 17%       126   2,153 16%
  Total Care/Syracuse PHSP   3,271   240   3,511 29%       269   3,780 27%
  United Healthcare of Upstate   4,190   196   4,386 37%       262   4,648 34%
Otsego TOTALS: 3,346 11 204 0 3,550 11 0% 91% 0% 849 0 4,399 11 0%
Voluntary Wellcare   11       11 0%           11 0%
Putnam TOTALS: 1,113 182 132 7 1,245 189 15% 88% 17% 563 29 1,808 218 12%
Voluntary Care Plus Health Plan   182   7   189 15%       29   218 12%
Rensselaer TOTALS: 9,173 8,097 961 723 10,134 8,820 87% 92% 95% 2,159 493 12,293 9,313 76%
Mandatory CDPHP   6,533   566   7,099 70%       421   7,520 61%
  Fidelis/NYS Catholic Hlth   699   39   738 7%       42   780 6%
  HealthNow/BlueShield of NENY   599   100   699 7%       19   718 6%
  Wellcare   266   18   284 3%       11   295 2%
Rockland TOTALS: 24,094 22,516 1,302 876 25,396 23,392 92% 92% 100% 2,645 595 28,041 23,987 86%
Mandatory Affinity Health Plan   1,725   134   1,859 7%       121   1,980 7%
  Community Choice Hlth Plan   128   20   148 1%       14   162 1%
  Fidelis/NYS Catholic Hlth   15,486   369   15,855 62%       263   16,118 57%
  Wellcare   1,964   106   2,070 8%       49   2,119 8%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,213   247   3,460 14%       148   3,608 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 5,569 429 314 7,166 5,883 82% 92% 90% 1,889 277 9,055 6,160 68%
Mandatory CDPHP   4,730   240   4,970 69%       247   5,217 58%
  Fidelis/NYS Catholic Hlth   647   49   696 10%       27   723 8%
  HealthNow/BlueShield of NENY   192   25   217 3%       3   220 2%
Schenectady TOTALS: 10,345 5,995 939 317 11,284 6,312 56% 90% 62% 2,599 735 13,883 7,047 51%
Voluntary CDPHP   5,187   273   5,460 48%       671   6,131 44%
  Fidelis/NYS Catholic Hlth   808   44   852 8%       64   916 7%
Schoharie TOTALS: 2,039 64 147 8 2,186 72 3% 92% 4% 381 5 2,567 77 3%
Voluntary CDPHP   64   8   72 3%       5   77 3%
Schuyler TOTALS: 1,423 67 116 6 1,539 73 5% 92% 5% 310 2 1,849 75 4%
Voluntary Southern Tier Priority (Partial)   67   6   73 5%       2   75 4%
Seneca TOTALS: 2,122 1,414 144 56 2,266 1,470 65% 92% 70% 463 180 2,729 1,650 60%
Voluntary Excellus   1,414   56   1,470 65%       180   1,650 60%
Steuben TOTALS: 8,070 2,192 769 227 8,839 2,419 27% 91% 30% 2,070 655 10,909 3,074 28%
Voluntary Southern Tier Pediatrics (Partial)   114       114 1%       15   129 1%
  Southern Tier Priority (Partial)   2,078   227   2,305 26%       640   2,945 27%
Suffolk TOTALS: 53,946 47,641 5,076 3,450 59,022 51,091 87% 91% 95% 13,448 2,990 72,470 54,081 75%
Mandatory Affinity Health Plan   5,227   289   5,516 9%       198   5,714 8%
  Fidelis/NYS Catholic Hlth   4,646   315   4,961 8%       162   5,123 7%
  HealthFirst PHSP   7,525   425   7,950 13%       572   8,522 12%
  HIP   5,989   849   6,838 12%       319   7,157 10%
  Suffolk Health Plan   11,230   696   11,926 20%       1,159   13,085 18%
  United Healthcare of NY   8,736   472   9,208 16%       255   9,463 13%
  Vytra   4,288   404   4,692 8%       325   5,017 7%
Sullivan TOTALS: 6,184 2,600 309 55 6,493 2,655 41% 91% 45% 1,493 152 7,986 2,807 35%
Voluntary Wellcare   275   2   277 4%       37   314 4%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,325   53   2,378 37%       115   2,493 31%
Tioga TOTALS: 3,130 92 218 4 3,348 96 3% 92% 3% 731 0 4,079 96 2%
Voluntary CDPHP   92   4   96 3%           96 2%
Tompkins TOTALS: 4,653 365 516 35 5,169 400 8% 90% 9% 1,005 29 6,174 429 7%
Voluntary Total Care/Syracuse PHSP   365   35   400 8%       29   429 7%
Ulster TOTALS: 9,395 2,349 852 81 10,247 2,430 24% 91% 26% 2,587 190 12,834 2,620 20%
Voluntary Wellcare   2,349   81   2,430 24%       190   2,620 20%
Warren TOTALS: 3,312 2,103 216 25 3,528 2,128 60% 92% 66% 922 78 4,450 2,206 50%
Voluntary HealthNow/BlueShield of NENY   2,103   25   2,128 60%       78   2,206 50%
Washington TOTALS: 3,942 1,670 213 42 4,155 1,712 41% 91% 45% 949 131 5,104 1,843 36%
Voluntary CDPHP   568   6   574 14%       28   602 12%
  Fidelis/NYS Catholic Hlth   20   1   21 1%       1   22 0%
  HealthNow/BlueShield of NENY   1,082   35   1,117 27%       102   1,219 24%
Wayne TOTALS: 4,943 4,307 292 209 5,235 4,516 86% 92% 94% 1,201 353 6,436 4,869 76%
Mandatory Excellus   2,110   104   2,214 42%       157   2,371 37%
  Preferred Care   2,197   105   2,302 44%       196   2,498 39%
Westchester TOTALS: 49,427 33,312 6,706 2,842 56,133 36,154 64% 89% 73% 10,325 2,540 66,458 38,694 58%
Mandatory Affinity Health Plan   4,898   393   5,291 9%       430   5,721 9%
  Community Choice Hlth Plan   5,841   518   6,359 11%       443   6,802 10%
  Fidelis/NYS Catholic Hlth   2,992   375   3,367 6%       227   3,594 5%
  HIP   2,583   443   3,026 5%       325   3,351 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   16,998   1,113   18,111 32%       1,115   19,226 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 1,172 96 57 1,809 1,229 68% 93% 73% 288 95 2,097 1,324 63%
Voluntary Excellus   1,172   57   1,229 68%       95   1,324 63%
Upstate Total   631,165 413,926 64,497 31,725 695,662 445,651 64% 91% 70% 147,644 35,691 843,306 481,342 57%
NYC ABC Health Plan   6,951   1,520   8,471 1%       182   8,653 0%
Mandatory Affinity Health Plan   72,643   15,960   88,603 6%       2,963   91,566 5%
  AmeriChoice of New York/MHS   64,959   19,225   84,184 5%       3,224   87,408 5%
  Care Plus Health Plan   53,930   8,837   62,767 4%       1,126   63,893 3%
  Community Choice Hlth Plan   3,510   679   4,189 0%       80   4,269 0%
  Community Premier Plus   37,061   7,132   44,193 3%       1,202   45,395 2%
  Fidelis/NYS Catholic Hlth   63,385   11,834   75,219 5%       2,085   77,304 4%
  Fidelis Care HealthierLife SN                            
  HealthFirst PHSP   111,734   21,746   133,480 8%       5,060   138,540 7%
  HealthFirst PHSP SN   8   2   10 0%       4   14 0%
  Health Plus PHSP   124,705   25,012   149,717 9%       2,725   152,442 8%
  HIP   114,884   38,287   153,171 10%       7,454   160,625 9%
  Manhattan PHSP/CenterCare   55,191   11,008   66,199 4%       1,818 68,017 4%
  MetroPlus Health Plan   112,797   22,959   135,756 8%       4,623   140,379 8%
  MetroPlus Health Plan SN   45   38   83 0%       78   161 0%
  Neighborhood Health Providers   59,384   9,148   68,532 4%       1,863   70,395 4%
  NY Hospital Community PHSP   30,194   7,929   38,123 2%       883   39,006 2%
  NYPS Select Health SN   2   7   9 0%       16   25 0%
  NYS Catholic Health SN   0   0   0 0%       1   1 0%
  St Barnabas/Partners in Health   17,664   3,204   20,868 1%       1,085   21,953 1%
  United Healthcare of NY   20,586   8,423   29,009 2%       855   29,864 2%
  VidaCare Inc. SN       13   13 0%       23   36 0%
  Wellcare   19,722   4,807   24,529 2%       479   25,008 1%
  NYC Total 1,232,048 969,355 365,179 217,770 1,597,227 1,187,125 74% 90% 82% 251,856 37,829 1,849,083 1,224,954 66%
                               
  UPSTATE TOTALS: 631,165 413,926 64,497 31,725 695,662 445,651 64% 91% 70% 147,644 35,691 843,306 481,342 57%
  NEW YORK CITY TOTALS: 1,232,048 969,355 365,179 217,770 1,597,227 1,187,125 74% 90% 82% 251,856 37,829 1,849,083 1,224,954 66%
  GRAND TOTALS 1,863,213 1,383,281 429,676 249,495 2,292,889 1,632,776 71% 91% 79% 399,500 73,520 2,692,389 1,706,296 63%
NYC Boroughs Bronx 305,681 245,516 83,283 45,425 388,964 290,942 75%     64,760 9,973 453,724 300,915 66%
  Brooklyn 456,460 359,659 140,056 89,813 596,516 449,472 75%     86,314 13,727 682,830 463,199 68%
  Manhattan 175,007 127,390 69,160 32,950 244,167 160,340 66%     48,437 5,869 292,604 166,209 57%
  Queens 261,844 209,647 64,935 44,260 326,779 253,906 78%     44,510 6,450 371,289 260,356 70%
  Staten Island 33,056 27,143 7,745 5,322 40,801 32,465 80%     7,835 1,811 48,636 34,276 70%
  Borough Total 1,232,048 969,355 365,179 217,770 1,597,227 1,187,125 74% 90% 82% 251,856 37,829 1,849,083 1,224,954 66%

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 - NYS Catholic Health SN

MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS October, 2003

PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 425
  Total 425
CO-OP CARE PLAN NYC 499
  Total 499
COMPREHENSIVE CARE MGT NYC 1,034
  WESTCHESTER 105
  Total 1,139
EDDY SENIORCARE SCHENECTADY 84
  Total 84
ELANT CHOICE ORANGE 71
  Total 71
GUILDNET NYC 1,816
  Total 1,816
HOMEFIRST NYC 1,033
  Total 1,033
INDEP CARE SYSTEMS INC NYC 536
  Total 536
INDEP LIVING FOR SENIORS MONROE 298
  Total 298
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 223
  Total 223
PARTNERS IN COMMUNITY CARE ORANGE 102
  ROCKLAND 25
  Total 127
SENIOR HEALTH PARTNERS INC NYC 137
  Total 137
SENIOR NETWORK HEALTH HERKIMER 13
  ONEIDA 295
  Total 308
TOTAL AGING IN PLACE ERIE 48
  Total 48
VNS CHOICE NYC 3,208
  Total 3,208
 
  UPSTATE TOTALS: 1,689
  NEW YORK CITY TOTALS: 8,263
  GRAND TOTALS: 9,952

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