Managed Care

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

NYS September 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 14,471 2,020 1,183 19,077 15,654 82% 92% 89% 4,370 956 23,447 16,610 71%
Mandatory CDPHP   11,814   911   12,725 67%   836   13,561 58%
  Fidelis/NYS Catholic Hlth   1,643   200   1,843 10%   80   1,923 8%
  Wellcare   1,014   72   1,086 6%   40   1,126 5%
Allegany TOTALS: 3,620 1,087 348 76 3,968 1,163 29% 90% 32% 987 197 4,955 1,360 27%
Voluntary Health Choice (Partial)   313   31   344 9%   156   500 10%
  HealthNow/BCBS-WNY/Community Blue   774   45   819 21%   41   860 17%
Broome TOTALS: 13,263 11,433 1,325 957 14,588 12,390 85% 90% 94% 3,561 988 18,149 13,378 74%
Mandatory Broome MC   4,800   331   5,131 35%   711   5,842 32%
  CDPHP   6,229   581   6,810 47%   256   7,066 39%
  Fidelis/NYS Catholic Hlth   404   45   449 3%   21   470 3%
Cattaraugus TOTALS: 6,269 4,909 422 324 6,691 5,233 78% 91% 86% 1,525 640 8,216 5,873 71%
Mandatory Fidelis/NYS Catholic Hlth   1,040   75   1,115 17%   79   1,194 15%
  HealthNow/BCBS-WNY/Community Blue   3,869   249   4,118 62%   561   4,679 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 9,773 1,554 1,103 14,397 10,876 76% 85% 89% 2,709 1,150 17,106 12,026 70%
Mandatory Fidelis/NYS Catholic Hlth   5,654   618   6,272 44%   550   6,822 40%
  HealthNow/BCBS-WNY/Community Blue   3,509   364   3,873 27%   359   4,232 25%
  Primary Health   610   121   731 5%   241   972 6%
Chemung TOTALS: 8,486 3,995 780 248 9,266 4,243 46% 89% 52% 1,955 927 11,221 5,170 46%
Voluntary Southern Tier Pediatrics (Partial)   2,759   0   2,759 30%       260   3,019 27%
  Southern Tier Priority (Partial)   1,236   248   1,484 16%   667   2,151 19%
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 2,575 263 177 3,423 2,752 80% 93% 86% 869 210 4,292 2,962 69%
Mandatory CDPHP   2,019   138   2,157 63%       175   2,332 54%
  Fidelis/NYS Catholic Hlth   194   14   208 6%       7   215 5%
  Wellcare   362   25   387 11%       28   415 10%
Cortland TOTALS: 4,220 418 282 20 4,502 438 10% 91% 11% 766 80 5,268 518 10%
Voluntary Fidelis/NYS Catholic Hlth   418   20   438 10%       80   518 10%
Delaware TOTALS: 2,870 102 219 5 3,089 107 3% 92% 4% 743 3 3,832 110 3%
Voluntary Wellcare   102   5   107 3%       3   110 3%
Dutchess TOTALS: 9,392 2,037 790 92 10,182 2,129 21% 90% 23% 2,764 126 12,946 2,255 17%
Voluntary Wellcare   2,037   92   2,129 21%       126   2,255 17%
Erie TOTALS: 66,731 54,836 8,821 5,265 75,552 60,101 80% 93% 86% 17,135 7,627 92,687 67,728 73%
Mandatory Buffalo Community Health   8,168   650   8,818 12%       352   9,170 10%
  Fidelis/NYS Catholic Hlth   14,258   808   15,066 20%       1,346   16,412 18%
  HealthNow/BCBS-WNY/Community Blue   12,621   1,179   13,800 18%       1,009   14,809 16%
  Independent Health Assoc/IHA   19,105   1,512   20,617 27%       1,638   22,255 24%
  Total Full Risk   54,152   4,149   58,301 77%       4,345   62,646 68%
  PCMP II (Partial)   99   33   132 0%       267   399 0%
  PCMP III (Partial)   5   18   23 0%       278   301 0%
  PCMP II-A Special Care (Partial)   580   1,065   1,645 2%       2,737   4,382 5%
  Total Partial Risk   684   1,116   1,800 2%       3,282   5,082 5%
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: 5,207 927 372 53 5,579 980 18% 92% 19% 1,080 43 6,659 1,023 15%
Voluntary CDPHP   927   53   980 18%       43   1,023 15%
Genesee TOTALS: 3,347 1,961 185 134 3,532 2,095 59% 89% 66% 617 123 4,149 2,218 53%
Voluntary HealthNow/BCBS-WNY/Community Blue   714   56   770 22%       14   784 19%
  Preferred Care   1,247   78   1,325 38%       109   1,434 35%
Greene TOTALS: 3,080 2,677 257 170 3,337 2,847 85% 93% 91% 669 249 4,006 3,096 77%
Mandatory CDPHP   1,817   117   1,934 58%       184   2,118 53%
  Fidelis/NYS Catholic Hlth   308   19   327 10%       17   344 9%
  Wellcare   552   34   586 18%       48   634 16%
Hamilton Voluntary TOTALS: 211 0 14 0 225 0 0% 91% 0% 47 0 272 0 0%
Herkimer TOTALS: 4,918 2,698 314 180 5,232 2,878 55% 92% 60% 898 70 6,130 2,948 48%
Mandatory Excellus   758   50   808 15%       19   827 13%
  Fidelis/NYS Catholic Hlth   1,200   90   1,290 25%       37   1,327 22%
  United Healthcare of Upstate   740   40   780 15%       14   794 13%
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 2,884 346 223 3,921 3,107 79% 92% 87% 675 195 4,596 3,302 72%
Mandatory Excellus   1,968   137   2,105 54%       93   2,198 48%
  Preferred Care   916   86   1,002 26%       102   1,104 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 41,775 8,702 3,927 63,576 45,702 72% 91% 79% 12,472 3,081 76,048 48,783 64%
Mandatory Excellus   31,548   3,023   34,571 54%       2,444   37,015 49%
  Preferred Care   10,227   904   11,131 18%       637   11,768 15%
Montgomery TOTALS: 4,274 884 386 36 4,660 920 20% 92% 22% 816 71 5,476 991 18%
Voluntary CDPHP   884   36   920 20%       71   991 18%
Nassau TOTALS: 34,739 29,412 3,380 1,861 38,119 31,273 82% 92% 89% 10,221 1,624 48,340 32,897 68%
Mandatory Affinity Health Plan   5,930   220   6,150 16%       252   6,402 13%
  Fidelis/NYS Catholic Hlth   4,461   234   4,695 12%       197   4,892 10%
  HealthFirst PHSP   7,628   335   7,963 21%       306   8,269 17%
  HIP   5,543   597   6,140 16%       516   6,656 14%
  United Healthcare of NY   3,222   319   3,541 9%       188   3,729 8%
  Vytra   2,628   156   2,784 7%       165   2,949 6%
Niagara TOTALS: 13,849 12,492 1,559 1,060 15,408 13,552 88% 93% 95% 3,394 1,647 18,802 15,199 81%
Mandatory Fidelis/NYS Catholic Hlth   2,318   225   2,543 17%       314   2,857 15%
  HealthNow/BCBS-WNY/Community Blue   4,734   385   5,119 33%       460   5,579 30%
  Independent Health Assoc/IHA   5,440   450   5,890 38%       873   6,763 36%
Oneida TOTALS: 18,945 15,790 1,652 1,211 20,597 17,001 83% 92% 89% 5,309 1,586 25,906 18,587 72%
Mandatory Excellus   1,980   206   2,186 11%       78   2,264 9%
  Fidelis/NYS Catholic Hlth   8,770   706   9,476 46%       1,151   10,627 41%
  United Healthcare of Upstate   5,040   299   5,339 26%       357   5,696 22%
Onondaga TOTALS: 33,876 27,159 3,883 2,296 37,759 29,455 78% 89% 88% 7,987 2,397 45,746 31,852 70%
Mandatory Excellus   2,483   267   2,750 7%       108   2,858 6%
  Fidelis/NYS Catholic Hlth   5,898   502   6,400 17%       585   6,985 15%
  Total Care/Syracuse PHSP   10,353   921   11,274 30%       1,098   12,372 27%
  United Healthcare of Upstate   8,425   606   9,031 24%       606   9,637 26%
Ontario TOTALS: 4,735 4,107 426 213 5,161 4,320 84% 91% 92% 1,142 405 6,303 4,725 75%
Mandatory Excellus   3,368   162   3,530 68%       338   3,868 61%
  Preferred Care   739   51   790 15%       67   857 14%
Orange TOTALS: 27,083 8,505 2,122 463 29,205 8,968 31% 91% 34% 4,243 758 33,448 9,726 29%
Voluntary Affinity Health Plan   5,865   274   6,139 21%       610   6,749 20%
  Wellcare   1,558   80   1,638 6%       95   1,733 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   1,082   109   1,191 4%       53   1,244 4%
Orleans TOTALS: 3,439 1,927 329 145 3,768 2,072 55% 92% 60% 591 118 4,359 2,190 50%
Mandatory Excellus   672   44   716 19%       55   771 18%
  Fidelis/NYS Catholic Hlth   837   65   902 24%       48   950 22%
  HealthNow/BCBS-WNY/Community Blue   418   36   454 12%       15   469 11%
Oswego TOTALS: 11,117 9,596 803 629 11,920 10,225 86% 92% 93% 1,926 659 13,846 10,884 79%
Mandatory Excellus   223   32   255 2%       12   267 2%
  Fidelis/NYS Catholic Hlth   1,899   144   2,043 17%       123   2,166 16%
  Total Care/Syracuse PHSP   3,297   247   3,544 30%       267   3,811 28%
  United Healthcare of Upstate   4,177   206   4,383 37%       257   4,640 34%
Otsego TOTALS: 3,346 11 204 0 3,550 11 0% 91% 0% 849 0 4,399 11 0%
Voluntary Wellcare   11   0   11 0%       0   11 0%
Putnam TOTALS: 1,113 180 132 6 1,245 186 15% 88% 17% 563 30 1,808 216 12%
Voluntary Care Plus Health Plan   180   6   186 15%       30   216 12%
Rensselaer TOTALS: 9,173 8,033 961 742 10,134 8,775 87% 92% 94% 2,159 485 12,293 9,260 75%
Mandatory CDPHP   6,563   578   7,141 70%       412   7,553 61%
  Fidelis/NYS Catholic Hlth   688   39   727 7%       46   773 6%
  HealthNow/BlueShield of NENY   533   103   636 6%       16   652 5%
  Wellcare   249   22   271 3%       11   282 2%
Rockland TOTALS: 24,094 22,467 1,302 852 25,396 23,319 92% 92% 100% 2,645 600 28,041 23,919 85%
Mandatory Affinity Health Plan   1,713   126   1,839 7%       120   1,959 7%
  Community Choice Hlth Plan   127   18   145 1%       12   157 1%
  Fidelis/NYS Catholic Hlth   15,414   360   15,774 62%       261   16,035 57%
  Wellcare   1,999   105   2,104 8%       53   2,157 8%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,214   243   3,457 14%       154   3,611 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 5,519 429 321 7,166 5,840 81% 92% 89% 1,889 266 9,055 6,106 67%
Mandatory CDPHP   4,689   247   4,936 69%       236   5,172 57%
  Fidelis/NYS Catholic Hlth   661   51   712 10%       27   739 8%
  HealthNow/BlueShield of NENY   139   19   158 2%       2   160 2%
  Wellcare   30   4   34 0%       1   35 0%
Schenectady TOTALS: 10,345 5,952 939 301 11,284 6,253 55% 90% 62% 2,599 729 13,883 6,982 50%
Voluntary CDPHP   5,156   262   5,418 48%       670   6,088 44%
  Fidelis/NYS Catholic Hlth   796   39   835 7%       59   894 6%
Schoharie TOTALS: 2,039 66 147 7 2,186 73 3% 92% 4% 381 5 2,567 78 3%
Voluntary CDPHP   66   7   73 3%       5   78 3%
Schuyler TOTALS: 1,423 67 116 4 1,539 71 5% 92% 5% 310 2 1,849 73 4%
Voluntary Southern Tier Priority (Partial)   67   4   71 5%       2   73 4%
Seneca TOTALS: 2,122 1,452 144 60 2,266 1,512 67% 92% 72% 463 178 2,729 1,690 62%
Voluntary Excellus   1,452   60   1,512 67%       178   1,690 62%
Steuben TOTALS: 8,070 2,234 769 225 8,839 2,459 28% 91% 31% 2,070 651 10,909 3,110 29%
Voluntary Southern Tier Pediatrics (Partial)   111   0   111 1%       15   126 1%
  Southern Tier Priority (Partial)   2,123   225   2,348 27%       636   2,984 27%
Suffolk TOTALS: 53,946 47,940 5,076 3,465 59,022 51,405 87% 91% 95% 13,448 2,976 72,470 54,381 75%
Mandatory Affinity Health Plan   5,329   288   5,617 10%       190   5,807 8%
  Fidelis/NYS Catholic Hlth   4,722   316   5,038 9%       158   5,196 7%
  HealthFirst PHSP   7,514   412   7,926 13%       564   8,490 12%
  HIP   6,063   884   6,947 12%       325   7,272 10%
  Suffolk Health Plan   11,421   712   12,133 21%       1,170   13,303 18%
  United Healthcare of NY   8,668   485   9,153 16%       248   9,401 13%
  Vytra   4,223   368   4,591 8%       321   4,912 7%
Sullivan TOTALS: 6,184 2,682 309 56 6,493 2,738 42% 91% 47% 1,493 153 7,986 2,891 36%
Voluntary Wellcare   304   2   306 5%       36   342 4%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,378   54   2,432 37%       117   2,549 32%
Tioga TOTALS: 3,130 92 218 5 3,348 97 3% 92% 3% 731 0 4,079 97 2%
Voluntary CDPHP   92   5   97 3%       0   97 2%
Tompkins TOTALS: 4,653 307 516 31 5,169 338 7% 90% 7% 1,005 26 6,174 364 6%
Voluntary Total Care/Syracuse PHSP   307   31   338 7%       26   364 6%
Ulster TOTALS: 9,395 2,312 852 77 10,247 2,389 23% 91% 26% 2,587 190 12,834 2,579 20%
Voluntary Wellcare   2,312   77   2,389 23%       190   2,579 20%
Warren TOTALS: 3,312 2,113 216 22 3,528 2,135 61% 92% 66% 922 75 4,450 2,210 50%
Voluntary HealthNow/BlueShield of NENY   2,113   22   2,135 61%       75   2,210 50%
Washington TOTALS: 3,942 1,643 213 42 4,155 1,685 41% 91% 45% 949 131 5,104 1,816 36%
Voluntary CDPHP   561   6   567 14%       27   594 12%
  Fidelis/NYS Catholic Hlth   13   0   13 0%       1   14 0%
  HealthNow/BlueShield of NENY   1,069   36   1,105 27%       103   1,208 24%
Wayne TOTALS: 4,943 4,284 292 212 5,235 4,496 86% 92% 93% 1,201 346 6,436 4,842 75%
Mandatory Excellus   2,046   105   2,151 41%       152   2,303 36%
  Preferred Care   2,238   107   2,345 45%       194   2,539 39%
Westchester TOTALS: 49,427 35,621 6,706 3,046 56,133 38,667 69% 89% 78% 10,325 2,534 66,458 41,201 62%
Mandatory Affinity Health Plan   5,288   438   5,726 10%       440   6,166 9%
  Community Choice Hlth Plan   6,178   550   6,728 12%       445   7,173 11%
  Fidelis/NYS Catholic Hlth   3,155   400   3,555 6%       225   3,780 6%
  HIP   2,751   486   3,237 6%       320   3,557 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   18,249   1,172   19,421 35%       1,104   20,525 31%
Wyoming Voluntary TOTALS: 1,908 0 116 0 2,024 0 0% 91% 0% 425 0 2,449 0 0%
Yates TOTALS: 1,713 1,201 96 54 1,809 1,255 69% 93% 75% 288 93 2,097 1,348 64%
Voluntary Excellus   1,201   54   1,255 69%       93   1,348 64%
Upstate Total   631,165 412,606 64,497 31,579 695,662 444,185 64% 91% 70% 147,644 35,400 843,306 479,585 57%
NYC ABC Health Plan   7,091   1,497   8,588 1%       179   8,767 0%
Mandatory Affinity Health Plan   72,552   15,152   87,704 5%       2,940   90,644 5%
  AmeriChoice of New York/MHS   64,469   18,889   83,358 5%       3,205   86,563 5%
  Care Plus Health Plan   53,368   8,649   62,017 4%       1,097   63,114 3%
  Community Choice Hlth Plan   3,421   657   4,078 0%       78   4,156 0%
  Community Premier Plus   35,741   6,606   42,347 3%       1,158   43,505 2%
  Fidelis/NYS Catholic Hlth   63,107   11,603   74,710 5%       2,029   76,739 4%
  Fidelis Care HealthierLife SN                            
  HealthFirst PHSP   109,003   20,875   129,878 8%       5,004   134,882 7%
  HealthFirst PHSP SN   5   4   9 0%       4   13 0%
  Health Plus PHSP   122,522   24,376   146,898 9%       2,596   149,494 8%
  HIP   114,121   38,088   152,209 10%       7,264   159,473 9%
  Manhattan PHSP/CenterCare   54,953   10,831   65,784 4%       1,798 67,582 4%
  MetroPlus Health Plan   110,882   22,571   133,453 8%       4,513   137,966 7%
  MetroPlus Health Plan SN   27   23   50 0%       58   108 0%
  Neighborhood Health Providers   59,107   8,954   68,061 4%       1,844   69,905 4%
  NY Hospital Community PHSP   29,802   7,821   37,623 2%       863   38,486 2%
  NYPS Select Health SN   0   4   4 0%       8   12 0%
  St Barnabas/Partners in Health   17,662   3,154   20,816 1%       1,084   21,900 1%
  United Healthcare of NY   20,210   8,263   28,473 2%       784   29,257 2%
  VidaCare Inc. SN   0   6   6 0%       13   19 0%
  Wellcare   19,390   4,478   23,868 1%       472   24,340 1%
  NYC Total 1,232,048 957,433 365,179 212,501 1,597,227 1,169,934 73% 90% 81% 251,856 36,991 1,849,083 1,206,925 65%
                               
  UPSTATE TOTALS: 631,165 412,606 64,497 31,579 695,662 444,185 64% 91% 70% 147,644 35,400 843,306 479,585 57%
  NEW YORK CITY TOTALS: 1,232,048 957,433 365,179 212,501 1,597,227 1,169,934 73% 90% 81% 251,856 36,991 1,849,083 1,206,925 65%
  GRAND TOTALS 1,863,213 1,370,039 429,676 244,080 2,292,889 1,614,119 70% 91% 78% 399,500 72,391 2,692,389 1,686,510 63%
NYC Boroughs Bronx 305,681 243,473 83,283 44,219 388,964 287,692 74%     64,760 9,791 453,724 297,483 66%
  Brooklyn 456,460 355,656 140,056 88,200 596,516 443,857 74%     86,314 13,451 682,830 457,308 67%
  Manhattan 175,007 124,756 69,160 31,847 244,167 156,602 64%     48,437 5,697 292,604 162,299 55%
  Queens 261,844 206,700 64,935 42,990 326,779 249,690 76%     44,510 6,273 371,289 255,963 69%
  Staten Island 33,056 26,848 7,745 5,245 40,801 32,093 79%     7,835 1,780 48,636 33,872 70%
  Borough Total 1,232,048 957,433 365,179 212,501 1,597,227 1,169,934 73% 90% 81% 251,856 36,991 1,849,083 1,206,925 65%

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: None

MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS September, 2003

PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 422
  Total 422
CO-OP CARE PLAN NYC 514
  Total 514
COMPREHENSIVE CARE MGT NYC 1,008
  WESTCHESTER 106
  Total 1,114
EDDY SENIORCARE SCHENECTADY 85
  Total 85
ELANT CHOICE ORANGE 72
  Total 72
GUILDNET NYC 1,816
  Total 1,816
HOMEFIRST NYC 1,032
  Total 1,032
INDEP CARE SYSTEMS INC NYC 531
  Total 531
INDEP LIVING FOR SENIORS MONROE 297
  Total 297
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 217
  Total 217
PARTNERS IN COMMUNITY CARE ORANGE 99
  ROCKLAND 26
  Total 125
SENIOR HEALTH PARTNERS INC NYC 141
  Total 141
SENIOR NETWORK HEALTH HERKIMER 12
  ONEIDA 290
  Total 302
TOTAL AGING IN PLACE ERIE 41
  Total 41
VNS CHOICE NYC 3,120
  Total 3,120
 
  UPSTATE TOTALS: 1,667
  NEW YORK CITY TOTALS: 8,162
  GRAND TOTALS: 9,829

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