Managed Care

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

NYS January, 2004

  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 14,494 2,154 1,210 19,842 15,704 79% 92% 86% 4,394 952 24,236 16,656 69%
Mandatory CDPHP   11,673   885   12,558 63%       820   13,378 55%
  Fidelis/NYS Catholic Hlth   1,747   226   1,973 10%       91   2,064 9%
  HealthNow/BlueShield of NENY   47   17   64 0%       1   65 0%
  Wellcare   1,027   82   1,109 6%       40   1,149 5%
Allegany TOTALS: 3,750 1,100 375 89 4,125 1,189 29% 90% 32% 979 200 5,104 1,389 27%
Voluntary Health Choice (Partial)   307   29   336 8%       150   486 10%
  HealthNow/BCBS-WNY/Community Blue   793   60   853 21%       50   903 18%
Broome TOTALS: 13,555 11,709 1,370 956 14,925 12,665 85% 90% 94% 3,597 995 18,522 13,660 74%
Mandatory Broome MC   4,537   300   4,837 32%       707   5,544 30%
  CDPHP   6,777   610   7,387 49%       268   7,655 41%
  Fidelis/NYS Catholic Hlth   395   46   441 3%       20   461 2%
Cattaraugus TOTALS: 6,400 4,947 412 315 6,812 5,262 77% 91% 84% 1,550 635 8,362 5,897 71%
Mandatory Fidelis/NYS Catholic Hlth   1,037   64   1,101 16%       76   1,177 14%
  HealthNow/BCBS-WNY/Community Blue   3,910   251   4,161 61%       559   4,720 56%
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 9,903 1,657 1,114 14,902 11,017 74% 85% 87% 2,726 1,158 17,628 12,175 69%
Mandatory Fidelis/NYS Catholic Hlth   5,558   571   6,129 41%       552   6,681 38%
  HealthNow/BCBS-WNY/Community Blue   3,750   425   4,175 28%       366   4,541 26%
  Primary Health   595   118   713 5%       240   953 5%
Chemung TOTALS: 8,763 3,597 851 235 9,614 3,832 40% 89% 45% 1,963 905 11,577 4,737 41%
Voluntary Southern Tier Pediatrics (Partial)   2,519   1   2,520 26%       254   2,774 24%
  Southern Tier Priority (Partial)   1,078   234   1,312 14%       651   1,963 17%
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 2,670 275 187 3,630 2,857 79% 93% 84% 880 225 4,510 3,082 68%
Mandatory CDPHP   2,087   143   2,230 61%       190   2,420 54%
  Fidelis/NYS Catholic Hlth   192   16   208 6%       7   215 5%
  Wellcare   391   28   419 12%       28   447 10%
Cortland TOTALS: 4,296 444 297 19 4,593 463 10% 91% 11% 770 85 5,363 548 10%
Voluntary Fidelis/NYS Catholic Hlth   444   19   463 10%       85   548 10%
Delaware TOTALS: 3,000 0 221 0 3,221 0 0% 92% 0% 746 0 3,967 0 0%
Dutchess TOTALS: 9,827 2,370 892 107 10,719 2,477 23% 90% 26% 2,781 136 13,500 2,613 19%
Voluntary Wellcare   2,343   105   2,448 23%       130   2,578 19%
  Westchester PHSP/HealthSource/Hudson Health Plan   27   2   29 0%       6   35 0%
Erie TOTALS: 68,813 57,018 9,135 5,576 77,948 62,594 80% 93% 87% 17,303 7,746 95,251 70,340 74%
Mandatory Buffalo Community Health   9,387   809   10,196 13%       384   10,580 11%
  Fidelis/NYS Catholic Hlth   14,492   829   15,321 20%       1,386   16,707 18%
  HealthNow/BCBS-WNY/Community Blue   13,372   1,293   14,665 19%       1,016   15,681 16%
  Independent Health Assoc/IHA   19,113   1,493   20,606 26%       1,711   22,317 23%
  Total Full Risk   56,364   4,424   60,788 78%       4,497   65,285 69%
  PCMP II (Partial)   92   35   127 0%       259   386 0%
  PCMP III (Partial)   3   11   14 0%       264   278 0%
  PCMP II-A Special Care (Partial)   559   1,106   1,665 2%       2,726   4,391 5%
  Total Partial Risk   654   1,152   1,806 2%       3,249   5,055 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: 5,329 877 421 43 5,750 920 16% 92% 17% 1,078 49 6,828 969 14%
Voluntary CDPHP   877   43   920 16%       49   969 14%
Genesee TOTALS: 3,447 2,195 193 132 3,640 2,327 64% 89% 71% 643 139 4,283 2,466 58%
Mandatory HealthNow/BCBS-WNY/Community Blue   866   60   926 25%       24   950 22%
  Preferred Care   1,329   72   1,401 38%       115   1,516 35%
Greene TOTALS: 3,194 2,779 265 185 3,459 2,964 86% 93% 92% 695 262 4,154 3,226 78%
Mandatory CDPHP   1,850   120   1,970 57%       197   2,167 52%
  Fidelis/NYS Catholic Hlth   352   29   381 11%       15   396 10%
  Wellcare   577   36   613 18%       50   663 16%
Hamilton Voluntary TOTALS: 216 0 21 0 237 0 0% 91% 0% 45 0 282 0 0%
Herkimer TOTALS: 5,087 3,734 311 250 5,398 3,984 74% 92% 80% 898 103 6,296 4,087 65%
Mandatory Excellus   1,291   93   1,384 26%       37   1,421 23%
  Fidelis/NYS Catholic Hlth   1,661   108   1,769 33%       51   1,820 29%
  United Healthcare of Upstate   782   49   831 15%       15   846 13%
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 2,989 377 244 4,015 3,233 81% 92% 88% 690 210 4,705 3,443 73%
Mandatory Excellus   2,054   152   2,206 55%       106   2,312 49%
  Preferred Care   935   92   1,027 26%       104   1,131 24%
Madison Voluntary TOTALS: 4,176 0 241 0 4,417 0 0% 91% 0% 768 0 5,185 0 0%
Monroe TOTALS: 56,320 42,913 9,107 3,994 65,427 46,907 72% 91% 79% 12,618 3,289 78,045 50,196 64%
Mandatory Excellus   32,018   3,080   35,098 54%       2,608   37,706 48%
  Preferred Care   10,895   914   11,809 18%       681   12,490 16%
Montgomery TOTALS: 4,461 915 411 47 4,872 962 20% 92% 22% 809 77 5,681 1,039 18%
Voluntary CDPHP   915   47   962 20%       77   1,039 18%
Nassau TOTALS: 38,269 32,697 3,750 2,097 42,019 34,794 83% 92% 90% 10,297 1,734 52,316 36,528 70%
Mandatory Affinity Health Plan   6,617   276   6,893 16%       253   7,146 14%
  Fidelis/NYS Catholic Hlth   4,963   248   5,211 12%       203   5,414 10%
  HealthFirst PHSP   8,678   375   9,053 22%       335   9,388 18%
  HIP   5,896   644   6,540 16%       556   7,096 14%
  United Healthcare of NY   3,727   337   4,064 10%       215   4,279 8%
  Vytra   2,816   217   3,033 7%       172   3,205 6%
Niagara TOTALS: 14,025 12,960 1,665 1,148 15,690 14,108 90% 93% 97% 3,429 1,701 19,119 15,809 83%
Mandatory Fidelis/NYS Catholic Hlth   2,441   243   2,684 17%       303   2,987 16%
  HealthNow/BCBS-WNY/Community Blue   4,956   417   5,373 34%       515   5,888 31%
  Independent Health Assoc/IHA   5,563   488   6,051 39%       883   6,934 36%
Oneida TOTALS: 19,559 15,577 1,704 1,197 21,263 16,774 79% 92% 85% 5,328 1,633 26,591 18,407 69%
Mandatory Excellus   2,161   211   2,372 11%       89   2,461 9%
  Fidelis/NYS Catholic Hlth   8,788   693   9,481 45%       1,195   10,676 40%
  United Healthcare of Upstate   4,628   293   4,921 23%       349   5,270 20%
Onondaga TOTALS: 34,698 28,250 4,264 2,424 38,962 30,674 79% 89% 89% 8,049 2,523 47,011 33,197 71%
Mandatory Excellus   2,643   290   2,933 8%       125   3,058 7%
  Fidelis/NYS Catholic Hlth   6,294   534   6,828 18%       619   7,447 16%
  Total Care/Syracuse PHSP   10,669   968   11,637 30%       1,128   12,765 27%
  United Healthcare of Upstate   8,644   632   9,276 24%       651   9,927 25%
Ontario TOTALS: 5,017 4,016 456 206 5,473 4,222 77% 91% 84% 1,142 419 6,615 4,641 70%
Mandatory Excellus   3,332   156   3,488 64%       351   3,839 58%
  Preferred Care   684   50   734 13%       68   802 12%
Orange TOTALS: 28,197 8,722 2,161 444 30,358 9,166 30% 91% 33% 4,269 801 34,627 9,967 29%
Voluntary Affinity Health Plan   5,800   247   6,047 20%       615   6,662 19%
  Wellcare   1,683   72   1,755 6%       109   1,864 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   1,239   125   1,364 4%       77   1,441 4%
Orleans TOTALS: 3,565 2,443 354 243 3,919 2,686 69% 92% 75% 602 132 4,521 2,818 62%
Mandatory Excellus   810   77   887 23%       54   941 21%
  Fidelis/NYS Catholic Hlth   1,029   94   1,123 29%       58   1,181 26%
  HealthNow/BCBS-WNY/Community Blue   604   72   676 17%       20   696 15%
Oswego TOTALS: 11,619 9,734 856 568 12,475 10,302 83% 92% 89% 1,936 695 14,411 10,997 76%
Mandatory Excellus   304   24   328 3%       15   343 2%
  Fidelis/NYS Catholic Hlth   1,928   139   2,067 17%       122   2,189 15%
  Total Care/Syracuse PHSP   3,343   237   3,580 29%       291   3,871 27%
  United Healthcare of Upstate   4,159   168   4,327 35%       267   4,594 32%
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: 1,187 175 148 7 1,335 182 14% 88% 15% 564 28 1,899 210 11%
Voluntary Care Plus Health Plan   175   7   182 14%       28   210 11%
Rensselaer TOTALS: 9,287 8,236 979 764 10,266 9,000 88% 92% 95% 2,179 511 12,445 9,511 76%
Mandatory CDPHP   6,615   585   7,200 70%       432   7,632 61%
  Fidelis/NYS Catholic Hlth   718   54   772 8%       46   818 7%
  HealthNow/BlueShield of NENY   652   105   757 7%       22   779 6%
  Wellcare   251   20   271 3%       11   282 2%
Rockland TOTALS: 24,897 23,268 1,343 927 26,240 24,195 92% 92% 100% 2,635 601 28,875 24,796 86%
Mandatory Affinity Health Plan   1,672   167   1,839 7%       124   1,963 7%
  Community Choice Hlth Plan   140   30   170 1%       14   184 1%
  Fidelis/NYS Catholic Hlth   16,067   384   16,451 63%       268   16,719 58%
  Wellcare   1,941   104   2,045 8%       48   2,093 7%
  Westchester PHSP/HealthSource/Hudson Health Plan   3,448   242   3,690 14%       147   3,837 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 5,851 455 330 7,631 6,181 81% 92% 88% 1,903 291 9,534 6,472 68%
Mandatory CDPHP   4,824   249   5,073 66%       251   5,324 56%
  Fidelis/NYS Catholic Hlth   644   45   689 9%       29   718 8%
  HealthNow/BlueShield of NENY   383   36   419 5%       11   430 5%
Schenectady TOTALS: 10,827 6,065 1,021 304 11,848 6,369 54% 90% 60% 2,644 748 14,492 7,117 49%
Voluntary CDPHP   5,137   239   5,376 45%       683   6,059 42%
  Fidelis/NYS Catholic Hlth   928   65   993 8%       65   1,058 7%
Schoharie TOTALS: 2,149 63 162 7 2,311 70 3% 92% 3% 388 6 2,699 76 3%
Voluntary CDPHP   63   7   70 3%       6   76 3%
Schuyler TOTALS: 1,406 104 125 17 1,531 121 8% 92% 9% 308 5 1,839 126 7%
Voluntary Southern Tier Priority (Partial)   104   17   121 8%       5   126 7%
Seneca TOTALS: 2,160 1,399 138 60 2,298 1,459 63% 92% 69% 457 179 2,755 1,638 59%
Voluntary Excellus   1,399   60   1,459 63%       179   1,638 59%
Steuben TOTALS: 8,244 2,251 833 221 9,077 2,472 27% 91% 30% 2,054 675 11,131 3,147 28%
Voluntary Southern Tier Pediatrics (Partial)   109       109 1%       15   124 1%
  Southern Tier Priority (Partial)   2,142   221   2,363 26%       660   3,023 27%
Suffolk TOTALS: 58,599 48,689 5,835 3,605 64,434 52,294 81% 91% 89% 13,489 3,057 77,923 55,351 71%
Mandatory Affinity Health Plan   5,218   298   5,516 9%       207   5,723 7%
  Fidelis/NYS Catholic Hlth   4,707   323   5,030 8%       158   5,188 7%
  HealthFirst PHSP   7,901   458   8,359 13%       570   8,929 11%
  HIP   6,042   830   6,872 11%       340   7,212 9%
  Suffolk Health Plan   11,201   708   11,909 18%       1,169   13,078 17%
  United Healthcare of NY   8,970   502   9,472 15%       266   9,738 12%
  Vytra   4,650   486   5,136 8%       347   5,483 7%
Sullivan TOTALS: 6,478 2,855 313 53 6,791 2,908 43% 91% 47% 1,510 157 8,301 3,065 37%
Voluntary Wellcare   234   2   236 3%       31   267 3%
  Westchester PHSP/HealthSource/Hudson Health Plan   2,621   51   2,672 39%       126   2,798 34%
Tioga TOTALS: 3,290 108 256 7 3,546 115 3% 92% 4% 725 0 4,271 115 3%
Voluntary CDPHP   108   7   115 3%           115 3%
Tompkins TOTALS: 4,800 460 527 43 5,327 503 9% 90% 11% 1,014 36 6,341 539 9%
Voluntary Total Care/Syracuse PHSP   460   43   503 9%       36   539 9%
Ulster TOTALS: 9,659 2,399 852 79 10,511 2,478 24% 91% 26% 2,601 208 13,112 2,686 20%
Voluntary Wellcare   2,399   79   2,478 24%       208   2,686 20%
Warren TOTALS: 3,503 2,162 241 19 3,744 2,181 58% 92% 64% 939 83 4,683 2,264 48%
Voluntary HealthNow/BlueShield of NENY   2,162   19   2,181 58%       83   2,264 48%
Washington TOTALS: 4,278 1,690 247 33 4,525 1,723 38% 91% 42% 954 145 5,479 1,868 34%
Voluntary CDPHP   561   4   565 12%       32   597 11%
  Fidelis/NYS Catholic Hlth   57   2   59 1%       1   60 1%
  HealthNow/BlueShield of NENY   1,072   27   1,099 24%       112   1,211 22%
Wayne TOTALS: 5,129 4,534 335 221 5,464 4,755 87% 92% 95% 1,212 358 6,676 5,113 77%
Mandatory Excellus   2,359   110   2,469 45%       169   2,638 40%
  Preferred Care   2,175   111   2,286 42%       189   2,475 37%
Westchester TOTALS: 51,454 36,500 6,984 3,204 58,438 39,704 68% 89% 77% 10,417 2,615 68,855 42,319 61%
Mandatory Affinity Health Plan   5,446   490   5,936 10%       421   6,357 9%
  Community Choice Hlth Plan   6,305   580   6,885 12%       452   7,337 11%
  Fidelis/NYS Catholic Hlth   3,414   435   3,849 7%       247   4,096 6%
  HIP   2,814   520   3,334 6%       342   3,676 5%
  Westchester PHSP/HealthSource/Hudson Health Plan   18,521   1,179   19,700 34%       1,153   20,853 30%
Wyoming Voluntary TOTALS: 2,041 0 120 0 2,161 0 0% 91% 0% 431 0 2,592 0 0%
Yates TOTALS: 1,774 1,166 113 60 1,887 1,226 65% 93% 70% 290 91 2,177 1,317 60%
Voluntary Excellus   1,166   60   1,226 65%       91   1,317 60%
Upstate Total   657,579 427,039 68,523 32,991 726,102 460,030 63% 91% 70% 148,709 36,598 874,811 496,628 57%
NYC ABC Health Plan   6,414   1,489   7,903 0%       188   8,091 0%
Mandatory Affinity Health Plan   74,670   17,492   92,162 6%       3,065   95,227 5%
  AmeriChoice of New York/MHS   66,075   19,977   86,052 5%       3,233   89,285 5%
  Care Plus Health Plan   56,212   9,522   65,734 4%       1,174   66,908 4%
  Community Choice Hlth Plan   3,410   651   4,061 0%       76   4,137 0%
  Community Premier Plus   40,657   8,091   48,748 3%       1,300   50,048 3%
  Fidelis/NYS Catholic Hlth   63,619   12,393   76,012 5%       2,147   78,159 4%
  FidelisCare HealthierLife SN   3   1   4 0%       1   5 0%
  HealthFirst PHSP   118,342   24,979   143,321 9%       5,237   148,558 8%
  HealthFirst PHSP SN   7   3   10 0%       4   14 0%
  Health Plus PHSP   130,358   27,503   157,861 10%       2,898   160,759 9%
  HIP   115,529   38,881   154,410 9%       7,594   162,004 9%
  Managed Health Inc   142   45   187 0%       0   187 0%
  Manhattan PHSP/CenterCare   54,783   11,462   66,245 4%       1,872   68,117 4%
  MetroPlus Health Plan   118,285   24,987   143,272 9%       4,730   148,002 8%
  MetroPlus Health Plan SN   46   44   90 0%       92   182 0%
  Neighborhood Health Providers   59,252   9,959   69,211 4%       1,924   71,135 4%
  NY Hospital Community PHSP   31,287   8,962   40,249 2%       953   41,202 2%
  NYPS Select Health SN   18   39   57 0%       64   121 0%
  St Barnabas/Partners in Health   17,667   3,262   20,929 1%       1,125   22,054 1%
  United Healthcare of NY   21,952   9,075   31,027 2%       954   31,981 2%
  VidaCare Inc. SN   5   30   35 0%       42   77 0%
  Wellcare   21,598   5,598   27,196 2%       512   27,708 1%
  NYC Total 1,248,302 1,000,331 378,155 234,445 1,626,457 1,234,776 76% 90% 84% 252,281 39,185 1,878,738 1,273,961 68%
                               
  UPSTATE TOTALS: 657,579 427,039 68,523 32,991 726,102 460,030 63% 91% 70% 148,709 36,598 874,811 496,628 57%
  NEW YORK CITY TOTALS: 1,248,302 1,000,331 378,155 234,445 1,626,457 1,234,776 76% 90% 84% 252,281 39,185 1,878,738 1,273,961 68%
  GRAND TOTALS 1,905,881 1,427,370 446,678 267,436 2,352,559 1,694,806 72% 91% 80% 400,990 75,783 2,753,549 1,770,589 64%
NYC Boroughs Bronx 308,575 252,412 85,716 48,650 394,291 301,062 76%     65,069 10,353 459,360 311,415 68%
  Brooklyn 460,939 369,482 144,450 95,441 605,389 464,924 77%     86,429 14,193 691,818 479,116 69%
  Manhattan 176,233 134,567 70,978 36,807 247,211 171,374 69%     48,492 6,145 295,703 177,519 60%
  Queens 269,105 215,692 68,807 47,721 337,912 263,412 78%     44,455 6,640 382,367 270,052 71%
  Staten Island 33,450 28,178 8,204 5,826 41,654 34,004 82%     7,836 1,854 49,490 35,858 72%
  Borough Total 1,248,302 1,000,331 378,155 234,445 1,626,457 1,234,776 76% 90% 84% 252,281 39,185 1,878,738 1,273,961 68%

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 : Dutchess County - Westchester PHSP/HealthSource/Hudson Health Plan; NYC - Managed Health Inc

 

NYS January, 2004
PROVIDER COUNTY TOTAL ENROLLMENT
BROADLAWN HEALTH PARTNERS NASSAU 434
  Total 434
CO-OP CARE PLAN NYC 477
  Total 477
COMPREHENSIVE CARE MGT NYC 1,098
  WESTCHESTER 121
  Total 1,219
EDDY SENIORCARE SCHENECTADY 77
  Total 77
ELANT CHOICE ORANGE 77
  Total 77
GUILDNET NYC 1,938
  Total 1,938
HOMEFIRST NYC 1,041
  Total 1,041
INDEP CARE SYSTEMS INC NYC 540
  Total 540
INDEP LIVING FOR SENIORS MONROE 305
  Total 305
LORETTO/INDEPENDENT LIVING SERVICES ONONDAGA 222
  Total 222
PARTNERS IN COMMUNITY CARE ORANGE 101
  ROCKLAND 24
  Total 125
SENIOR HEALTH PARTNERS INC NYC 161
  Total 161
SENIOR NETWORK HEALTH HERKIMER 16
  ONEIDA 312
  Total 328
TOTAL AGING IN PLACE ERIE 65
  Total 65
VNS CHOICE NYC 3,438
  Total 3,438
 
  UPSTATE TOTALS: 1,754
  NEW YORK CITY TOTALS: 8,693
  GRAND TOTALS: 10,447

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