BMCO Monthly Physical Health Managed Care Program ... Care Enrollment...BMCO Monthly Physical Health Managed Care Program Enrollment Report NOTE: This report contains the number of

BMCO Monthly Physical Health Managed Care Program Enrollment Report

NOTE: This report contains the number of consumers that are MA eligible and managed care eligible any time during the month. The data is based on capitation payments and therefore each consumer we paid for in the month is counted.

Released: January 17, 2020

HEALTHCHOICES

Map 4 Enrollment by Plan and by County 5-7 Market Share by Plan – Statewide 8 Market Share by Zone and by Plan 9 Enrollment by Plan, by Race and by County 10-19 Enrollment by Ethnicity, by Plan and by County 20-29 Plan Make Up by Age Group and Gender 30-32 Plan Make Up by Age Group 33-34 Aid Category Distribution 35 PCP Selection During Enrollment 36

MEDICAL ASSISTANCE TRANSPORTATION PROGRAM

All Zones 38-42

LINK TO MCO DIRECTORY 43

Table of Contents

2

3

HealthChoices

Managed Care

Erie

Crawford

Mercer

Warren McKean Potter Tioga Bradford Susquehanna Wayne

Pike

Lackawanna

Monroe Luzerne

Wyoming

Carbon

Schuylkill

Columbia

Sullivan Lycoming

Montour Northumberland Snyder

Union

Juniata Mifflin

Centre

Clinton

Cameron Elk

Clearfield

Jefferson Clarion

Forest Venango

Blair

Bedford

Huntingdon

Fulton Franklin Somerset

Cambria

Lawrence

Beaver

Washington

Greene

Butler

Allegheny

Fayette

Westmoreland

Armstrong

Indiana

Perry

Cumberland

Adams York Lancaster

Dauphin Lebanon Berks

Lehigh

Northampton

Bucks

Montgomery

Chester

Delaware Philadelphia

HC SE – 1997

HC SW – 1999

HC L/C – 2001

HC NW – 2012

HC NE – 2013 4

Mandatory ENROLLMENT BY PLAN AND BY COUNTY December 2019

SOUTHEAST

County 42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL 09 Bucks 5,351 7,005 11,822 40,119 64,297 15 Chester 12,608 7,164 2,638 21,950 44,360 23 Delaware 8,289 9,568 8,234 68,083 94,174 46 Montgomery 8,692 10,390 10,223 54,553 83,858 51 Philadelphia 51,070 34,628 195,807 237,461 518,966 TOTAL 86,010 68,755 228,724 422,166 805,655 PERCENTAGE 11% 9% 28% 52%

SOUTHWEST

County 31 Gateway 32 United 34 UPMC 59 Aetna TOTAL 02 Allegheny 54,640 20,347 99,145 8,021 182,153 03 Armstrong 969 562 9,341 429 11,301 04 Beaver 10,117 2,316 12,954 1,257 26,644 05 Bedford 616 992 5,802 629 8,039 07 Blair 5,361 3,238 14,031 1,947 24,577 10 Butler 4,596 1,147 13,968 854 20,565 11 Cambria 3,411 4,773 14,900 2,580 25,664 26 Fayette 3,394 8,290 18,944 734 31,362 30 Greene 699 2,884 3,245 347 7,175 32 Indiana 2,129 1,588 8,637 571 12,925 37 Lawrence 6,275 1,499 8,698 728 17,200 56 Somerset 1,522 2,543 6,441 920 11,426 63 Washington 5,041 4,979 18,567 1,496 30,083 65 Westmoreland 10,180 7,196 31,214 2,080 50,670 TOTAL 108,950 62,354 265,887 22,593 459,784 PERCENTAGE 24% 14% 58% 5%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 1/10/20 5


cont. LEHIGH/CAPITAL

County 51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL 01 Adams 3,650 4,245 1,226 1,239 1,319 11,679 06 Berks 13,334 7,971 6,795 8,526 39,844 76,470 21 Cumberland 11,202 3,838 4,046 2,778 4,808 26,672 22 Dauphin 25,710 10,345 8,054 6,514 6,311 56,934 28 Franklin 1,073 1,492 7,857 460 11,372 22,254 29 Fulton 152 353 800 500 653 2,458 31 Huntingdon 402 619 1,033 3,249 1,570 6,873 36 Lancaster 20,922 10,277 3,281 10,123 28,853 73,456 38 Lebanon 13,367 1,809 1,779 2,153 3,208 22,316 39 Lehigh 20,511 5,146 2,981 5,155 38,079 71,872 48 Northampton 11,352 2,674 2,313 2,666 23,881 42,886 50 Perry 3,167 661 756 483 1,017 6,084 67 York 19,723 20,426 8,025 8,053 14,278 70,505 TOTAL 144,565 69,856 48,946 51,899 175,193 490,459 PERCENTAGE 29% 14% 10% 11% 36%

NORTHWEST

County 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL 12 Cameron 763 27 111 43 944 16 Clarion 4,194 629 535 566 5,924 17 Clearfield 9,673 1,151 1,969 1,757 14,550 20 Crawford 11,866 900 974 1,063 14,803 24 Elk 3,536 392 282 276 4,486 25 Erie 31,955 12,593 5,537 9,734 59,819 27 Forest 563 74 63 56 756 33 Jefferson 6,384 726 314 357 7,781 42 McKean 5,947 215 1,146 604 7,912 43 Mercer 13,549 3,409 2,045 1,985 20,988 53 Potter 1,775 38 1,183 65 3,061 61 Venango 6,737 723 941 894 9,295 62 Warren 4,588 648 715 437 6,388

TOTAL 101,530 21,525 15,815 17,837 156,707 PERCENTAGE 65% 14% 10% 11%



cont.

NORTHEAST County 41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

08 Bradford 2,980 4,282 3,183 10,445 13 Carbon 7,798 2,205 969 10,972 14 Centre 2,375 5,894 2,420 10,689 18 Clinton 1,098 4,788 717 6,603 19 Columbia 1,487 6,773 1,098 9,358 34 Juniata 809 1,665 642 3,116 35 Lackawanna 7,654 30,533 5,675 43,862 40 Luzerne 18,269 44,533 8,366 71,168 41 Lycoming 4,892 14,385 1,591 20,868 44 Mifflin 2,025 4,254 1,525 7,804 45 Monroe 14,905 11,028 4,857 30,790 47 Montour 350 1,515 279 2,144 49 Northumberland 3,398 10,583 3,403 17,384 52 Pike 2,772 4,977 1,294 9,043 54 Schuylkill 9,235 13,460 2,907 25,602 55 Snyder 1,144 3,020 807 4,971 57 Sullivan 161 458 158 777 58 Susquehanna 1,162 4,286 900 6,348 59 Tioga 5,646 902 568 7,116 60 Union 788 2,681 677 4,146 64 Wayne 1,630 5,334 1,115 8,079 66 Wyoming 731 3,395 548 4,674

TOTAL 91,309 180,951 43,699 315,959 PERCENTAGE 29% 57% 14%


Mandatory MARKET SHARE BY PLAN – STATEWIDE December 2019

Total Enrollment = 2,228,564

AmeriHealth NE 91,309

4% Aetna

201,830 9%

AmeriHealth 191,008

9%

Gateway 275,040

12%

Health Partners 228,724

10%

Keystone 422,166

19%

United 218,220

10%

UPMC 419,316

19%

Geisinger 180,951

8%


-

-

Mandatory MARKET SHARE BY ZONE AND BY PLAN December 2019

Southeast Southwest Aetna 22,593

5%

Lehigh/Capital

UPMC 51,899

11%

Northwest

Aetna 48,946

10%

Ameri Health

175,193 Gateway 36% 144,565

29%

United 69,856

14%

Northeast Ameri-

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 1/10/20

Aetna 68,755

9%

Health Partners 228,724

28%

Keystone 422,166

52%

United 86,010

11% Gateway 108,950

24%

United 62,354

13%

UPMC 265,887

58%

Aetna 17,837

11%

Health 15,815

10%

Gateway 21,525

14%

UPMC 101,530

65%

Aetna 43,699

14%

Ameri Health NE

91,309 29%

Geisinger 180,951

57%

9

Mandatory ENROLLMENT BY PLAN, BY RACE AND BY COUNTY December 2019

Southeast 09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast

Black or African American

42 United 588 2,341 4,384 2,057 31,455 40,825 43 Aetna 617 1,190 4,243 2,224 20,900 29,174 45 Health Partners 1,365 470 4,323 2,900 91,971 101,029 47 Keystone 4,282 3,823 32,808 12,646 142,532 196,091 Southeast MCOs 6,852 7,824 45,758 19,827 286,858 367,119

American Indian or Alaskan Native

42 United 7 31 17 30 76 161 43 Aetna 30 37 17 44 71 199 45 Health Partners 35 4 20 36 248 343 47 Keystone 81 98 116 178 354 827 Southeast MCOs 153 170 170 288 749 1,530

Asian

42 United 265 291 471 454 3,249 4,730 43 Aetna 311 191 478 710 1,529 3,219 45 Health Partners 746 69 420 758 7,703 9,696 47 Keystone 1,446 695 4,567 3,782 19,144 29,634 Southeast MCOs 2,768 1,246 5,936 5,704 31,625 47,279

White

42 United 3,496 6,884 2,470 4,392 7,675 24,917 43 Aetna 4,878 4,417 3,801 5,725 6,268 25,089 45 Health Partners 7,391 1,566 2,350 4,624 31,610 47,541 47 Keystone 28,017 13,228 23,765 27,857 38,649 131,516 Southeast MCOs 43,782 26,095 32,386 42,598 84,202 229,063

Other or system default

42 United 657 2,115 601 1,210 6,596 11,179 43 Aetna 710 808 611 1,062 4,372 7,563 45 Health Partners 1,634 322 756 1,338 58,129 62,179 47 Keystone 4,492 2,890 4,724 7,494 29,443 49,043 Southeast MCOs 7,493 6,135 6,692 11,104 98,540 129,964

Native Hawaiian or Other Pacific Islander

42 United 12 19 16 21 115 183 43 Aetna 24 11 21 33 93 182 45 Health Partners 28 16 11 27 320 402 47 Keystone 62 43 68 85 240 498 Southeast MCOs 126 89 116 166 768 1,265

Unknown

42 United 326 927 330 528 1,904 4,015 43 Aetna 435 510 397 592 1,395 3,329 45 Health Partners 623 191 354 540 5,826 7,534 47 Keystone 1,739 1,173 2,035 2,511 7,099 14,557 Southeast MCOs 3,123 2,801 3,116 4,171 16,224 29,435

MCO TOTAL

42 United 64,752 44,576 94,765 84,954 526,422 815,469 43 Aetna 7,005 7,164 9,568 10,390 34,628 68,755 45 Health Partners 11,822 2,638 8,234 10,223 195,807 228,724 47 Keystone 40,119 21,950 68,083 54,553 237,461 422,166

TOTAL 64,297 44,360 94,174 83,858 518,966 805,655 Racial/Ethnic information is self-reported by consumers.


10


Southwest 02 Allegheny 03 Armstrong 04 Beaver 05 Bedford 07 Blair 10 Butler 11 Cambria 26 Fayette


31 Gateway 26,735 31 2,469 13 377 203 527 336 32 United 8,356 16 475 11 258 47 1,007 825 34 UPMC 32,618 146 2,113 70 747 387 1,462 1,517 59 Aetna 2,940 5 264 12 115 29 721 79 Southwest MCOs 70,649 198 5,321 106 1,497 666 3,717 2,757


31 Gateway 130 0 19 1 6 3 9 4 32 United 62 0 6 1 11 1 1 10 34 UPMC 316 15 41 8 17 19 32 50 59 Aetna 17 0 9 0 4 2 4 4 Southwest MCOs 525 15 75 10 38 25 46 68

Asian

31 Gateway 680 0 21 0 9 21 7 16 32 United 481 2 29 6 24 19 11 16 34 UPMC 4,922 31 105 20 92 159 34 43 59 Aetna 208 4 9 1 8 15 7 1 Southwest MCOs 6,291 37 164 27 133 214 59 76

White

31 Gateway 23,692 916 7,334 593 4,872 4,221 2,757 2,944 32 United 9,652 523 1,652 957 2,867 994 3,586 7,234 34 UPMC 51,979 9,002 10,082 5,574 12,832 12,731 12,855 16,814 59 Aetna 3,803 409 895 602 1,769 745 1,742 609 Southwest MCOs 89,126 10,850 19,963 7,726 22,340 18,691 20,940 27,601


31 Gateway 1,747 4 197 4 54 74 63 41 32 United 894 11 89 9 40 48 112 93 34 UPMC 4,921 71 349 90 164 308 307 216 59 Aetna 503 4 53 9 22 31 66 20 Southwest MCOs 8,065 90 688 112 280 461 548 370



Unknown

31 Gateway 1,623 18 74 5 42 71 47 48 32 United 874 9 65 8 38 38 50 99 34 UPMC 4,218 74 259 37 173 350 198 285 59 Aetna 524 7 25 4 28 32 35 16 Southwest MCOs 7,239 108 423 54 281 491 330 448

MCO TOTAL

31 Gateway 186,906 11,540 27,310 8,144 25,053 21,439 26,077 3,394 32 United 20,347 562 2,316 992 3,238 1,147 4,773 8,290 34 UPMC 99,145 9,341 12,954 5,802 14,031 13,968 14,900 18,944 59 Aetna 8,021 429 1,257 629 1,947 854 2,580 734

TOTAL 182,153 11,301 26,644 8,039 24,577 20,565 25,664 31,362 Racial/Ethnic information is self-reported by consumers.


11


Southwest cont.

30 Greene 32 Indiana 37 Lawrence 56 Somerset 63 Washington 65 Westmoreland Southwest


31 Gateway 15 75 903 20 676 1,446 33,826 32 United 24 84 230 27 598 727 12,685 34 UPMC 40 273 887 69 1,709 2,304 44,342 59 Aetna 7 34 122 22 180 201 4,731 Southwest MCOs 86 466 2,142 138 3,163 4,678 95,584


31 Gateway 0 2 11 1 12 24 222 32 United 2 3 0 3 14 25 139 34 UPMC 14 23 16 8 28 59 646 59 Aetna 1 1 2 2 3 8 57 Southwest MCOs 17 29 29 14 57 116 1,064

Asian

31 Gateway 1 9 4 2 14 35 819 32 United 3 8 4 6 18 37 664 34 UPMC 12 62 45 21 130 245 5,921 59 Aetna 2 2 2 2 7 22 290 Southwest MCOs 18 81 55 31 169 339 7,694

White

31 Gateway 672 1,987 5,245 1,471 4,149 8,254 69,107 32 United 2,829 1,449 1,210 2,450 4,135 6,022 45,560 34 UPMC 3,122 8,013 7,460 6,194 15,804 26,896 199,358 59 Aetna 329 494 569 868 1,205 1,667 15,706 Southwest MCOs 6,952 11,943 14,484 10,983 25,293 42,839 329,731


31 Gateway 5 28 62 21 98 189 2,587 32 United 18 23 37 37 108 164 1,683 34 UPMC 33 109 184 70 393 719 7,934 59 Aetna 4 26 21 6 48 76 889 Southwest MCOs 60 186 304 134 647 1,148 13,093


31 Gateway 0 1 0 1 0 2 50 32 United 0 0 0 0 3 4 55 34 UPMC 2 1 6 0 11 25 277 59 Aetna 0 0 0 0 1 0 41 Southwest MCOs 2 2 6 1 15 31 423

Unknown

31 Gateway 6 27 50 6 92 230 2,339 32 United 8 21 18 20 103 217 1,568 34 UPMC 22 156 100 79 492 966 7,409 59 Aetna 4 14 12 20 52 106 879 Southwest MCOs 40 218 180 125 739 1,519 12,195

MCO TOTAL

31 Gateway 7,480 13,174 17,452 11,681 30,569 51,346 108,950 32 United 2,884 1,588 1,499 2,543 4,979 7,196 62,354 34 UPMC 3,245 8,637 8,698 6,441 18,567 31,214 265,887 59 Aetna 347 571 728 920 1,496 2,080 22,593

TOTAL 7,175 12,925 17,200 11,426 30,083 50,670 459,784

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 1/10/20

12


Lehigh/Capital

Racial/Ethnic information is self-reported by consumers.

01 Adams 06 Berks 21 Cumberland 22 Dauphin 28 Franklin 29 Fulton 31 Huntingdon


51 Gateway 117 1,147 1,484 10,057 93 3 15 52 United 227 718 600 3,736 159 3 30 53 Aetna 57 848 456 2,475 607 17 61 54 UPMC 46 624 276 1,836 35 10 88 57 AmeriHealth 59 3,184 544 1,824 961 25 31 Lehigh/Capital MCOs 506 6,521 3,360 19,928 1,855 58 225


51 Gateway 11 25 27 58 13 1 0 52 United 9 22 16 26 4 0 0 53 Aetna 3 11 17 44 15 2 0 54 UPMC 3 13 9 26 5 0 1 57 AmeriHealth 1 62 14 31 41 2 1 Lehigh/Capital MCOs 27 133 83 185 78 5 2

Asian

51 Gateway 31 137 324 1,371 5 0 2 52 United 36 111 185 881 6 0 2 53 Aetna 12 108 135 596 59 1 2 54 UPMC 17 132 141 718 2 0 16 57 AmeriHealth 12 264 114 330 84 0 3 Lehigh/Capital MCOs 108 752 899 3,896 156 1 25

White

51 Gateway 3,128 6,340 7,548 7,725 815 144 375 52 United 3,291 4,162 2,258 3,426 1,073 337 567 53 Aetna 988 3,843 2,773 3,315 6,106 756 948 54 UPMC 1,004 5,216 1,784 2,529 354 490 3,080 57 AmeriHealth 1,080 13,781 3,351 2,411 8,183 595 1,499 Lehigh/Capital MCOs 9,491 33,342 17,714 19,406 16,531 2,322 6,469


51 Gateway 188 5,099 1,255 5,260 83 1 8 52 United 506 2,454 527 1,614 161 9 12 53 Aetna 97 1,584 384 1,098 623 15 15 54 UPMC 98 1,996 382 907 37 0 42 57 AmeriHealth 99 20,597 521 1,232 1,288 24 19 Lehigh/Capital MCOs 988 31,730 3,069 10,111 2,192 49 96



Unknown

51 Gateway 171 570 546 1,205 63 3 2 52 United 173 473 242 630 88 4 8 53 Aetna 68 373 271 507 433 9 7 54 UPMC 69 515 173 469 27 0 22 57 AmeriHealth 67 1,870 252 473 789 7 15 Lehigh/Capital MCOs 548 3,801 1,484 3,284 1,400 23 54

MCO TOTAL

51 Gateway 12,258 79,489 26,341 57,326 22,383 2,403 402 52 United 4,245 7,971 3,838 10,345 1,492 353 619 53 Aetna 1,226 6,795 4,046 8,054 7,857 800 1,033 54 UPMC 1,239 8,526 2,778 6,514 460 500 3,249 57 AmeriHealth 1,319 39,844 4,808 6,311 11,372 653 1,570

TOTAL 11,679 76,470 26,672 56,934 22,254 2,458 6,873

Source: PA Department ofHuman Services EnterpriseData Warehouse – Updated1/10/20 13


Lehigh/Capital cont.


36 Lancaster 38 Lebanon 39 Lehigh 48 Northampton 50 Perry 67 York Lehigh/Capital


51 Gateway 1,770 581 2,920 1,592 47 2,310 22,136 52 United 1,285 104 769 394 8 3,619 11,652 53 Aetna 351 93 468 366 26 1,312 7,137 54 UPMC 1,012 129 714 298 13 1,093 6,174 57 AmeriHealth 3,203 142 4,422 2,663 22 2,172 19,252 Lehigh/Capital MCOs 7,621 1,049 9,293 5,313 116 10,506 66,351


51 Gateway 66 15 21 29 3 94 363 52 United 15 0 9 6 0 57 164 53 Aetna 6 5 13 12 7 53 188 54 UPMC 29 5 8 8 2 55 164 57 AmeriHealth 62 1 53 81 1 71 421 Lehigh/Capital MCOs 178 26 104 136 13 330 1,300

Asian

51 Gateway 802 135 313 211 6 204 3,541 52 United 269 26 142 74 2 238 1,972 53 Aetna 87 24 52 53 5 111 1,245 54 UPMC 359 48 156 68 2 107 1,766 57 AmeriHealth 712 52 642 521 3 169 2,906 Lehigh/Capital MCOs 2,229 285 1,305 927 18 829 11,430

White

51 Gateway 12,881 8,726 13,683 6,619 2,997 13,929 84,910 52 United 5,587 1,167 3,196 1,654 599 11,431 38,748 53 Aetna 2,087 1,246 1,832 1,447 682 5,083 31,106 54 UPMC 6,041 1,448 3,327 1,722 435 5,180 32,610 57 AmeriHealth 14,380 1,684 26,209 15,073 948 8,102 97,296 Lehigh/Capital MCOs 40,976 14,271 48,247 26,515 5,661 43,725 284,670


51 Gateway 3,808 3,461 2,739 2,430 71 2,433 26,836 52 United 2,331 402 634 381 31 4,191 13,253 53 Aetna 501 338 402 287 20 1,017 6,381 54 UPMC 1,650 409 625 388 20 1,119 7,673 57 AmeriHealth 8,109 1,150 5,012 4,467 24 2,873 45,415 Lehigh/Capital MCOs 16,399 5,760 9,412 7,953 166 11,633 99,558


51 Gateway 31 11 44 28 1 26 214 52 United 23 1 44 9 0 28 182 53 Aetna 7 6 15 9 0 23 132 54 UPMC 14 3 22 17 0 16 146 57 AmeriHealth 56 12 119 87 0 56 467 Lehigh/Capital MCOs 131 33 244 150 1 149 1,141

Unknown

51 Gateway 1,564 438 791 443 42 727 6,565 52 United 767 109 352 156 21 862 3,885 53 Aetna 242 67 199 139 16 426 2,757 54 UPMC 1,018 111 303 165 11 483 3,366 57 AmeriHealth 2,331 167 1,622 989 19 835 9,436 Lehigh/Capital MCOs 5,922 892 3,267 1,892 109 3,333 26,009

MCO TOTAL

51 Gateway 73,803 22,374 72,385 43,771 6,196 70,776 144,565 52 United 10,277 1,809 5,146 2,674 661 20,426 69,856 53 Aetna 3,281 1,779 2,981 2,313 756 8,025 48,946 54 UPMC 10,123 2,153 5,155 2,666 483 8,053 51,899 57 AmeriHealth 28,853 3,208 38,079 23,881 1,017 14,278 175,193

TOTAL 73,456 22,316 71,872 42,886 6,084 70,505 490,459

Source: PA Departmentof Human Services Enterprise DataWarehouse – Updated1/10/20 14


Northwest 12 Cameron 16 Clarion 17 Clearfield 20 Crawford 24 Elk 25 Erie 27 Forest


35 UPMC 16 125 118 426 52 5,023 9 36 Gateway 0 9 16 43 7 3,309 0 37 AmeriHealth 4 26 31 44 4 1,207 1 56 Aetna 0 21 19 35 2 2,616 1 Northwest MCOs 20 181 184 548 65 12,155 11


35 UPMC 1 5 19 30 9 107 3 36 Gateway 0 2 0 2 0 32 4 37 AmeriHealth 0 3 1 2 2 14 0 56 Aetna 0 0 1 1 0 36 0 Northwest MCOs 1 10 21 35 11 189 7

Asian

35 UPMC 7 13 34 45 13 1,294 1 36 Gateway 0 2 2 1 0 185 0 37 AmeriHealth 0 0 3 2 0 160 0 56 Aetna 0 1 6 2 4 129 0 Northwest MCOs 7 16 45 50 17 1,768 1

White

35 UPMC 731 3,938 9,350 11,063 3,417 23,127 541 36 Gateway 26 609 1,110 834 381 8,091 69 37 AmeriHealth 104 495 1,896 902 271 3,748 62 56 Aetna 43 531 1,698 999 263 6,221 49 Northwest MCOs 904 5,573 14,054 13,798 4,332 41,187 721


35 UPMC 7 46 68 115 25 1,804 5 36 Gateway 1 4 14 8 4 805 1 37 AmeriHealth 3 4 19 10 3 305 0 56 Aetna 0 5 19 9 2 566 3 Northwest MCOs 11 59 120 142 34 3,480 9



Unknown


MCO TOTAL

35 UPMC 998 5,997 14,899 14,894 4,317 60,936 771 36 Gateway 27 629 1,151 900 392 12,593 74 37 AmeriHealth 111 535 1,969 974 282 5,537 63 56 Aetna 43 566 1,757 1,063 276 9,734 56

TOTAL 944 5,924 14,550 14,803 4,486 59,819 756


15


Northwest cont. 33 Jefferson 42 McKean 43 Mercer 53 Potter 61 Venango 62 Warren Northwest


35 UPMC 61 81 1,767 19 194 56 7,947 36 Gateway 4 2 637 0 34 13 4,074 37 AmeriHealth 3 16 440 17 24 5 1,822 56 Aetna 2 9 434 2 40 4 3,185 Northwest MCOs 70 108 3,278 38 292 78 17,028



Asian

35 UPMC 17 21 79 0 28 13 1,565 36 Gateway 4 0 20 0 2 0 216 37 AmeriHealth 2 7 11 1 4 2 192 56 Aetna 1 1 11 0 2 2 159 Northwest MCOs 24 29 121 1 36 17 2,132

White

35 UPMC 6,239 5,758 11,225 1,726 6,341 4,438 87,894 36 Gateway 711 208 2,646 38 664 622 16,009 37 AmeriHealth 300 1,110 1,498 1,141 898 696 13,121 56 Aetna 345 586 1,445 63 823 420 13,486 Northwest MCOs 7,595 7,662 16,814 2,968 8,726 6,176 130,510





Unknown


MCO TOTAL

35 UPMC 7,829 8,229 21,673 3,036 9,558 6,444 101,530 36 Gateway 726 215 3,409 38 723 648 21,525 37 AmeriHealth 314 1,146 2,045 1,183 941 715 15,815 56 Aetna 357 604 1,985 65 894 437 17,837

TOTAL 7,781 7,912 20,988 3,061 9,295 6,388 156,707


16


Northeast

08 Bradford 13 Carbon 14 Centre 18 Clinton 19 Columbia 34 Juniata 35 Lackawanna 40 Luzerne


41 AmeriHealth NE 41 325 112 44 74 11 874 2,098 44 Geisinger 67 82 285 109 223 21 2,727 4,653 50 Aetna 57 67 153 39 64 12 782 1,402 Northeast MCOs 165 474 550 192 361 44 4,383 8,153


41 AmeriHealth NE 13 19 4 3 2 0 25 40 44 Geisinger 11 10 14 8 11 1 80 73 50 Aetna 6 2 4 0 1 4 28 10 Northeast MCOs 30 31 22 11 14 5 133 123

Asian

41 AmeriHealth NE 25 24 75 10 14 1 224 107 44 Geisinger 16 9 124 17 42 10 887 403 50 Aetna 5 4 71 3 14 5 181 85 Northeast MCOs 46 37 270 30 70 16 1,292 595

White

41 AmeriHealth NE 2,792 6,918 2,013 1,010 1,315 679 5,022 9,852 44 Geisinger 4,063 1,922 5,219 4,531 6,228 1,464 21,653 29,829 50 Aetna 3,017 784 2,047 646 946 571 3,633 5,362 Northeast MCOs 9,872 9,624 9,279 6,187 8,489 2,714 30,308 45,043


41 AmeriHealth NE 48 333 93 15 51 87 1,007 5,654 44 Geisinger 52 120 128 62 176 136 3,539 8,344 50 Aetna 40 80 89 13 52 46 681 1,230 Northeast MCOs 140 533 310 90 279 269 5,227 15,228



Unknown

41 AmeriHealth NE 59 171 71 13 31 31 492 475 44 Geisinger 71 62 113 60 87 30 1,618 1,141 50 Aetna 56 29 50 16 17 4 359 254 Northeast MCOs 186 262 234 89 135 65 2,469 1,870

MCO TOTAL 41 AmeriHealth NE 10,712 11,073 10,770 6,865 9,565 3,188 44,011 18,269 44 Geisinger 4,282 2,205 5,894 4,788 6,773 1,665 30,533 44,533 50 Aetna 3,183 969 2,420 717 1,098 642 5,675 8,366

TOTAL 10,445 10,972 10,689 6,603 9,358 3,116 43,862 71,168




Northeast cont.

41 Lycoming 44 Mifflin 45 Monroe 47 Montour 49 Northumberland 52 Pike 54 Schuylkill 55 Snyder


41 AmeriHealth NE 883 64 2,674 14 275 336 423 37 44 Geisinger 2,118 103 2,021 30 462 304 527 86 50 Aetna 283 50 1,102 6 253 143 177 20 Northeast MCOs 3,284 217 5,797 50 990 783 1,127 143



Asian


White

41 AmeriHealth NE 3,822 1,900 8,849 311 2,830 1,927 7,815 1,050 44 Geisinger 11,791 4,045 6,402 1,386 9,392 4,039 11,904 2,790 50 Aetna 1,213 1,418 2,448 253 2,911 931 2,508 743 Northeast MCOs 16,826 7,363 17,699 1,950 15,133 6,897 22,227 4,583


41 AmeriHealth NE 107 35 2,337 14 195 330 728 20 44 Geisinger 237 53 1,731 54 449 378 708 89 50 Aetna 51 37 885 12 161 136 142 19 Northeast MCOs 395 125 4,953 80 805 844 1,578 128



Unknown

41 AmeriHealth NE 50 18 759 4 71 121 184 14 44 Geisinger 142 31 583 18 199 165 229 41 50 Aetna 27 11 306 1 62 67 54 15 Northeast MCOs 219 60 1,648 23 332 353 467 70

MCO TOTAL 41 AmeriHealth NE 21,157 8,056 31,808 2,177 17,262 9,238 25,886 1,144 44 Geisinger 14,385 4,254 11,028 1,515 10,583 4,977 13,460 3,020 50 Aetna 1,591 1,525 4,857 279 3,403 1,294 2,907 807

TOTAL 20,868 7,804 30,790 2,144 17,384 9,043 25,602 4,971


18


Northeast cont.

57 Sullivan 58 Susquehanna 59 Tioga 60 Union 64 Wayne 66 Wyoming Northeast


41 AmeriHealth NE 2 10 94 37 57 11 8,496 44 Geisinger 4 41 20 201 120 29 14,233 50 Aetna 5 19 16 65 30 9 4,754 Northeast MCOs 11 70 130 303 207 49 27,483


41 AmeriHealth NE 1 0 16 2 15 5 257 44 Geisinger 0 12 0 5 19 9 414 50 Aetna 1 2 1 3 12 3 128 Northeast MCOs 2 14 17 10 46 17 799

Asian

41 AmeriHealth NE 1 3 17 8 20 2 852 44 Geisinger 1 16 3 23 28 15 2,061 50 Aetna 0 1 1 1 4 0 504 Northeast MCOs 2 20 21 32 52 17 3,417

White

41 AmeriHealth NE 153 1,112 5,426 703 1,462 687 67,648 44 Geisinger 445 4,094 858 2,321 4,982 3,240 142,598 50 Aetna 149 854 527 594 1,000 519 33,074 Northeast MCOs 747 6,060 6,811 3,618 7,444 4,446 243,320





Unknown


MCO TOTAL 41 AmeriHealth NE 725 6,551 7,234 4,167 8,373 4,605 91,309 44 Geisinger 458 4,286 902 2,681 5,334 3,395 180,951 50 Aetna 158 900 568 677 1,115 548 43,699

TOTAL 777 6,348 7,116 4,146 8,079 4,674 315,959


19

Mandatory ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY December 2019

Southeast

09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast

Other/Unknown

42 United 7 5 3 12 46 73 43 Aetna 10 7 5 14 26 62 45 Health Partners 12 5 6 15 46 84 47 Keystone 20 10 25 40 84 179 Southeast MCOs 49 27 39 81 202 398

Non-Hispanic

42 United 4,705 9,357 7,776 7,504 44,563 73,905 43 Aetna 6,364 6,021 9,052 9,438 30,321 61,196 45 Health Partners 10,141 2,351 7,535 9,064 132,815 161,906 47 Keystone 35,563 17,761 63,929 47,725 208,819 373,797 Southeast MCOs 56,773 35,490 88,292 73,731 416,518 670,804

Hispanic

42 United 639 3,246 510 1,176 6,461 12,032 43 Aetna 631 1,136 511 938 4,281 7,497 45 Health Partners 1,669 282 693 1,144 62,946 66,734 47 Keystone 4,536 4,179 4,129 6,788 28,558 48,190 Southeast MCOs 7,475 8,843 5,843 10,046 102,246 134,453

TOTAL 64,297 44,360 94,174 83,858 518,966 805,655




Southwest

02 Allegheny 03 Armstrong 04 Beaver 05 Bedford 07 Blair 10 Butler 11 Cambria 26 Fayette

Other/Unknown


Non-Hispanic

31 Gateway 53,743 958 9,981 612 5,280 4,508 3,339 3,367 32 United 19,861 552 2,235 982 3,182 1,116 4,632 8,234 34 UPMC 96,522 9,253 12,723 5,724 13,839 13,692 14,686 18,722 59 Aetna 7,803 422 1,215 625 1,918 831 2,524 710 Southwest MCOs 177,929 11,185 26,154 7,943 24,219 20,147 25,181 31,033

Hispanic

31 Gateway 873 11 134 4 80 84 72 27 32 United 478 9 80 10 56 30 139 56 34 UPMC 2,568 86 223 77 190 272 211 213 59 Aetna 210 7 41 4 29 23 55 24 Southwest MCOs 4,129 113 478 95 355 409 477 320

TOTAL 182,153 11,301 26,644 8,039 24,577 20,565 25,664 31,362


21


Southwest cont.

30 Greene 32 Indiana 37 Lawrence 56 Somerset 63 Washington 65 Westmoreland Southwest

Other/Unknown

31 Gateway 0 0 0 0 3 2 36 32 United 0 0 0 0 3 7 23 34 UPMC 1 0 2 3 3 16 109 59 Aetna 0 0 0 0 1 2 13 Southwest MCOs 1 0 2 3 10 27 181

Non-Hispanic

31 Gateway 696 2,115 6,216 1,504 4,956 10,070 107,345 32 United 2,872 1,560 1,463 2,507 4,901 7,088 61,185 34 UPMC 3,217 8,537 8,444 6,368 18,254 30,781 260,762 59 Aetna 342 549 703 908 1,441 2,035 22,026 Southwest MCOs 7,127 12,761 16,826 11,287 29,552 49,974 451,318

Hispanic

31 Gateway 3 14 59 18 82 108 1,569 32 United 12 28 36 36 75 101 1,146 34 UPMC 27 100 252 70 310 417 5,016 59 Aetna 5 22 25 12 54 43 554 Southwest MCOs 47 164 372 136 521 669 8,285

TOTAL 7,175 12,925 17,200 11,426 30,083 50,670 459,784




Lehigh/Capital

01 Adams 06 Berks 21 Cumberland 22 Dauphin 28 Franklin 29 Fulton 31 Huntingdon

Other/Unknown


Non-Hispanic

51 Gateway 3,416 7,227 10,299 19,890 976 148 394 52 United 3,449 4,980 3,414 8,543 1,356 352 609 53 Aetna 1,102 4,899 3,801 6,957 7,184 788 1,023 54 UPMC 1,095 6,123 2,589 5,658 431 495 3,218 57 AmeriHealth 1,178 14,970 4,379 4,809 9,584 630 1,556 Lehigh/Capital MCOs 10,240 38,199 24,482 45,857 19,531 2,413 6,800

Hispanic

51 Gateway 233 6,099 896 5,816 96 4 8 52 United 794 2,984 420 1,791 136 1 10 53 Aetna 122 1,889 243 1,094 669 12 10 54 UPMC 144 2,400 188 854 27 4 31 57 AmeriHealth 141 24,868 426 1,497 1,781 23 14 Lehigh/Capital MCOs 1,434 38,240 2,173 11,052 2,709 44 73

TOTAL 11,679 76,470 26,672 56,934 22,254 2,458 6,873


23


Lehigh/Capital cont.

36 Lancaster 38 Lebanon 39 Lehigh 48 Northampton 50 Perry 67 York Lehigh/Capital

Other/Unknown


Non-Hispanic

51 Gateway 16,330 8,368 9,431 7,405 3,094 16,969 103,947 52 United 7,423 1,254 2,873 2,126 633 15,319 52,331 53 Aetna 2,724 1,327 1,762 1,865 725 6,831 40,988 54 UPMC 8,138 1,555 3,445 2,112 470 6,779 42,108 57 AmeriHealth 18,356 1,606 18,383 16,757 995 10,570 103,773 Lehigh/Capital MCOs 52,971 14,110 35,894 30,265 5,917 56,468 343,147

Hispanic

51 Gateway 4,582 4,998 11,073 3,943 72 2,752 40,572 52 United 2,853 553 2,271 544 28 5,096 17,481 53 Aetna 555 451 1,217 445 30 1,188 7,925 54 UPMC 1,975 597 1,704 551 13 1,271 9,759 57 AmeriHealth 10,476 1,602 19,679 7,113 22 3,704 71,346 Lehigh/Capital MCOs 20,441 8,201 35,944 12,596 165 14,011 147,083

TOTAL 73,456 22,316 71,872 42,886 6,084 70,505 490,459




Northwest

12 Cameron 16 Clarion 17 Clearfield 20 Crawford 24 Elk 25 Erie 27 Forest

Other/Unknown


Non-Hispanic

35 UPMC 738 4,156 9,591 11,726 3,488 29,798 562 36 Gateway 27 629 1,146 890 391 11,371 70 37 AmeriHealth 101 531 1,947 953 277 5,134 63 56 Aetna 43 551 1,734 1,051 271 8,884 55 Northwest MCOs 909 5,867 14,418 14,620 4,427 55,187 750

Hispanic

35 UPMC 25 37 80 138 48 2,152 1 36 Gateway 0 0 5 10 1 1,222 4 37 AmeriHealth 10 3 22 20 5 401 0 56 Aetna 0 15 23 9 5 848 1 Northwest MCOs 35 55 130 177 59 4,623 6

TOTAL 944 5,924 14,550 14,803 4,486 59,819 756


25


Northwest cont.

33 Jefferson 42 McKean 43 Mercer 53 Potter 61 Venango 62 Warren Northwest

Other/Unknown


Non-Hispanic

35 UPMC 6,301 5,877 13,377 1,755 6,652 4,548 98,569 36 Gateway 725 214 3,373 36 712 642 20,226 37 AmeriHealth 309 1,138 2,016 1,174 925 709 15,277 56 Aetna 356 603 1,969 63 884 431 16,895 Northwest MCOs 7,691 7,832 20,735 3,028 9,173 6,330 150,967

Hispanic

35 UPMC 81 70 168 20 83 39 2,942 36 Gateway 1 1 35 2 10 6 1,297 37 AmeriHealth 5 8 25 9 16 6 530 56 Aetna 1 1 16 2 10 6 937 Northwest MCOs 88 80 244 33 119 57 5,706

TOTAL 7,781 7,912 20,988 3,061 9,295 6,388 156,707




Northeast

08 Bradford 13 Carbon 14 Centre 18 Clinton 19 Columbia 34 Juniata 35 Lackawanna 40 Luzerne

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 2,939 7,061 2,305 1,066 1,421 701 6,143 11,583 44 Geisinger 4,206 2,035 5,749 4,699 6,494 1,514 25,193 34,121 50 Aetna 3,141 879 2,364 696 1,035 579 4,668 6,726 Northeast MCOs 10,286 9,975 10,418 6,461 8,950 2,794 36,004 52,430

Hispanic

41 AmeriHealth NE 39 733 68 32 66 107 1,509 6,682 44 Geisinger 74 170 136 89 279 149 5,324 10,398 50 Aetna 39 90 55 21 63 63 1,004 1,640 Northeast MCOs 152 993 259 142 408 319 7,837 18,720

TOTAL 10,445 10,972 10,689 6,603 9,358 3,116 43,862 71,168




Northeast cont.

41 Lycoming 44 Mifflin 45 Monroe 47 Montour 49 Northumberland 52 Pike 54 Schuylkill 55 Snyder

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 4,762 1,945 12,056 332 3,071 2,288 7,903 1,107 44 Geisinger 14,094 4,127 8,832 1,449 9,732 4,382 12,158 2,895 50 Aetna 1,553 1,428 3,784 270 3,124 1,094 2,654 783 Northeast MCOs 20,409 7,500 24,672 2,051 15,927 7,764 22,715 4,785

Hispanic

41 AmeriHealth NE 127 79 2,844 18 327 484 1,332 37 44 Geisinger 285 127 2,191 66 851 587 1,302 123 50 Aetna 37 97 1,070 9 278 199 252 24 Northeast MCOs 449 303 6,105 93 1,456 1,270 2,886 184

TOTAL 20,868 7,804 30,790 2,144 17,384 9,043 25,602 4,971




Northeast cont.

57 Sullivan 58 Susquehanna 59 Tioga 60 Union 64 Wayne 66 Wyoming Northeast

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 161 1,139 5,592 729 1,541 715 76,560 44 Geisinger 447 4,192 897 2,476 5,131 3,315 158,138 50 Aetna 156 882 558 649 1,048 544 38,615 Northeast MCOs 764 6,213 7,047 3,854 7,720 4,574 273,313

Hispanic


TOTAL 777 6,348 7,116 4,146 8,079 4,674 315,959



Mandatory PLAN MAKE UP BY AGE GROUP AND GENDER December 2019

SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL

< 21 Yrs Female 20,285 16,249 56,097 115,549 208,180 Male 21,173 17,775 57,705 124,752 221,405 Total 41,458 34,024 113,802 240,301 429,585

22-45 Yrs Female 16,255 12,521 47,773 77,543 154,092 Male 14,648 12,391 28,630 44,438 100,107 Total 30,903 24,912 76,403 121,981 254,199


Over 64 Yrs Female 375 295 997 1,674 3,341 Male 250 188 605 1,015 2,058 Total 625 483 1,602 2,689 5,399

TOTAL 86,010 68,755 228,724 422,166 805,655

SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL




Over 64 Yrs Female 140 54 386 25 605 Male 88 46 256 25 415 Total 228 100 642 50 1,020

TOTAL 108,950 62,354 265,887 22,593 459,784



LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL

< 21 Yrs Female 41,337 19,166 12,238 13,190 48,632 134,563 Male 44,040 20,494 13,125 14,192 51,396 143,247 Total 85,377 39,660 25,363 27,382 100,028 277,810

22-45 Yrs Female 27,686 12,994 10,086 10,276 34,640 95,682 Male 12,959 7,922 6,733 6,616 16,458 50,688 Total 40,645 20,916 16,819 16,892 51,098 146,370

46-64 Yrs Female 10,596 4,913 3,398 3,967 13,975 36,849 Male 7,270 4,009 3,152 3,406 9,141 26,978 Total 17,866 8,922 6,550 7,373 23,116 63,827

Over 64 Yrs Female 449 216 134 150 638 1,587 Male 228 142 80 102 313 865 Total 677 358 214 252 951 2,452

TOTAL 144,565 69,856 48,946 51,899 175,193 490,459

NORTHWEST

35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL




Over 64 Yrs Female 74 17 18 16 125 Male 62 11 13 19 105 Total 136 28 31 35 230

TOTAL 101,530 21,525 15,815 17,837 156,707



NORTHEAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

< 21 Yrs Female 23,223 46,540 10,731 80,494

Male 24,466 49,160 11,472 85,098

Total 47,689 95,700 22,203 165,592

22-45 Yrs Female 18,533 36,238 8,798 63,569

Male 10,756 20,483 6,253 37,492

Total 29,289 56,721 15,051 101,061

46-64 Yrs Female 7,962 16,150 3,431 27,543

Male 6,059 11,868 2,905 20,832

Total 14,021 28,018 6,336 48,375

Over 64 Yrs Female 206 346 61 613

Male 104 166 48 318

Total 310 512 109 931

TOTAL 91,309 180,951 43,699 315,959


Mandatory PLAN MAKE UP BY AGE GROUP December 2019

SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL < 21 Yrs 41,458 34,024 113,802 240,301 429,585 22-45 Yrs 30,903 24,912 76,403 121,981 254,199 46-64 Yrs 13,024 9,336 36,917 57,195 116,472 Over 64 Yrs 625 483 1,602 2,689 5,399

TOTAL 86,010 68,755 228,724 422,166 805,655 SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL < 21 Yrs 58,064 32,197 134,016 9,673 233,950 22-45 Yrs 34,120 20,584 85,754 9,172 149,630 46-64 Yrs 16,538 9,473 45,475 3,698 75,184 Over 64 Yrs 228 100 642 50 1,020

TOTAL 108,950 62,354 265,887 22,593 459,784 LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL < 21 Yrs 85,377 39,660 25,363 27,382 100,028 277,810 22-45 Yrs 40,645 20,916 16,819 16,892 51,098 146,370 46-64 Yrs 17,866 8,922 6,550 7,373 23,116 63,827 Over 64 Yrs 677 358 214 252 951 2,452

TOTAL 144,565 69,856 48,946 51,899 175,193 490,459


Mandatory PLAN MAKE UP BY AGE GROUP December 2019

NORTHWEST

35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL < 21 Yrs 53,983 11,118 7,414 8,931 81,446 22-45 Yrs 31,625 7,147 5,626 6,267 50,665 46-64 Yrs 15,786 3,232 2,744 2,604 24,366 Over 64 Yrs 136 28 31 35 230

TOTAL 101,530 21,525 15,815 17,837 156,707 NORTHEAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL < 21 Yrs 47,689 95,700 22,203 165,592 22-45 Yrs 29,289 56,721 15,051 101,061 46-64 Yrs 14,021 28,018 6,336 48,375 Over 64 Yrs 310 512 109 931

TOTAL 91,309 180,951 43,699 315,959


-

-

-

-

-

HealthChoices Enrollment AID CATEGORY DISTRIBUTION 4th Quarter 2018

TANF/HB/MAGI TANF/HB/MAGI Southeast (Ages 21+) Southwest (Ages 21+)

Lehigh/Capital TANF/HB/MAGI (Ages 21+)

3%

11%

TANF/HB/MAGI (Ages 1 20)

42% Disabled/BC&C 14%

Newly Eligible (45+) 9%

Newly Eligible (19-44)

20%

3% TANF/HB/MAGI Northwest (Ages 21+)

TANF/HB/MAGI Northeast

Under Age 1 3%

Source: Bureau of Fiscal Management 3% 3%

11%


39%

Under Age 1

Disabled/BC&C 15%



23%

11%


37%

Under Age 1

Disabled/BC&C 17%



22%

11%


39%

Under Age 1

Disabled/BC&C 17%



21%

(Ages 21+) 11%


39%

Under Age 1

Disabled/BC&C 14%



22%

New Categories of Aid: TANF/HB/MAGI is Temporary Assistance for Needy Families, Healthy Beginnings, and Modified Adjusted Gross Income.

35

HealthChoices Enrollment PCP SELECTION December 2019

The table displays the total number of new members that voluntarily enrolled in HealthChoices and selected a PCP as a percentage of total new members that voluntarily enrolled in HealthChoices.

December 2019

Zone Percentage

Southeast 93.9%

Southwest 94.5%

Lehigh/Capital 93.4%

Northwest 95.1%

Northeast 93.8%

Total 94.0%

Source: Maximus

36

Medical Assistance Transportation Program

Based on Data Submitted by Each County

37

MATP 4Q FY 17/18

Southeast

COUNTY Total Expenditure Para Transit Trips Mass Transit Trips Mileage

Reimbursement Trips

Total Trips Client Utilization

Bucks $ 616,655 19,313 - 18,445 37,758 1.1%

Chester $ 594,753 11,809 2,967 5,710 20,486 2.2%

Delaware $ 1,328,938 26,002 5,364 5,500 36,866 1.4%

Montgomery $ 802,730 18,225 3,331 3,954 25,510 2.1%

Philadelphia $ 11,574,441 276,388 754,897 10,311 1,041,596 7.9%

HC-SE Zone $ 14,917,517 351,737 766,559 43,920 1,162,216 5.7%

38

Southwest

MATP 4Q FY 17/18


Reimbursement Trips


Allegheny $ 2,557,362 46,498 164,914 33,172 244,584 6.6%

Armstrong $ 429,787 8,709 - 4,520 13,229 7.8%

Beaver $ 584,480 13,893 270 16,592 30,755 4.9%

Bedford $ 139,319 3,860 - 4,793 8,653 6.4%

Blair $ 327,045 11,996 1,738 3,853 17,587 5.0%

Butler $ 590,275 11,772 - 4,778 16,550 4.8%

Cambria $ 1,060,018 31,032 5,024 6,839 42,895 8.9%

Fayette $ 379,949 15,906 27 20,207 36,140 5.2%

Greene $ 205,067 5,578 - 2,510 8,088 5.5%

Indiana $ 237,373 5,447 906 3,622 9,975 5.5%

Lawrence $ 288,568 7,176 3,170 12,610 22,956 5.6%

Somerset $ 393,484 7,676 - 6,202 13,878 6.0%

Washington $ 580,930 19,299 1,253 11,391 31,943 6.7%

Westmoreland $ 763,995 24,535 167 14,556 39,258 4.6%

HC-SW Zone $ 8,537,651 213,377 177,469 145,645 536,491 6.1%

39

Lehigh/Capital

MATP 4Q FY 17/18


Reimbursement Trips


Adams* $ 55,192 1,733 - 958 2,691 1.7%

Berks $ 771,155 19,404 9,517 5,188 34,109 1.6%

Cumberland $ 160,409 5,565 - 2,256 7,821 2.0%

Dauphin $ 729,895 24,159 4,808 1,797 30,764 4.8%

Franklin $ 111,000 3,546 - 1,866 5,412 1.8%

Fulton $ 97,922 1,438 - 1,197 2,635 11.5%

Huntingdon $ 179,533 3,457 - 5,346 8,803 8.3%

Lancaster $ 661,824 20,550 814 5,162 26,526 1.0%

Lebanon $ 394,546 17,022 782 1,284 19,088 4.4%

Lehigh $ 622,849 14,906 2,536 2,624 20,066 1.5%

Northampton $ 366,084 8,008 1,512 3,266 12,786 1.6%

Perry $ 67,519 2,613 - 679 3,292 3.4%

York* $ 249,771 7,701 793 3,684 12,178 1.2%

HC-L/C Zone $ 4,467,698 130,102 20,762 35,307 186,171 2.1%

* As of FY 17-18, the sole source contractor for Adams and York Counties were reported separate. Previously, they had combined reporting. 40

Northwest

MATP 4Q FY 17/18

COUNTY Total Expenditure

Para Transit Trips

Mass Transit Trips

Mileage Reimbursement

Trips Total Trips Client Utilization

Cameron $ 51,383 662 52 409 1,123 7.8%

Clarion $ 165,043 2,488 - 1,960 4,448 7.0%

Clearfield $ 346,003 11,184 - 6,268 17,452 4.9%

Crawford $ 233,657 1,299 724 9,501 15,844 7.2%

Elk $ 197,221 3,106 6 1,294 4,406 7.6%

Erie $ 429,250 16,467 1,151 3,248 20,866 1.6%

Forest $ 35,322 695 - 188 883 6.4%

Jefferson $ 398,819 9,476 16 3,956 13,448 11.1%

McKean $ 138,618 2,249 53 857 3,159 4.8%

Mercer $ 254,179 10,907 - 1,749 12,656 4.3%

Potter $ 225,772 2,787 - 1,099 3,886 9.8%

Venango $ 291,942 5,161 46 2,042 7,249 5.0%

Warren $ 95,227 1,464 83 1,724 3,271 7.4%

HC-Northwest Zone $ 2,862,436 67,945 2,131 34,295 108,691 4.5%

41

Northeast

MATP 4Q FY 17/18

COUNTY Total Expenditure

Para Transit Trips

Mass Transit Trips

Mileage Reimbursement

Trips Total Trips Client Utilization

Bradford/Tioga $ 450,417 6,993 66 1,846 8,905 3.8%

Carbon $ 214,340 3,408 - 660 4,068 3.3%

Centre $ 160,348 3,909 314 1,439 5,662 2.3%

Clinton $ 230,220 3,974 - 553 4,527 6.2%

Columbia $ 106,837 3,007 - 2,202 5,209 3.2%

Juniata $ 34,826 653 - 592 1,245 3.1%

Lackawanna $ 276,318 7,819 3,038 2,532 13,389 1.7%

Luzerne $ 358,333 14,263 1,970 6,225 22,458 2.5%

Lycoming $ 379,011 9,178 1,914 2,634 13,726 6.4%

Mifflin $ 114,999 3,795 - 997 4,792 6.3%

Monroe $ 210,255 6,035 415 4,886 11,336 2.6%

Montour $ 46,701 1,479 - 798 2,277 4.6%

Northumberland $ 262,651 8,987 - 3,819 12,806 5.2%

Pike $ 83,023 1,460 - 2,161 3,621 1.2%

Schuylkill $ 381,663 6,521 634 2,677 9,832 3.3%

Snyder $ 49,942 1,184 - 1,251 2,435 3.3%

Sullivan $ - - - - - 0.0%

Susquehanna $ 128,785 2,043 - 1,425 3,468 5.2%

Union $ 38,272 1,530 - 336 1,866 3.4%

Wayne $ 179,355 4,075 - 1,471 5,546 5.5%

Wyoming $ 52,928 980 - 916 1,896 3.5%

HC-Northeast Zone $ 3,759,223 91,293 8,351 39,420 139,064 3.4%

42

Useful Information

To view a complete Pennsylvania Medicaid Managed Care Organization (MCO) Directory go to http://dhs.pa.gov/provider/healthcaremedicalassistance/managedcar einformation/ and choose the Pennsylvania Medicaid MCO Directory.

43

http://dhs.pa.gov/provider/healthcaremedicalassistance/managedcareinformation/

Documents

BMCO Monthly Physical Health Managed Care Program ... Care Enrollment...BMCO Monthly Physical Health Managed Care Program Enrollment Report NOTE: This report contains the number of