BMCO Monthly Physical Health Managed Care Program Enrollment … · 2020-07-24 · Total Enrollment = 2,259,973 : AmeriHealth NE 93,149 4%: Aetna 206,479 9% AmeriHealth 192,255 9%

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: July 23, 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 April 2020

SOUTHEAST

County 42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL 09 Bucks 5,445 7,215 12,187 40,775 65,622 15 Chester 12,889 7,383 2,826 22,459 45,557 23 Delaware 8,384 9,591 8,481 69,032 95,488 46 Montgomery 8,740 10,461 10,320 55,415 84,936 51 Philadelphia 52,010 35,701 196,115 240,093 523,919 TOTAL 87,468 70,351 229,929 427,774 815,522 PERCENTAGE 11% 9% 28% 52%

SOUTHWEST

County 31 Gateway 32 United 34 UPMC 59 Aetna TOTAL 02 Allegheny 54,757 20,642 100,358 8,312 184,069 03 Armstrong 991 608 9,649 419 11,667 04 Beaver 10,142 2,397 13,276 1,287 27,102 05 Bedford 640 1,007 5,904 641 8,192 07 Blair 5,282 3,188 14,426 1,996 24,892 10 Butler 4,509 1,184 14,107 916 20,716 11 Cambria 3,452 4,770 15,224 2,616 26,062 26 Fayette 3,433 8,309 19,364 754 31,860 30 Greene 726 2,869 3,352 331 7,278 32 Indiana 2,142 1,655 8,879 637 13,313 37 Lawrence 6,278 1,559 8,931 766 17,534 56 Somerset 1,533 2,558 6,649 920 11,660 63 Washington 5,122 5,092 19,127 1,561 30,902 65 Westmoreland 10,156 7,265 31,812 2,128 51,361 TOTAL 109,163 63,103 271,058 23,284 466,608 PERCENTAGE 23% 14% 58% 5%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/10/20 5

Source: PA Department of Human Services Enterprise Data Warehouse Updated 7/10/20


cont. LEHIGH/CAPITAL

County 51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL 01 Adams 3,582 4,319 1,251 1,276 1,328 11,756 06 Berks 13,356 8,068 7,017 8,895 39,822 77,158 21 Cumberland 11,255 3,935 4,182 3,138 4,915 27,425 22 Dauphin 25,677 10,325 8,230 7,142 6,365 57,739 28 Franklin 1,152 1,750 7,932 480 11,494 22,808 29 Fulton 172 364 768 514 675 2,493 31 Huntingdon 405 624 1,059 3,268 1,587 6,943 36 Lancaster 21,098 10,465 3,489 10,750 28,746 74,548 38 Lebanon 13,581 1,932 1,891 2,242 3,332 22,978 39 Lehigh 20,789 5,384 3,133 5,218 38,445 72,969 48 Northampton 11,467 2,739 2,488 2,765 24,173 43,632 50 Perry 3,215 658 791 527 1,046 6,237 67 York 19,692 20,612 8,295 8,551 14,439 71,589 TOTAL 145,441 71,175 50,526 54,766 176,367 498,275 PERCENTAGE 29% 14% 10% 11% 36%

NORTHWEST

County 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL 12 Cameron 782 31 101 47 961 16 Clarion 4,300 630 529 593 6,052 17 Clearfield 9,793 1,170 2,026 1,759 14,748 20 Crawford 11,924 912 998 1,062 14,896 24 Elk 3,594 421 294 307 4,616 25 Erie 32,092 12,394 5,546 9,817 59,849 27 Forest 570 72 69 52 763 33 Jefferson 6,515 754 309 396 7,974 42 McKean 6,004 230 1,181 634 8,049 43 Mercer 13,826 3,385 2,027 1,938 21,176 53 Potter 1,801 42 1,171 67 3,081 61 Venango 6,846 715 913 893 9,367 62 Warren 4,579 641 724 442 6,386

TOTAL 102,626 21,397 –15,888 18,007 157,918 PERCENTAGE 65% 14% 10% 11%

6


cont.

NORTHEAST County 41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

08 Bradford 3,110 4,432 3,224 10,766 13 Carbon 7,847 2,263 973 11,083 14 Centre 2,369 5,970 2,435 10,774 18 Clinton 1,148 4,815 718 6,681 19 Columbia 1,500 6,952 1,151 9,603 34 Juniata 787 1,651 639 3,077 35 Lackawanna 7,833 30,857 5,837 44,527 40 Luzerne 18,692 45,562 8,504 72,758 41 Lycoming 4,860 14,595 1,668 21,123 44 Mifflin 2,033 4,306 1,529 7,868 45 Monroe 15,216 11,320 4,929 31,465 47 Montour 352 1,530 281 2,163 49 Northumberland 3,435 10,837 3,352 17,624 52 Pike 2,868 5,094 1,337 9,299 54 Schuylkill 9,544 13,445 2,820 25,809 55 Snyder 1,159 3,155 805 5,119 57 Sullivan 152 484 156 792 58 Susquehanna 1,216 4,434 958 6,608 59 Tioga 5,798 902 586 7,286 60 Union 810 2,698 667 4,175 64 Wayne 1,677 5,420 1,185 8,282 66 Wyoming 743 3,468 557 4,768

TOTAL 93,149 184,190 44,311 321,650 PERCENTAGE 29% 57% 14%


Mandatory MARKET SHARE BY PLAN – STATEWIDE April 2020

Total Enrollment = 2,259,973

AmeriHealth NE 93,149

4% Aetna

206,479 9%

AmeriHealth 192,255

9%

Gateway 276,001

12%

Health Partners 229,929

10%

Keystone 427,774

19%

United 221,746

10%

UPMC 428,450

19%

Geisinger 184,190

8%


-

-

Mandatory MARKET SHARE BY ZONE AND BY PLAN April 2020

Southeast Southwest Aetna 23,284

5%

Lehigh/Capital UPMC 54,766

11%

Northwest

Aetna 50,526

10%

Ameri Health

176,367 36%

Gateway 145,441

29%

United 71,175

14%

Northeast Ameri-

Aetna 70,351

9%

Health Partners 229,929

28%

Keystone 427,774

52%

United 87,468

11% Gateway 109,163

23%

United 63,103

14%

UPMC 271,058

58%

Aetna 18,007

11%

Health 15,888

10%

Gateway 21,397

14%

UPMC 102,626

65%

Aetna 44,311

14%

Ameri Health NE

93,149 29%

Geisinger 184,190

57%


Mandatory ENROLLMENT BY PLAN, BY RACE AND BY COUNTY April 2020

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

Black or African American

42 United 605 2,360 4,372 2,046 31,917 41,300 43 Aetna 655 1,207 4,294 2,175 21,462 29,793 45 Health Partners 1,357 473 4,443 2,933 91,760 100,966 47 Keystone 4,324 3,793 33,081 12,859 143,417 197,474 Southeast MCOs 6,941 7,833 46,190 20,013 288,556 369,533

American Indian or Alaskan Native

42 United 14 38 15 35 83 185 43 Aetna 27 38 18 42 90 215 45 Health Partners 36 4 13 39 247 339 47 Keystone 88 90 99 180 419 876 Southeast MCOs 165 170 145 296 839 1,615

Asian

42 United 259 297 465 464 3,228 4,713 43 Aetna 314 199 484 726 1,562 3,285 45 Health Partners 801 65 412 786 7,694 9,758 47 Keystone 1,475 735 4,659 3,817 19,503 30,189 Southeast MCOs 2,849 1,296 6,020 5,793 31,987 47,945

White

42 United 3,546 7,078 2,545 4,425 7,921 25,515 43 Aetna 4,987 4,534 3,758 5,745 6,454 25,478 45 Health Partners 7,614 1,691 2,434 4,640 31,837 48,216 47 Keystone 28,431 13,611 24,104 28,283 39,309 133,738 Southeast MCOs 44,578 26,914 32,841 43,093 85,521 232,947

Other or system default

42 United 672 2,147 612 1,226 6,782 11,439 43 Aetna 765 867 613 1,114 4,615 7,974 45 Health Partners 1,715 354 798 1,343 58,341 62,551 47 Keystone 4,618 2,956 4,818 7,556 29,916 49,864 Southeast MCOs 7,770 6,324 6,841 11,239 99,654 131,828

Native Hawaiian or Other Pacific Islander

42 United 19 25 19 28 128 219 43 Aetna 29 10 19 34 96 188 45 Health Partners 31 16 18 36 351 452 47 Keystone 61 36 75 94 258 524 Southeast MCOs 140 87 131 192 833 1,383

Unknown

42 United 330 944 356 516 1,951 4,097 43 Aetna 438 528 405 625 1,422 3,418 45 Health Partners 633 223 363 543 5,885 7,647 47 Keystone 1,778 1,238 2,196 2,626 7,271 15,109 Southeast MCOs 3,179 2,933 3,320 4,310 16,529 30,271

MCO TOTAL

42 United 5,445 12,889 8,384 8,740 52,010 87,468 43 Aetna 7,215 7,383 9,591 10,461 35,701 70,351 45 Health Partners 12,187 2,826 8,481 10,320 196,115 229,929 47 Keystone 40,775 22,459 69,032 55,415 240,093 427,774

TOTAL 65,622 45,557 95,488 84,936 523,919 815,522 Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/10/20

10


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


31 Gateway 26,810 22 2,493 15 378 198 549 322 32 United 8,520 18 509 20 254 50 1,006 839 34 UPMC 32,920 148 2,133 76 805 403 1,516 1,569 59 Aetna 3,046 7 280 15 119 32 707 74 Southwest MCOs 71,296 195 5,415 126 1,556 683 3,778 2,804


31 Gateway 141 0 19 1 5 5 11 3 32 United 75 3 3 0 7 4 4 8 34 UPMC 342 21 41 9 20 20 35 53 59 Aetna 20 0 8 0 5 8 2 3 Southwest MCOs 578 24 71 10 37 37 52 67

Asian

31 Gateway 681 3 19 0 9 18 10 16 32 United 471 2 26 7 24 18 13 12 34 UPMC 4,985 34 113 21 89 161 33 48 59 Aetna 209 1 10 2 9 14 8 2 Southwest MCOs 6,346 40 168 30 131 211 64 78

White

31 Gateway 23,583 943 7,336 611 4,791 4,146 2,772 3,008 32 United 9,700 560 1,697 961 2,824 1,023 3,567 7,228 34 UPMC 52,315 9,297 10,342 5,670 13,165 12,802 13,114 17,143 59 Aetna 3,933 402 914 604 1,802 794 1,790 623 Southwest MCOs 89,531 11,202 20,289 7,846 22,582 18,765 21,243 28,002


31 Gateway 1,785 5 197 8 59 67 62 33 32 United 911 16 94 12 39 52 118 94 34 UPMC 5,149 66 371 95 175 337 305 221 59 Aetna 527 3 49 13 33 37 62 27 Southwest MCOs 8,372 90 711 128 306 493 547 375



Unknown

31 Gateway 1,730 18 76 5 38 71 47 44 32 United 937 9 68 7 40 34 55 115 34 UPMC 4,474 79 270 33 168 373 210 311 59 Aetna 544 6 26 6 27 31 41 20 Southwest MCOs 7,685 112 440 51 273 509 353 490

MCO TOTAL

31 Gateway 54,757 991 10,142 640 5,282 4,509 3,452 3,433 32 United 20,642 608 2,397 1,007 3,188 1,184 4,770 8,309 34 UPMC 100,358 9,649 13,276 5,904 14,426 14,107 15,224 19,364 59 Aetna 8,312 419 1,287 641 1,996 916 2,616 754

TOTAL 184,069 11,667 27,102 8,192 24,892 20,716 26,062 31,860 Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/10/20

11


Southwest cont.

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


31 Gateway 13 85 928 21 679 1,461 33,974 32 United 30 90 233 27 623 723 12,942 34 UPMC 42 269 928 75 1,732 2,319 44,935 59 Aetna 5 37 131 23 184 220 4,880 Southwest MCOs 90 481 2,220 146 3,218 4,723 96,731


31 Gateway 0 5 8 1 11 32 242 32 United 3 3 1 3 10 19 143 34 UPMC 14 27 21 9 26 67 705 59 Aetna 1 1 3 2 3 6 62 Southwest MCOs 18 36 33 15 50 124 1,152

Asian

31 Gateway 1 9 7 2 14 44 833 32 United 2 7 4 6 22 30 644 34 UPMC 16 65 44 23 142 254 6,028 59 Aetna 1 4 2 2 7 20 291 Southwest MCOs 20 85 57 33 185 348 7,796

White

31 Gateway 698 1,985 5,216 1,472 4,211 8,193 68,965 32 United 2,806 1,502 1,269 2,464 4,201 6,080 45,882 34 UPMC 3,226 8,227 7,630 6,380 16,263 27,343 202,917 59 Aetna 315 554 597 868 1,262 1,702 16,160 Southwest MCOs 7,045 12,268 14,712 11,184 25,937 43,318 333,924


31 Gateway 7 29 65 23 108 193 2,641 32 United 19 31 36 35 116 188 1,761 34 UPMC 30 123 198 70 428 779 8,347 59 Aetna 3 26 21 8 48 80 937 Southwest MCOs 59 209 320 136 700 1,240 13,686


31 Gateway 0 1 0 1 0 4 49 32 United 0 0 0 0 5 4 60 34 UPMC 1 2 6 0 14 21 272 59 Aetna 1 0 0 0 1 1 49 Southwest MCOs 2 3 6 1 20 30 430

Unknown

31 Gateway 7 28 54 13 99 229 2,459 32 United 9 22 16 23 115 221 1,671 34 UPMC 23 166 104 92 522 1,029 7,854 59 Aetna 5 15 12 17 56 99 905 Southwest MCOs 44 231 186 145 792 1,578 12,889

MCO TOTAL

31 Gateway 726 2,142 6,278 1,533 5,122 10,156 109,163 32 United 2,869 1,655 1,559 2,558 5,092 7,265 63,103 34 UPMC 3,352 8,879 8,931 6,649 19,127 31,812 271,058 59 Aetna 331 637 766 920 1,561 2,128 23,284

TOTAL 7,278 13,313 17,534 11,660 30,902 51,361 466,608

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/10/20

12


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


51 Gateway 126 1,143 1,493 10,085 98 3 18 52 United 214 736 608 3,728 196 6 28 53 Aetna 55 855 493 2,538 603 17 59 54 UPMC 50 659 334 2,013 37 12 89 57 AmeriHealth 57 3,176 562 1,808 958 27 29 Lehigh/Capital MCOs 502 6,569 3,490 20,172 1,892 65 223


51 Gateway 13 26 30 63 14 1 0 52 United 11 20 17 29 3 0 0 53 Aetna 2 14 16 50 16 1 0 54 UPMC 2 19 14 33 2 0 1 57 AmeriHealth 4 62 19 30 46 2 1 Lehigh/Capital MCOs 32 141 96 205 81 4 2

Asian

51 Gateway 34 149 324 1,220 3 0 2 52 United 40 110 193 800 10 0 2 53 Aetna 12 114 137 587 65 1 3 54 UPMC 18 132 173 739 3 1 16 57 AmeriHealth 11 250 125 302 84 0 4 Lehigh/Capital MCOs 115 755 952 3,648 165 2 27

White

51 Gateway 3,060 6,266 7,533 7,746 877 163 376 52 United 3,373 4,195 2,319 3,432 1,226 345 573 53 Aetna 998 3,926 2,849 3,331 6,148 726 975 54 UPMC 1,018 5,371 2,003 2,805 371 501 3,097 57 AmeriHealth 1,084 13,648 3,396 2,449 8,254 614 1,513 Lehigh/Capital MCOs 9,533 33,406 18,100 19,763 16,876 2,349 6,534


51 Gateway 177 5,121 1,278 5,217 91 1 8 52 United 497 2,468 535 1,665 197 9 14 53 Aetna 108 1,667 399 1,139 626 16 14 54 UPMC 108 2,102 414 998 35 0 45 57 AmeriHealth 104 20,612 534 1,241 1,301 22 21 Lehigh/Capital MCOs 994 31,970 3,160 10,260 2,250 48 102



Unknown

51 Gateway 169 630 573 1,307 68 4 1 52 United 182 501 249 644 114 4 7 53 Aetna 74 411 275 554 464 7 8 54 UPMC 78 582 187 522 32 0 20 57 AmeriHealth 66 1,972 263 523 829 10 17 Lehigh/Capital MCOs 569 4,096 1,547 3,550 1,507 25 53

MCO TOTAL

51 Gateway 12,258 79,489 26,341 57,326 22,383 2,403 405 52 United 4,319 8,068 3,935 10,325 1,750 364 624 53 Aetna 1,251 7,017 4,182 8,230 7,932 768 1,059 54 UPMC 1,276 8,895 3,138 7,142 480 514 3,268 57 AmeriHealth 1,328 39,822 4,915 6,365 11,494 675 1,587

TOTAL 11,756 77,158 27,425 57,739 22,808 2,493 6,943

Source: PA Department of Racial/Ethnic Human Services Enterprise information is self- Data Warehouse – Updated

reported by consumers. 7/10/20 13


Lehigh/Capital cont.

Racial/Ethnic information is self-reported by consumers.

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


51 Gateway 1,781 580 2,927 1,545 69 2,272 22,140 52 United 1,301 110 793 391 9 3,696 11,816 53 Aetna 367 89 493 381 28 1,356 7,334 54 UPMC 1,011 128 695 295 22 1,136 6,481 57 AmeriHealth 3,172 137 4,492 2,686 16 2,213 19,333 Lehigh/Capital MCOs 7,632 1,044 9,400 5,298 144 10,673 67,104


51 Gateway 60 12 23 31 2 85 360 52 United 20 0 9 7 0 60 176 53 Aetna 12 4 11 19 5 44 194 54 UPMC 30 4 8 9 2 56 180 57 AmeriHealth 67 4 55 75 1 68 434 Lehigh/Capital MCOs 189 24 106 141 10 313 1,344

Asian

51 Gateway 765 139 313 202 4 208 3,363 52 United 283 37 145 74 3 248 1,945 53 Aetna 85 29 53 59 6 127 1,278 54 UPMC 381 35 158 69 2 111 1,838 57 AmeriHealth 676 46 641 516 4 170 2,829 Lehigh/Capital MCOs 2,190 286 1,310 920 19 864 11,253

White

51 Gateway 13,006 8,871 13,825 6,731 3,019 13,903 85,376 52 United 5,637 1,249 3,330 1,694 593 11,456 39,422 53 Aetna 2,213 1,316 1,920 1,555 715 5,212 31,884 54 UPMC 6,463 1,500 3,358 1,795 454 5,494 34,230 57 AmeriHealth 14,298 1,763 26,272 15,283 980 8,127 97,681 Lehigh/Capital MCOs 41,617 14,699 48,705 27,058 5,761 44,192 288,593


51 Gateway 3,798 3,513 2,790 2,438 78 2,450 26,960 52 United 2,371 423 675 382 31 4,214 13,481 53 Aetna 548 371 413 317 22 1,077 6,717 54 UPMC 1,756 443 651 403 33 1,217 8,205 57 AmeriHealth 8,082 1,195 5,104 4,439 24 2,938 45,617 Lehigh/Capital MCOs 16,555 5,945 9,633 7,979 188 11,896 100,980


51 Gateway 34 15 44 25 0 28 234 52 United 24 1 51 10 0 29 200 53 Aetna 10 3 20 9 0 21 149 54 UPMC 15 5 27 15 0 20 159 57 AmeriHealth 64 19 120 100 0 52 511 Lehigh/Capital MCOs 147 43 262 159 0 150 1,253

Unknown

51 Gateway 1,654 451 867 495 43 746 7,008 52 United 829 112 381 181 22 909 4,135 53 Aetna 254 79 223 148 15 458 2,970 54 UPMC 1,094 127 321 179 14 517 3,673 57 AmeriHealth 2,387 168 1,761 1,074 21 871 9,962 Lehigh/Capital MCOs 6,218 937 3,553 2,077 115 3,501 27,748

MCO TOTAL

51 Gateway 73,803 22,374 72,385 43,771 6,196 70,776 145,441 52 United 10,465 1,932 5,384 2,739 658 20,612 71,175 53 Aetna 3,489 1,891 3,133 2,488 791 8,295 50,526 54 UPMC 10,750 2,242 5,218 2,765 527 8,551 54,766 57 AmeriHealth 28,746 3,332 38,445 24,173 1,046 14,439 176,367

TOTAL 74,548 22,978 72,969 43,632 6,237 71,589 498,275



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


35 UPMC 18 134 117 411 55 5,021 8 36 Gateway 0 11 19 42 8 3,225 1 37 AmeriHealth 4 29 33 36 3 1,184 1 56 Aetna 1 22 27 32 6 2,639 1 Northwest MCOs 23 196 196 521 72 12,069 11


35 UPMC 1 4 19 35 7 126 3 36 Gateway 0 2 0 2 0 36 4 37 AmeriHealth 0 3 1 1 2 11 1 56 Aetna 0 1 1 0 0 43 1 Northwest MCOs 1 10 21 38 9 216 9

Asian

35 UPMC 7 17 40 44 13 1,189 1 36 Gateway 0 2 1 1 1 174 0 37 AmeriHealth 0 0 4 0 0 153 0 56 Aetna 0 2 6 1 3 128 0 Northwest MCOs 7 21 51 46 17 1,644 1

White

35 UPMC 748 4,036 9,462 11,121 3,476 23,295 553 36 Gateway 30 608 1,132 848 409 7,979 66 37 AmeriHealth 97 485 1,952 936 282 3,777 67 56 Aetna 46 551 1,688 999 295 6,250 48 Northwest MCOs 921 5,680 14,234 13,904 4,462 41,301 734


35 UPMC 7 45 67 130 25 1,832 3 36 Gateway 1 5 10 8 3 799 1 37 AmeriHealth 0 4 20 12 5 315 0 56 Aetna 0 7 20 12 0 578 1 Northwest MCOs 8 61 117 162 33 3,524 5



Unknown

35 UPMC 1 61 82 181 15 599 2 36 Gateway 0 2 8 11 0 170 0 37 AmeriHealth 0 8 16 13 2 96 0 56 Aetna 0 10 17 18 2 167 1 Northwest MCOs 1 81 123 223 19 1,032 3

MCO TOTAL

35 UPMC 782 4,300 9,793 11,924 3,594 32,092 570 36 Gateway 31 630 1,170 912 421 12,394 72 37 AmeriHealth 101 529 2,026 998 294 5,546 69 56 Aetna 47 593 1,759 1,062 307 9,817 52

TOTAL 961 6,052 14,748 14,896 4,616 59,849 763


15


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


35 UPMC 64 87 1,751 20 212 52 7,950 36 Gateway 5 4 615 1 32 12 3,975 37 AmeriHealth 6 14 412 16 21 7 1,766 56 Aetna 6 11 396 1 46 5 3,193 Northwest MCOs 81 116 3,174 38 311 76 16,884



Asian

35 UPMC 11 22 76 0 33 16 1,469 36 Gateway 4 0 20 0 2 0 205 37 AmeriHealth 1 7 12 4 4 2 187 56 Aetna 1 0 10 0 1 2 154 Northwest MCOs 17 29 118 4 40 20 2,015

White

35 UPMC 6,366 5,815 11,471 1,748 6,426 4,432 88,949 36 Gateway 736 222 2,648 40 655 615 15,988 37 AmeriHealth 294 1,145 1,503 1,119 874 701 13,232 56 Aetna 380 613 1,441 66 815 420 13,612 Northwest MCOs 7,776 7,795 17,063 2,973 8,770 6,168 131,781





Unknown


MCO TOTAL

35 UPMC 7,897 7,936 21,027 3,059 9,262 6,297 156,461 36 Gateway 754 230 3,385 42 715 641 21,397 37 AmeriHealth 309 1,181 2,027 1,171 913 724 15,888 56 Aetna 396 634 1,938 67 893 442 18,007

TOTAL 7,974 8,049 21,176 3,081 9,367 6,386 157,918


16


Northeast

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


41 AmeriHealth NE 36 327 111 38 58 11 922 2,176 44 Geisinger 63 95 268 108 242 12 2,814 4,727 50 Aetna 57 60 152 32 83 12 779 1,452 Northeast MCOs 156 482 531 178 383 35 4,515 8,355


41 AmeriHealth NE 11 24 3 2 3 1 23 45 44 Geisinger 7 14 13 8 12 1 67 72 50 Aetna 7 3 3 0 3 4 23 8 Northeast MCOs 25 41 19 10 18 6 113 125

Asian

41 AmeriHealth NE 24 23 74 10 12 1 235 110 44 Geisinger 10 8 128 13 48 10 865 403 50 Aetna 7 5 74 0 18 4 177 90 Northeast MCOs 41 36 276 23 78 15 1,277 603

White

41 AmeriHealth NE 2,918 6,941 2,009 1,063 1,336 656 5,143 9,971 44 Geisinger 4,210 1,947 5,296 4,561 6,350 1,454 21,732 30,259 50 Aetna 3,044 792 2,036 653 966 574 3,766 5,374 Northeast MCOs 10,172 9,680 9,341 6,277 8,652 2,684 30,641 45,604


41 AmeriHealth NE 54 339 101 19 57 89 993 5,813 44 Geisinger 65 135 144 63 197 135 3,563 8,718 50 Aetna 48 76 108 17 53 42 693 1,288 Northeast MCOs 167 550 353 99 307 266 5,249 15,819



Unknown

41 AmeriHealth NE 65 186 64 14 33 29 507 537 44 Geisinger 75 64 109 61 98 36 1,778 1,272 50 Aetna 57 33 55 16 23 3 387 270 Northeast MCOs 197 283 228 91 154 68 2,672 2,079

MCO TOTAL 41 AmeriHealth NE 3,110 7,847 2,369 1,148 1,500 787 7,833 18,692 44 Geisinger 4,432 2,263 5,970 4,815 6,952 1,651 30,857 45,562 50 Aetna 3,224 973 2,435 718 1,151 639 5,837 8,504

TOTAL 10,766 11,083 10,774 6,681 9,603 3,077 44,527 72,758




Northeast cont.

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


41 AmeriHealth NE 849 61 2,672 13 265 360 446 27 44 Geisinger 2,153 108 2,077 26 491 313 504 91 50 Aetna 310 52 1,130 5 273 141 176 18 Northeast MCOs 3,312 221 5,879 44 1,029 814 1,126 136



Asian


White

41 AmeriHealth NE 3,838 1,911 8,988 313 2,862 1,962 8,001 1,073 44 Geisinger 11,965 4,074 6,517 1,408 9,594 4,110 11,863 2,914 50 Aetna 1,253 1,409 2,441 254 2,848 963 2,412 746 Northeast MCOs 17,056 7,394 17,946 1,975 15,304 7,035 22,276 4,733


41 AmeriHealth NE 100 41 2,423 17 206 339 803 26 44 Geisinger 228 63 1,826 54 457 400 728 95 50 Aetna 51 45 902 13 149 146 140 20 Northeast MCOs 379 149 5,151 84 812 885 1,671 141



Unknown

41 AmeriHealth NE 48 12 837 4 71 145 211 9 44 Geisinger 149 35 614 17 206 173 250 40 50 Aetna 30 13 328 2 64 71 61 10 Northeast MCOs 227 60 1,779 23 341 389 522 59

MCO TOTAL 41 AmeriHealth NE 4,860 2,033 15,216 352 3,435 2,868 9,544 1,159 44 Geisinger 14,595 4,306 11,320 1,530 10,837 5,094 13,445 3,155 50 Aetna 1,668 1,529 4,929 281 3,352 1,337 2,820 805

TOTAL 21,123 7,868 31,465 2,163 17,624 9,299 25,809 5,119


18


Northeast cont.

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


41 AmeriHealth NE 0 17 104 44 58 10 8,605 44 Geisinger 5 38 21 218 135 32 14,541 50 Aetna 7 23 18 59 36 8 4,883 Northeast MCOs 12 78 143 321 229 50 28,029


41 AmeriHealth NE 1 0 16 0 13 7 276 44 Geisinger 0 10 0 4 22 11 403 50 Aetna 1 3 2 4 10 3 125 Northeast MCOs 2 13 18 8 45 21 804

Asian

41 AmeriHealth NE 1 3 18 6 18 2 847 44 Geisinger 0 16 3 23 28 14 2,049 50 Aetna 0 1 1 2 6 0 534 Northeast MCOs 1 20 22 31 52 16 3,430

White

41 AmeriHealth NE 145 1,160 5,567 716 1,498 700 68,771 44 Geisinger 472 4,236 855 2,315 5,025 3,305 144,462 50 Aetna 144 896 544 594 1,063 529 33,301 Northeast MCOs 761 6,292 6,966 3,625 7,586 4,534 246,534





Unknown


MCO TOTAL 41 AmeriHealth NE 152 1,216 5,798 810 1,677 743 93,149 44 Geisinger 484 4,434 902 2,698 5,420 3,468 184,190 50 Aetna 156 958 586 667 1,185 557 44,311

TOTAL 792 6,608 7,286 4,175 8,282 4,768 321,650


19

Mandatory ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY April 2020

Southeast

09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast

Other/Unknown

42 United 7 4 2 10 40 63 43 Aetna 7 5 4 14 23 53 45 Health Partners 10 2 5 13 37 67 47 Keystone 15 7 19 36 62 139 Southeast MCOs 39 18 30 73 162 322

Non-Hispanic

42 United 4,776 9,563 7,876 7,551 45,281 75,047 43 Aetna 6,555 6,170 9,062 9,485 31,190 62,462 45 Health Partners 10,475 2,503 7,762 9,169 132,823 162,732 47 Keystone 36,102 18,190 64,807 48,477 210,970 378,546 Southeast MCOs 57,908 36,426 89,507 74,682 420,264 678,787

Hispanic

42 United 662 3,322 506 1,179 6,689 12,358 43 Aetna 653 1,208 525 962 4,488 7,836 45 Health Partners 1,702 321 714 1,138 63,255 67,130 47 Keystone 4,658 4,262 4,206 6,902 29,061 49,089 Southeast MCOs 7,675 9,113 5,951 10,181 103,493 136,413

TOTAL 65,622 45,557 95,488 84,936 523,919 815,522




Southwest

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

Other/Unknown


Non-Hispanic

31 Gateway 53,836 981 10,004 636 5,202 4,423 3,376 3,408 32 United 20,144 599 2,315 995 3,137 1,151 4,628 8,251 34 UPMC 97,665 9,558 13,025 5,827 14,214 13,819 15,022 19,147 59 Aetna 8,096 412 1,242 637 1,959 896 2,560 730 Southwest MCOs 179,741 11,550 26,586 8,095 24,512 20,289 25,586 31,536

Hispanic

31 Gateway 898 10 137 4 79 82 76 25 32 United 488 8 81 12 51 32 140 58 34 UPMC 2,644 87 246 76 210 285 199 210 59 Aetna 208 7 44 4 37 20 55 24 Southwest MCOs 4,238 112 508 96 377 419 470 317

TOTAL 184,069 11,667 27,102 8,192 24,892 20,716 26,062 31,860


21


Southwest cont.

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

Other/Unknown

31 Gateway 0 0 0 0 0 2 31 32 United 0 0 0 0 4 2 21 34 UPMC 1 0 1 3 1 12 92 59 Aetna 0 0 0 0 1 1 12 Southwest MCOs 1 0 1 3 6 17 156

Non-Hispanic

31 Gateway 722 2,125 6,216 1,516 5,040 10,055 107,540 32 United 2,857 1,625 1,515 2,523 5,007 7,148 61,895 34 UPMC 3,327 8,776 8,662 6,571 18,814 31,379 265,806 59 Aetna 328 617 742 910 1,500 2,086 22,715 Southwest MCOs 7,234 13,143 17,135 11,520 30,361 50,668 457,956

Hispanic

31 Gateway 4 17 62 17 82 99 1,592 32 United 12 30 44 35 81 115 1,187 34 UPMC 24 103 268 75 312 421 5,160 59 Aetna 3 20 24 10 60 41 557 Southwest MCOs 43 170 398 137 535 676 8,496

TOTAL 7,278 13,313 17,534 11,660 30,902 51,361 466,608




Lehigh/Capital

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

Other/Unknown


Non-Hispanic

51 Gateway 3,358 7,175 10,318 19,763 1,045 168 399 52 United 3,532 5,063 3,506 8,442 1,577 363 617 53 Aetna 1,115 4,975 3,925 7,064 7,248 757 1,047 54 UPMC 1,123 6,353 2,916 6,178 443 507 3,238 57 AmeriHealth 1,175 14,823 4,440 4,782 9,637 654 1,570 Lehigh/Capital MCOs 10,303 38,389 25,105 46,229 19,950 2,449 6,871

Hispanic

51 Gateway 223 6,176 928 5,910 106 4 6 52 United 785 3,002 425 1,872 173 1 7 53 Aetna 135 2,036 255 1,164 681 11 12 54 UPMC 153 2,541 221 962 35 6 30 57 AmeriHealth 153 24,995 472 1,580 1,850 21 17 Lehigh/Capital MCOs 1,449 38,750 2,301 11,488 2,845 43 72

TOTAL 11,756 77,158 27,425 57,739 22,808 2,493 6,943


23


Lehigh/Capital cont.

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

Other/Unknown


Non-Hispanic

51 Gateway 16,495 8,405 9,558 7,462 3,138 16,930 104,214 52 United 7,504 1,338 3,011 2,192 627 15,411 53,183 53 Aetna 2,879 1,388 1,865 2,016 752 7,017 42,048 54 UPMC 8,670 1,596 3,491 2,168 508 7,189 44,380 57 AmeriHealth 18,267 1,650 18,544 16,947 1,028 10,626 104,143 Lehigh/Capital MCOs 53,815 14,377 36,469 30,785 6,053 57,173 347,968

Hispanic

51 Gateway 4,595 5,176 11,225 4,002 76 2,761 41,188 52 United 2,960 592 2,372 543 31 5,193 17,956 53 Aetna 608 502 1,266 469 38 1,276 8,453 54 UPMC 2,071 645 1,722 594 19 1,360 10,359 57 AmeriHealth 10,462 1,682 19,889 7,215 18 3,811 72,165 Lehigh/Capital MCOs 20,696 8,597 36,474 12,823 182 14,401 150,121

TOTAL 74,548 22,978 72,969 43,632 6,237 71,589 498,275




Northwest

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

Other/Unknown


Non-Hispanic

35 UPMC 759 4,262 9,707 11,773 3,549 29,890 568 36 Gateway 31 629 1,165 906 421 11,190 68 37 AmeriHealth 95 525 2,003 983 288 5,145 69 56 Aetna 47 577 1,734 1,050 301 8,954 51 Northwest MCOs 932 5,993 14,609 14,712 4,559 55,179 756

Hispanic

35 UPMC 23 37 85 151 45 2,199 2 36 Gateway 0 1 5 6 0 1,204 4 37 AmeriHealth 6 3 23 14 6 398 0 56 Aetna 0 16 25 9 6 862 1 Northwest MCOs 29 57 138 180 57 4,663 7

TOTAL 961 6,052 14,748 14,896 4,616 59,849 763


25


Northwest cont.

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

Other/Unknown


Non-Hispanic

35 UPMC 6,433 5,939 13,641 1,780 6,757 4,544 99,602 36 Gateway 751 229 3,348 40 696 634 20,108 37 AmeriHealth 306 1,176 1,997 1,160 897 717 15,361 56 Aetna 394 633 1,917 67 883 436 17,044 Northwest MCOs 7,884 7,977 20,903 3,047 9,233 6,331 152,115

Hispanic

35 UPMC 80 65 182 21 87 34 3,011 36 Gateway 3 1 36 2 18 7 1,287 37 AmeriHealth 3 5 26 11 16 7 518 56 Aetna 2 1 21 0 10 6 959 Northwest MCOs 88 72 265 34 131 54 5,775

TOTAL 7,974 8,049 21,176 3,081 9,367 6,386 157,918




Northeast

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

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 3,072 7,093 2,295 1,113 1,425 680 6,288 11,787 44 Geisinger 4,363 2,067 5,832 4,720 6,654 1,498 25,377 34,627 50 Aetna 3,176 884 2,369 697 1,086 580 4,808 6,788 Northeast MCOs 10,611 10,044 10,496 6,530 9,165 2,758 36,473 53,202

Hispanic

41 AmeriHealth NE 36 750 72 35 75 106 1,543 6,902 44 Geisinger 67 196 130 95 298 151 5,468 10,920 50 Aetna 46 89 65 21 65 59 1,027 1,716 Northeast MCOs 149 1,035 267 151 438 316 8,038 19,538

TOTAL 10,766 11,083 10,774 6,681 9,603 3,077 44,527 72,758




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 4,737 1,947 12,282 328 3,095 2,376 8,092 1,112 44 Geisinger 14,314 4,168 9,022 1,459 9,935 4,488 12,130 3,034 50 Aetna 1,623 1,421 3,809 270 3,081 1,123 2,564 786 Northeast MCOs 20,674 7,536 25,113 2,057 16,111 7,987 22,786 4,932

Hispanic

41 AmeriHealth NE 120 86 2,929 24 340 492 1,452 47 44 Geisinger 276 138 2,291 71 902 598 1,315 119 50 Aetna 44 108 1,116 11 270 213 255 19 Northeast MCOs 440 332 6,336 106 1,512 1,303 3,022 185

TOTAL 21,123 7,868 31,465 2,163 17,624 9,299 25,809 5,119




Northeast cont.

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

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 152 1,186 5,740 746 1,577 722 77,845 44 Geisinger 471 4,332 897 2,487 5,204 3,387 160,466 50 Aetna 152 937 576 642 1,118 553 39,043 Northeast MCOs 775 6,455 7,213 3,875 7,899 4,662 277,354

Hispanic


TOTAL 792 6,608 7,286 4,175 8,282 4,768 321,650



Mandatory PLAN MAKE UP BY AGE GROUP AND GENDER April 2020

SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL

< 21 Yrs Female 20,460 16,479 56,123 116,465 209,527 Male 21,355 17,999 57,788 125,960 223,102 Total 41,815 34,478 113,911 242,425 432,629

22-45 Yrs Female 16,651 12,919 48,295 78,895 156,760 Male 15,087 12,827 29,223 45,690 102,827 Total 31,738 25,746 77,518 124,585 259,587


Over 64 Yrs Female 368 308 986 1,717 3,379 Male 256 211 622 1,051 2,140 Total 624 519 1,608 2,768 5,519

TOTAL 87,468 70,351 229,929 427,774 815,522

SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL




Over 64 Yrs Female 123 71 386 31 611 Male 82 45 238 22 387 Total 205 116 624 53 998

TOTAL 109,163 63,103 271,058 23,284 466,608



LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL

< 21 Yrs Female 41,664 19,483 12,533 13,776 49,042 136,498 Male 44,261 20,795 13,536 14,859 51,696 145,147 Total 85,925 40,278 26,069 28,635 100,738 281,645

22-45 Yrs Female 27,904 13,472 10,537 10,897 34,911 97,721 Male 13,318 8,175 7,035 7,226 16,752 52,506 Total 41,222 21,647 17,572 18,123 51,663 150,227

46-64 Yrs Female 10,334 4,899 3,430 4,177 13,815 36,655 Male 7,306 4,038 3,266 3,580 9,211 27,401 Total 17,640 8,937 6,696 7,757 23,026 64,056

Over 64 Yrs Female 420 191 116 142 639 1,508 Male 234 122 73 109 301 839 Total 654 313 189 251 940 2,347

TOTAL 145,441 71,175 50,526 54,766 176,367 498,275

NORTHWEST

35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL




Over 64 Yrs Female 54 8 13 11 86 Male 53 9 11 14 87 Total 107 17 24 25 173

TOTAL 102,626 21,397 15,888 18,007 157,918



NORTHEAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

< 21 Yrs Female 23,570 47,227 10,853 81,650

Male 24,966 49,985 11,593 86,544

Total 48,536 97,212 22,446 168,194

22-45 Yrs Female 19,013 36,862 9,001 64,876

Male 11,197 21,293 6,454 38,944

Total 30,210 58,155 15,455 103,820

46-64 Yrs Female 7,998 16,205 3,403 27,606

Male 6,135 12,121 2,912 21,168

Total 14,133 28,326 6,315 48,774

Over 64 Yrs Female 184 325 55 564

Male 86 172 40 298

Total 270 497 95 862

TOTAL 93,149 184,190 44,311 321,650


Mandatory PLAN MAKE UP BY AGE GROUP April 2020

SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL < 21 Yrs 41,815 34,478 113,911 242,425 432,629 22-45 Yrs 31,738 25,746 77,518 124,585 259,587 46-64 Yrs 13,291 9,608 36,892 57,996 117,787 Over 64 Yrs 624 519 1,608 2,768 5,519

TOTAL 87,468 70,351 229,929 427,774 815,522 SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL < 21 Yrs 57,950 32,170 136,372 9,920 236,412 22-45 Yrs 34,465 21,095 87,829 9,483 152,872 46-64 Yrs 16,543 9,722 46,233 3,828 76,326 Over 64 Yrs 205 116 624 53 998

TOTAL 109,163 63,103 271,058 23,284 466,608 LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL < 21 Yrs 85,925 40,278 26,069 28,635 100,738 281,645 22-45 Yrs 41,222 21,647 17,572 18,123 51,663 150,227 46-64 Yrs 17,640 8,937 6,696 7,757 23,026 64,056 Over 64 Yrs 654 313 189 251 940 2,347

TOTAL 145,441 71,175 50,526 54,766 176,367 498,275


Mandatory PLAN MAKE UP BY AGE GROUP April 2020

NORTHWEST 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL

< 21 Yrs 54,738 11,092 7,428 8,999 82,257 22-45 Yrs 32,203 7,162 5,734 6,383 51,482 46-64 Yrs 15,578 3,126 2,702 2,600 24,006 Over 64 Yrs 107 17 24 25 173

TOTAL 102,626 21,397 15,888 18,007 157,918 NORTHEAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL < 21 Yrs 48,536 97,212 22,446 168,194 22-45 Yrs 30,210 58,155 15,455 103,820 46-64 Yrs 14,133 28,326 6,315 48,774 Over 64 Yrs 270 497 95 862

TOTAL 93,149 184,190 44,311 321,650


-

-

-

-

HealthChoices Enrollment AID CATEGORY DISTRIBUTION 2nd Quarter 2019

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

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

3% TANF/HB/MAGI

11%

TANF/HB/MAGI (Ages 1 20)

42%Disabled/BC&C 15%

Newly Eligible (45+) 9%

Newly Eligible (19-44)

20%

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

Under Age 1 3%

Source: Bureau of Fiscal Management 3% 3%

11%


40%

Under Age 1

Disabled/BC&C 14%



23%

11%

TANF/HB/MAGI (Ages 1-20)

37%

Under Age 1

Disabled/BC&C 18%



22%

11%


39%

Under Age 1

Disabled/BC&C 18%



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 April 2020

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.

April 2020

Zone Percentage

Southeast 91.6%

Southwest 92.4%

Lehigh/Capital 92.4%

Northwest 93.2%

Northeast 91.7%

Total 92.1%

Source: Maximus

36

Medical Assistance Transportation Program

Based on Data Submitted by Each County

37

MATP 1Q FY 18/19

Southeast

COUNTY Total Expenditure Para Transit Trips Mass Transit Trips Mileage

Reimbursement Trips

Total Trips Client Utilization

Bucks $ 541,632 18,247 - 17,366 35,613 1.1%

Chester $ 570,936 11,205 3,181 5,940 20,326 1.6%

Delaware $ 1,259,087 22,144 5,192 5,262 32,598 0.8%

Montgomery $ 792,399 17,988 3,248 3,957 25,193 1.3%

Philadelphia $ 11,545,940 277,092 760,540 10,121 1,047,753 4.5%

HC-SE Zone $ 14,709,994 346,676 772,161 42,646 1,161,483 3.3%

38

Southwest

MATP 1Q FY 18/19


Reimbursement Trips


Allegheny $ 2,676,073 46,190 153,372 34,556 234,118 4.1%

Armstrong $ 417,494 8,121 - 4,712 12,833 4.8%

Beaver $ 669,140 14,237 283 14,016 28,536 3.3%

Bedford $ 144,152 4,074 - 3,753 7,827 4.0%

Blair $ 349,537 12,386 2,336 2,155 16,877 2.5%

Butler $ 563,232 10,953 - 4,437 15,390 2.6%

Cambria $ 1,024,987 30,238 3,884 4,258 38,380 5.7%

Fayette $ 386,008 16,055 9 21,058 37,122 3.1%

Greene $ 170,276 4,699 - 2,606 7,305 3.6%

Indiana $ 257,210 5,738 821 2,972 9,531 3.3%

Lawrence $ 308,891 7,926 2,918 10,239 21,083 3.2%

Somerset $ 389,998 8,376 - 4,882 13,258 3.9%

Washington $ 634,083 19,070 1,925 10,978 31,973 4.3%

Westmoreland $ 758,785 21,752 109 12,340 34,201 2.8%

HC-SW Zone $ 8,749,864 209,815 165,657 132,962 508,434 3.7%

39

Lehigh/Capital

MATP 1Q FY 18/19


Reimbursement Trips


Adams* $ 50,228 1,546 - 490 2,036 0.9%

Berks $ 804,600 18,874 9,881 4,818 33,573 2.3%

Cumberland $ 159,985 5,100 - 1,385 6,485 1.3%

Dauphin $ 751,035 24,659 5,084 1,172 30,915 2.7%

Franklin $ 128,161 3,873 - 1,322 5,195 1.2%

Fulton $ 106,947 1,485 - 1,084 2,569 6.4%

Huntingdon $ 185,951 3,021 - 5,014 8,035 5.1%

Lancaster $ 688,488 21,841 1,025 5,849 28,715 1.5%

Lebanon $ 447,081 17,874 98 1,188 19,160 1.9%

Lehigh $ 489,177 12,315 1,216 1,364 14,895 0.9%

Northampton $ 221,304 6,439 1,048 1,488 8,975 0.9%

Perry $ 68,361 2,404 - 367 2,771 1.8%

York* $ 274,034 7,793 478 2,837 11,108 0.7%

HC-L/C Zone $ 4,325,123 125,678 18,830 27,888 172,396 1.6%

* 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 1Q FY 18/19

COUNTY Total Expenditure Para Transit Trips

Mass Transit Trips

Mileage Reimbursement

Trips

Volunteer Trips Total Trips Client

Utilization

Cameron $ 61,150 779 50 271 - 1,100 4.6%

Clarion $ 174,753 2,251 - 2,143 - 4,394 4.2%

Clearfield $ 350,723 9,741 - 5,689 - 15,430 4.9%

Crawford $ 219,165 1,313 758 6,536 4,140 12,747 4.2%

Elk $ 210,755 2,826 1 1,030 - 3,857 4.6%

Erie $ 430,044 15,802 822 2,597 - 19,221 1.2%

Forest $ 42,919 620 - 370 - 990 4.8%

Jefferson $ 382,944 8,379 - 3,494 - 11,873 6.9%

McKean $ 161,287 2,109 14 1,002 - 3,125 3.0%

Mercer $ 242,537 9,924 - 1,705 - 11,629 2.8%

Potter $ 219,015 2,750 - 1,036 - 3,786 7.3%

Venango $ 274,226 4,733 23 1,184 - 5,940 3.5%

Warren $ 93,277 1,275 84 1,845 - 3,204 4.1%

HC-NW Zone $ 2,862,796 62,502 1,752 28,902 4,140 97,296 3.1%

41

Northeast

MATP 1Q FY 18/19

COUNTY Total Expenditure

Para Transit Trips

Mass Transit Trips

Mileage Reimbursement

Trips Total Trips Client Utilization

Bradford/Sullivan/Tioga $ 603,276 6,735 55 2,126 8,916 3.2%

Carbon $ 156,133 2,878 - 496 3,374 2.0%

Centre $ 169,620 4,034 301 1,502 5,837 1.8%

Clinton $ 206,090 3,961 - 514 4,475 4.3%

Columbia $ 108,055 3,349 - 1,031 4,380 2.0%

Juniata $ 32,555 640 - 576 1,216 1.0%

Lackawanna $ 294,207 7,746 2,767 1,909 12,422 1.0%

Luzerne $ 498,279 17,614 1,506 6,436 25,556 1.6%

Lycoming $ 378,213 9,021 1,420 2,048 12,489 3.5%

Mifflin $ 100,897 3,882 - 514 4,396 1.6%

Monroe $ 194,695 5,155 506 4,806 10,467 1.6%

Montour $ 43,888 1,225 - 554 1,779 3.1%

Northumberland $ 293,548 9,019 - 2,880 11,899 3.2%

Pike $ 71,505 1,227 - 1,643 2,870 1.1%

Schuylkill $ 422,504 6,998 379 2,457 9,834 2.2%

Snyder $ 61,724 1,346 - 1,156 2,502 2.4%

Susquehanna $ 151,567 2,475 - 1,642 4,117 3.7%

Union $ 31,627 1,028 - 254 1,282 1.7%

Wayne $ 155,843 3,846 - 1,480 5,326 3.6%

Wyoming $ 79,642 1,563 - 946 2,509 2.7%

HC-NE Zone $ 4,053,868 93,742 6,934 34,970 135,646 2.1%

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 Enrollment … · 2020-07-24 · Total Enrollment = 2,259,973 : AmeriHealth NE 93,149 4%: Aetna 206,479 9% AmeriHealth 192,255 9%