BMCO Monthly Physical Health Managed Care Program … · 2020. 5. 13. · BMCO. Monthly Physical Health Managed Care Program Enrollment Report. NOTE: This report contains the number

BMCOMonthly 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: May 13, 2020

HEALTHCHOICES

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

MEDICAL ASSISTANCETRANSPORTATION PROGRAM

All Zones 38-42

LINK TO MCO DIRECTORY 43

Table of Contents

2

3

HealthChoices

Managed Care

4

Erie

Crawford

Mercer

Warren McKean Potter Tioga Bradford SusquehannaWayne

Pike

Lacka-wanna

MonroeLuzerne

Wyoming

Carbon

Schuylkill

Columbia

SullivanLycoming

MontourNorth-umberlandSnyder

Union

JuniataMifflin

Centre

Clinton

CameronElk

Clearfield

JeffersonClarion

ForestVenango

Blair

Bedford

Huntingdon

Fulton FranklinSomerset

Cambria

Lawrence

Beaver

Washington

Greene

Butler

Allegheny

Fayette

Westmoreland

Armstrong

Indiana

Perry

Cumberland

Adams YorkLancaster

Dauphin LebanonBerks

Lehigh

Northampton

Bucks

Montgomery

Chester

DelawarePhiladelphia

HC SE – 1997

HC SW – 1999

HC NE – 2013

HC L/C – 2001

HC NW – 2012

ENROLLMENT BY PLAN AND BY COUNTY

5Source: PA Department of Human Services Enterprise Data Warehouse – Updated 4/09/20

Mandatory March 2020

SOUTHEAST

County 42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL09 Bucks 5,385 7,125 12,061 40,327 64,89815 Chester 12,727 7,302 2,735 22,222 44,98623 Delaware 8,293 9,496 8,415 68,451 94,65546 Montgomery 8,625 10,327 10,194 54,717 83,86351 Philadelphia 51,455 35,160 194,865 237,945 519,425TOTAL 86,485 69,410 228,270 423,662 807,827PERCENTAGE 11% 9% 28% 52%

SOUTHWEST

County 31 Gateway 32 United 34 UPMC 59 Aetna TOTAL02 Allegheny 54,419 20,404 99,414 8,146 182,38303 Armstrong 989 602 9,566 410 11,56704 Beaver 10,063 2,333 13,132 1,242 26,77005 Bedford 635 995 5,858 626 8,11407 Blair 5,292 3,172 14,226 1,958 24,64810 Butler 4,488 1,178 13,943 890 20,49911 Cambria 3,457 4,725 15,065 2,614 25,86126 Fayette 3,439 8,268 19,149 738 31,59430 Greene 709 2,842 3,319 318 7,18832 Indiana 2,131 1,647 8,819 614 13,21137 Lawrence 6,245 1,521 8,784 745 17,29556 Somerset 1,520 2,531 6,584 900 11,53563 Washington 5,067 5,031 18,922 1,516 30,53665 Westmoreland 10,106 7,222 31,431 2,100 50,859TOTAL 108,560 62,471 268,212 22,817 462,060PERCENTAGE 23% 14% 58% 5%


6


cont.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 4/09/20

LEHIGH/CAPITAL

County 51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL01 Adams 3,574 4,257 1,225 1,261 1,319 11,63606 Berks 13,225 7,935 6,887 8,699 39,544 76,29021 Cumberland 11,139 3,837 4,131 2,950 4,824 26,88122 Dauphin 25,525 10,137 8,101 6,902 6,297 56,96228 Franklin 1,117 1,657 7,918 458 11,386 22,53629 Fulton 174 364 770 512 668 2,48831 Huntingdon 398 612 1,039 3,263 1,570 6,88236 Lancaster 20,818 10,345 3,409 10,463 28,594 73,62938 Lebanon 13,387 1,888 1,833 2,150 3,259 22,51739 Lehigh 20,531 5,206 3,028 5,186 37,908 71,85948 Northampton 11,318 2,698 2,432 2,719 23,851 43,01850 Perry 3,166 645 790 515 1,047 6,16367 York 19,605 20,355 8,199 8,339 14,253 70,751TOTAL 143,977 69,936 49,762 53,417 174,520 491,612PERCENTAGE 29% 14% 10% 11% 36%

NORTHWEST

County 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL12 Cameron 765 34 107 44 95016 Clarion 4,253 636 515 584 5,98817 Clearfield 9,728 1,156 1,959 1,718 14,56120 Crawford 11,752 903 952 1,041 14,64824 Elk 3,572 407 288 297 4,56425 Erie 31,897 12,373 5,504 9,730 59,50427 Forest 577 74 66 51 76833 Jefferson 6,443 746 315 393 7,89742 McKean 5,929 217 1,166 624 7,93643 Mercer 13,709 3,363 2,033 1,922 21,02753 Potter 1,799 47 1,149 64 3,05961 Venango 6,773 696 908 885 9,26262 Warren 4,524 633 707 433 6,297

TOTAL 101,721 21,285 15,669 17,786 156,461PERCENTAGE 65% 14% 10% 11%


7


cont.


NORTHEASTCounty 41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

08 Bradford 3,077 4,356 3,202 10,63513 Carbon 7,797 2,246 962 11,00514 Centre 2,355 5,884 2,402 10,64118 Clinton 1,140 4,787 701 6,62819 Columbia 1,482 6,888 1,147 9,51734 Juniata 777 1,636 630 3,04335 Lackawanna 7,736 30,478 5,711 43,92540 Luzerne 18,355 44,924 8,350 71,62941 Lycoming 4,832 14,429 1,637 20,89844 Mifflin 2,012 4,250 1,516 7,77845 Monroe 14,969 11,190 4,869 31,02847 Montour 348 1,512 283 2,14349 Northumberland 3,401 10,669 3,340 17,41052 Pike 2,801 5,047 1,293 9,14154 Schuylkill 9,424 13,341 2,806 25,57155 Snyder 1,148 3,107 803 5,05857 Sullivan 151 480 143 77458 Susquehanna 1,185 4,392 949 6,52659 Tioga 5,719 900 566 7,18560 Union 798 2,690 658 4,14664 Wayne 1,644 5,357 1,156 8,15766 Wyoming 734 3,449 551 4,734

TOTAL 91,885 182,012 43,675 317,572PERCENTAGE 29% 57% 14%

MARKET SHARE BY PLAN – STATEWIDE

8


Total Enrollment = 2,235, 532


Aetna203,450

9%

AmeriHealth 190,189

9%

Gateway273,822

12%

Health Partners228,270

10%

Keystone423,662

19%

United218,892

10%

UPMC423,350

19%

AmeriHealth NE91,885

4%

Geisinger182,012

8%

MARKET SHARE BY ZONE AND BY PLAN

Lehigh/Capital

SouthwestSoutheast

9


Northwest Northeast


Aetna69,410

9%

Health Partners228,270

28%

Keystone423,662

52%

United86,485

11%

Aetna22,817

5%

Gateway108,560

23%

United62,471

14%

UPMC268,212

58%

Aetna49,762

10%

Ameri-Health

174,52036%

Gateway143,977

29%

United69,936

14%

UPMC53,417

11%

Aetna17,786

11%

Ameri-Health15,669

10%

Gateway21,285

14%

UPMC101,721

65%

Aetna43,675

14%

Ameri-Health NE

91,88529%

Geisinger182,012

57%

ENROLLMENT BY PLAN, BY RACE AND BY COUNTY

10

Southeast

Racial/Ethnic information is self-reported by consumers.



09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast

Black or African American

42 United 604 2,350 4,341 2,024 31,654 40,97343 Aetna 652 1,195 4,218 2,143 21,111 29,31945 Health Partners 1,356 473 4,373 2,904 91,188 100,29447 Keystone 4,274 3,780 32,798 12,630 142,259 195,741Southeast MCOs 6,886 7,798 45,730 19,701 286,212 366,327

American Indian or Alaskan Native

42 United 11 33 18 32 84 17843 Aetna 28 34 17 40 75 19445 Health Partners 32 4 18 36 233 32347 Keystone 91 79 100 174 376 820Southeast MCOs 162 150 153 282 768 1,515

Asian

42 United 256 296 457 451 3,207 4,66743 Aetna 311 194 479 713 1,539 3,23645 Health Partners 788 64 431 772 7,647 9,70247 Keystone 1,451 720 4,641 3,792 19,280 29,884Southeast MCOs 2,806 1,274 6,008 5,728 31,673 47,489

White

42 United 3,487 6,973 2,493 4,372 7,777 25,10243 Aetna 4,921 4,492 3,758 5,675 6,384 25,23045 Health Partners 7,502 1,630 2,419 4,584 31,556 47,69147 Keystone 28,108 13,458 23,906 27,945 38,827 132,244Southeast MCOs 44,018 26,553 32,576 42,576 84,544 230,267

Other or system default

42 United 677 2,124 621 1,218 6,678 11,31843 Aetna 750 856 605 1,107 4,531 7,84945 Health Partners 1,726 338 800 1,326 58,052 62,24247 Keystone 4,564 2,917 4,798 7,485 29,685 49,449Southeast MCOs 7,717 6,235 6,824 11,136 98,946 130,858

Native Hawaiian or Other Pacific Islander

42 United 20 23 18 21 121 20343 Aetna 25 11 21 35 95 18745 Health Partners 31 17 17 34 344 44347 Keystone 63 39 70 95 255 522Southeast MCOs 139 90 126 185 815 1,355

Unknown

42 United 330 928 345 507 1,934 4,04443 Aetna 438 520 398 614 1,425 3,39545 Health Partners 626 209 357 538 5,845 7,57547 Keystone 1,776 1,229 2,138 2,596 7,263 15,002Southeast MCOs 3,170 2,886 3,238 4,255 16,467 30,016

MCO TOTAL

42 United 5,385 12,727 8,293 8,625 51,455 86,48543 Aetna 7,125 7,302 9,496 10,327 35,160 69,41045 Health Partners 12,061 2,735 8,415 10,194 194,865 228,27047 Keystone 40,327 22,222 68,451 54,717 237,945 423,662

TOTAL 64,898 44,986 94,655 83,863 519,425 807,827


11

Southwest


Racial/Ethnic information is self-reported by consumers.Source: PA Department of Human Services Enterprise Data Warehouse – Updated 4/09/20

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


31 Gateway 26,619 23 2,477 13 378 198 549 33132 United 8,386 19 494 13 264 47 1,000 83734 UPMC 32,612 142 2,091 77 769 402 1,482 1,54759 Aetna 2,992 7 274 13 118 27 722 73Southwest MCOs 70,609 191 5,336 116 1,529 674 3,753 2,788


31 Gateway 130 0 20 1 6 5 10 432 United 65 2 3 0 6 4 3 1134 UPMC 327 19 42 9 19 19 32 5059 Aetna 17 0 8 0 3 9 1 2Southwest MCOs 539 21 73 10 34 37 46 67

Asian

31 Gateway 685 3 22 0 8 22 7 1532 United 460 2 23 7 23 18 12 1034 UPMC 4,945 34 108 20 91 157 38 4659 Aetna 213 1 9 1 9 14 7 2Southwest MCOs 6,303 40 162 28 131 211 64 73

White

31 Gateway 23,479 940 7,268 609 4,798 4,119 2,777 3,00332 United 9,649 554 1,647 955 2,801 1,024 3,533 7,18734 UPMC 51,840 9,218 10,254 5,620 12,997 12,661 12,976 16,96959 Aetna 3,849 391 879 595 1,770 777 1,777 610Southwest MCOs 88,817 11,103 20,048 7,779 22,366 18,581 21,063 27,769


31 Gateway 1,786 5 195 8 61 70 64 3332 United 899 15 96 11 39 49 115 9834 UPMC 5,108 70 369 98 176 324 309 21259 Aetna 506 4 48 11 30 32 62 27Southwest MCOs 8,299 94 708 128 306 475 550 370



Unknown

31 Gateway 1,693 18 79 4 39 70 49 4732 United 918 9 70 9 39 35 55 11234 UPMC 4,410 81 262 34 168 370 216 30559 Aetna 542 7 24 5 27 31 39 19Southwest MCOs 7,563 115 435 52 273 506 359 483

MCO TOTAL

31 Gateway 186,906 11,540 27,310 8,144 25,053 21,439 26,077 3,43932 United 20,404 602 2,333 995 3,172 1,178 4,725 8,26834 UPMC 99,414 9,566 13,132 5,858 14,226 13,943 15,065 19,14959 Aetna 8,146 410 1,242 626 1,958 890 2,614 738

TOTAL 182,383 11,567 26,770 8,114 24,648 20,499 25,861 31,594


12

Southwest cont.



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


31 Gateway 13 81 911 22 667 1,444 33,72632 United 28 82 221 28 623 725 12,76734 UPMC 41 271 909 73 1,735 2,283 44,43459 Aetna 5 39 120 19 182 209 4,800Southwest MCOs 87 473 2,161 142 3,207 4,661 95,727


31 Gateway 0 2 7 1 9 30 22532 United 3 4 1 4 10 18 13434 UPMC 15 18 20 10 25 58 66359 Aetna 1 1 3 3 3 8 59Southwest MCOs 19 25 31 18 47 114 1,081

Asian

31 Gateway 2 10 7 2 13 42 83832 United 2 7 4 7 19 31 62534 UPMC 12 65 42 20 139 252 5,96959 Aetna 1 4 2 2 7 21 293Southwest MCOs 17 86 55 31 178 346 7,725

White

31 Gateway 681 1,978 5,210 1,461 4,166 8,167 68,65632 United 2,782 1,505 1,242 2,434 4,145 6,044 45,50234 UPMC 3,196 8,180 7,511 6,319 16,081 27,039 200,86159 Aetna 303 533 584 853 1,226 1,685 15,832Southwest MCOs 6,962 12,196 14,547 11,067 25,618 42,935 330,851


31 Gateway 7 30 59 21 111 193 2,64332 United 18 29 37 36 115 180 1,73734 UPMC 32 122 193 76 422 769 8,28059 Aetna 3 25 25 7 44 76 900Southwest MCOs 60 206 314 140 692 1,218 13,560


31 Gateway 0 1 0 1 0 5 4932 United 0 0 0 0 6 3 5834 UPMC 1 3 6 0 12 21 27159 Aetna 0 0 0 0 1 1 42Southwest MCOs 1 4 6 1 19 30 420

Unknown

31 Gateway 6 29 51 12 101 225 2,42332 United 9 20 16 22 113 221 1,64834 UPMC 22 160 103 86 508 1,009 7,73459 Aetna 5 12 11 16 53 100 891Southwest MCOs 42 221 181 136 775 1,555 12,696

MCO TOTAL

31 Gateway 7,480 13,174 17,452 11,681 30,569 51,346 108,56032 United 2,842 1,647 1,521 2,531 5,031 7,222 62,47134 UPMC 3,319 8,819 8,784 6,584 18,922 31,431 268,21259 Aetna 318 614 745 900 1,516 2,100 22,817

TOTAL 7,188 13,211 17,295 11,535 30,536 50,859 462,060



Lehigh/Capital

13



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


51 Gateway 128 1,123 1,463 10,071 96 3 1952 United 220 737 591 3,698 184 5 2953 Aetna 57 828 480 2,514 611 17 5954 UPMC 51 654 304 1,928 33 10 9657 AmeriHealth 60 3,165 572 1,796 938 26 30Lehigh/Capital MCOs 516 6,507 3,410 20,007 1,862 61 233


51 Gateway 12 30 27 58 13 1 052 United 10 21 17 28 3 0 153 Aetna 2 13 14 43 14 1 054 UPMC 2 18 13 29 1 0 157 AmeriHealth 2 58 15 30 44 3 1Lehigh/Capital MCOs 28 140 86 188 75 5 3

Asian

51 Gateway 33 143 311 1,176 2 0 252 United 38 112 177 771 9 0 253 Aetna 11 112 134 560 63 1 254 UPMC 19 134 159 685 2 0 1557 AmeriHealth 11 250 126 290 88 0 4Lehigh/Capital MCOs 112 751 907 3,482 164 1 25

White

51 Gateway 3,062 6,253 7,496 7,694 847 165 36852 United 3,306 4,126 2,277 3,376 1,164 344 56053 Aetna 979 3,873 2,838 3,301 6,142 725 95654 UPMC 1,006 5,274 1,902 2,759 352 502 3,08357 AmeriHealth 1,075 13,578 3,318 2,432 8,166 608 1,494Lehigh/Capital MCOs 9,428 33,104 17,831 19,562 16,671 2,344 6,461


51 Gateway 170 5,044 1,262 5,207 91 1 852 United 501 2,407 528 1,599 185 9 1353 Aetna 106 1,632 382 1,123 618 17 1454 UPMC 110 2,026 391 980 34 0 4757 AmeriHealth 101 20,460 522 1,238 1,299 22 20Lehigh/Capital MCOs 988 31,569 3,085 10,147 2,227 49 102



Unknown

51 Gateway 166 610 556 1,282 67 4 152 United 180 500 236 636 108 6 753 Aetna 68 400 270 534 460 9 854 UPMC 72 563 169 493 36 0 2157 AmeriHealth 68 1,945 257 500 829 9 19Lehigh/Capital MCOs 554 4,018 1,488 3,445 1,500 28 56

MCO TOTAL

51 Gateway 12,258 79,489 26,341 57,326 22,383 2,403 39852 United 4,257 7,935 3,837 10,137 1,657 364 61253 Aetna 1,225 6,887 4,131 8,101 7,918 770 1,03954 UPMC 1,261 8,699 2,950 6,902 458 512 3,26357 AmeriHealth 1,319 39,544 4,824 6,297 11,386 668 1,570

TOTAL 11,636 76,290 26,881 56,962 22,536 2,488 6,882


Lehigh/Capital cont.

14




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


51 Gateway 1,732 565 2,924 1,528 63 2,280 21,99552 United 1,279 107 765 393 9 3,614 11,63153 Aetna 355 87 458 374 28 1,325 7,19354 UPMC 981 123 694 290 17 1,109 6,29057 AmeriHealth 3,139 128 4,405 2,645 19 2,150 19,073Lehigh/Capital MCOs 7,486 1,010 9,246 5,230 136 10,478 66,182


51 Gateway 64 14 24 31 3 80 35752 United 19 0 8 6 0 61 17453 Aetna 11 4 12 18 5 47 18454 UPMC 33 5 10 9 2 48 17157 AmeriHealth 62 4 45 74 1 61 400Lehigh/Capital MCOs 189 27 99 138 11 297 1,286

Asian

51 Gateway 747 142 309 204 4 209 3,28252 United 282 28 145 75 2 238 1,87953 Aetna 72 24 47 56 5 124 1,21154 UPMC 377 36 159 74 2 108 1,77057 AmeriHealth 670 50 653 510 4 166 2,822Lehigh/Capital MCOs 2,148 280 1,313 919 17 845 10,964

White

51 Gateway 12,860 8,732 13,642 6,643 2,978 13,828 84,56852 United 5,589 1,224 3,213 1,662 580 11,355 38,77653 Aetna 2,170 1,284 1,857 1,516 711 5,162 31,51454 UPMC 6,278 1,435 3,342 1,752 450 5,363 33,49857 AmeriHealth 14,268 1,710 25,992 15,073 977 8,056 96,747Lehigh/Capital MCOs 41,165 14,385 48,046 26,646 5,696 43,764 285,103


51 Gateway 3,770 3,467 2,751 2,411 75 2,421 26,67852 United 2,340 415 664 372 32 4,179 13,24453 Aetna 543 355 426 314 24 1,076 6,63054 UPMC 1,710 429 639 399 31 1,194 7,99057 AmeriHealth 8,009 1,194 4,991 4,402 24 2,904 45,186Lehigh/Capital MCOs 16,372 5,860 9,471 7,898 186 11,774 99,728


51 Gateway 33 15 42 26 0 25 22852 United 27 1 42 10 0 30 18853 Aetna 12 4 19 10 0 20 14554 UPMC 16 3 23 16 0 19 14857 AmeriHealth 55 11 123 96 0 57 481Lehigh/Capital MCOs 143 34 249 158 0 151 1,190

Unknown

51 Gateway 1,612 452 839 475 43 762 6,86952 United 809 113 369 180 22 878 4,04453 Aetna 246 75 209 144 17 445 2,88554 UPMC 1,068 119 319 179 13 498 3,55057 AmeriHealth 2,391 162 1,699 1,051 22 859 9,811Lehigh/Capital MCOs 6,126 921 3,435 2,029 117 3,442 27,159

MCO TOTAL

51 Gateway 73,803 22,374 72,385 43,771 6,196 70,776 143,97752 United 10,345 1,888 5,206 2,698 645 20,355 69,93653 Aetna 3,409 1,833 3,028 2,432 790 8,199 49,76254 UPMC 10,463 2,150 5,186 2,719 515 8,339 53,41757 AmeriHealth 28,594 3,259 37,908 23,851 1,047 14,253 174,520

TOTAL 73,629 22,517 71,859 43,018 6,163 70,751 491,612


Northwest

15



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


35 UPMC 18 130 112 425 56 4,986 936 Gateway 0 12 17 39 8 3,217 137 AmeriHealth 4 26 32 39 3 1,186 156 Aetna 0 24 26 32 6 2,598 1Northwest MCOs 22 192 187 535 73 11,987 12


35 UPMC 1 4 19 27 9 118 336 Gateway 0 2 0 1 0 34 437 AmeriHealth 0 3 0 2 2 12 056 Aetna 0 0 1 0 0 38 0Northwest MCOs 1 9 20 30 11 202 7

Asian

35 UPMC 7 14 34 43 13 1,158 136 Gateway 0 2 0 1 1 175 037 AmeriHealth 0 0 4 0 0 152 056 Aetna 0 2 6 0 4 129 0Northwest MCOs 7 18 44 44 18 1,614 1

White

35 UPMC 731 3,988 9,413 10,939 3,450 23,176 55736 Gateway 33 613 1,120 842 395 7,975 6837 AmeriHealth 103 474 1,883 885 276 3,733 6556 Aetna 44 541 1,649 979 284 6,209 47Northwest MCOs 911 5,616 14,065 13,645 4,405 41,093 737


35 UPMC 7 49 61 131 24 1,833 336 Gateway 1 5 11 9 3 793 137 AmeriHealth 0 4 22 12 5 318 056 Aetna 0 7 20 12 0 579 1Northwest MCOs 8 65 114 164 32 3,523 5



Unknown

35 UPMC 1 65 83 185 17 597 436 Gateway 0 2 8 11 0 168 037 AmeriHealth 0 8 18 14 2 93 056 Aetna 0 10 16 17 2 167 2Northwest MCOs 1 85 125 227 21 1,025 6

MCO TOTAL

35 UPMC 950 5,988 14,561 14,648 4,564 59,504 76836 Gateway 34 636 1,156 903 407 12,373 7437 AmeriHealth 107 515 1,959 952 288 5,504 6656 Aetna 44 584 1,718 1,041 297 9,730 51

TOTAL 950 5,988 14,561 14,648 4,564 59,504 768


Northwest cont.

16



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


35 UPMC 62 84 1,766 23 202 49 7,92236 Gateway 6 3 629 1 35 11 3,97937 AmeriHealth 6 14 417 15 21 7 1,77156 Aetna 4 11 406 1 46 5 3,160Northwest MCOs 78 112 3,218 40 304 72 16,832



Asian

35 UPMC 11 22 77 0 32 17 1,42936 Gateway 4 0 17 0 2 0 20237 AmeriHealth 1 7 12 4 4 2 18656 Aetna 1 0 10 0 1 1 154Northwest MCOs 17 29 116 4 39 20 1,971

White

35 UPMC 6,298 5,738 11,345 1,746 6,361 4,378 88,12036 Gateway 728 210 2,618 45 633 608 15,88837 AmeriHealth 300 1,131 1,504 1,099 870 685 13,00856 Aetna 379 604 1,417 63 809 413 13,438Northwest MCOs 7,705 7,683 16,884 2,953 8,673 6,084 130,454





Unknown


MCO TOTAL

35 UPMC 7,897 7,936 21,027 3,059 9,262 6,297 156,46136 Gateway 746 217 3,363 47 696 633 21,28537 AmeriHealth 315 1,166 2,033 1,149 908 707 15,66956 Aetna 393 624 1,922 64 885 433 17,786

TOTAL 7,897 7,936 21,027 3,059 9,262 6,297 156,461


Northeast

17




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


41 AmeriHealth NE 36 316 110 39 53 10 920 2,13444 Geisinger 61 90 266 108 237 13 2,767 4,65450 Aetna 52 60 145 35 87 10 764 1,440Northeast MCOs 149 466 521 182 377 33 4,451 8,228


41 AmeriHealth NE 10 26 4 2 2 1 25 4644 Geisinger 5 14 14 8 9 1 58 6950 Aetna 6 3 4 0 3 4 26 8Northeast MCOs 21 43 22 10 14 6 109 123

Asian

41 AmeriHealth NE 25 20 78 10 12 1 230 10944 Geisinger 13 10 128 14 45 10 839 39650 Aetna 6 5 72 0 15 4 173 90Northeast MCOs 44 35 278 24 72 15 1,242 595

White

41 AmeriHealth NE 2,886 6,917 1,989 1,051 1,329 652 5,049 9,84944 Geisinger 4,137 1,936 5,217 4,531 6,300 1,444 21,497 29,93950 Aetna 3,031 780 2,024 636 962 568 3,685 5,268Northeast MCOs 10,054 9,633 9,230 6,218 8,591 2,664 30,231 45,056


41 AmeriHealth NE 54 335 100 20 52 83 991 5,66244 Geisinger 66 134 141 62 198 129 3,543 8,53750 Aetna 46 79 101 13 54 41 675 1,258Northeast MCOs 166 548 342 95 304 253 5,209 15,457



Unknown

41 AmeriHealth NE 63 177 66 12 33 30 506 51644 Geisinger 72 62 107 64 94 36 1,741 1,22650 Aetna 59 32 49 17 20 3 375 265Northeast MCOs 194 271 222 93 147 69 2,622 2,007

MCO TOTAL41 AmeriHealth NE 10,712 11,073 10,770 6,865 9,565 3,188 44,011 18,35544 Geisinger 4,356 2,246 5,884 4,787 6,888 1,636 30,478 44,92450 Aetna 3,202 962 2,402 701 1,147 630 5,711 8,350

TOTAL 10,635 11,005 10,641 6,628 9,517 3,043 43,925 71,629


Northeast cont.

18



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


41 AmeriHealth NE 848 59 2,616 12 264 351 433 2944 Geisinger 2,144 105 2,037 27 473 318 501 8950 Aetna 301 52 1,117 5 272 135 165 19Northeast MCOs 3,293 216 5,770 44 1,009 804 1,099 137



Asian


White

41 AmeriHealth NE 3,803 1,897 8,881 309 2,834 1,928 7,909 1,06044 Geisinger 11,815 4,024 6,451 1,390 9,455 4,073 11,793 2,86750 Aetna 1,235 1,398 2,424 258 2,837 934 2,419 743Northeast MCOs 16,853 7,319 17,756 1,957 15,126 6,935 22,121 4,670


41 AmeriHealth NE 100 35 2,374 16 204 325 798 2544 Geisinger 228 64 1,820 52 452 392 708 9550 Aetna 52 43 886 11 152 140 141 19Northeast MCOs 380 142 5,080 79 808 857 1,647 139



Unknown

41 AmeriHealth NE 52 13 817 6 70 139 202 1144 Geisinger 146 34 603 16 206 171 246 4250 Aetna 27 13 321 2 64 69 55 10Northeast MCOs 225 60 1,741 24 340 379 503 63

MCO TOTAL41 AmeriHealth NE 21,157 8,056 31,808 2,177 17,262 9,238 25,886 1,14844 Geisinger 14,429 4,250 11,190 1,512 10,669 5,047 13,341 3,10750 Aetna 1,637 1,516 4,869 283 3,340 1,293 2,806 803

TOTAL 20,898 7,778 31,028 2,143 17,410 9,141 25,571 5,058


Northeast cont.

19



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


41 AmeriHealth NE 1 18 98 45 59 12 8,46344 Geisinger 3 39 20 217 131 29 14,32950 Aetna 6 22 16 59 32 8 4,802Northeast MCOs 10 79 134 321 222 49 27,594


41 AmeriHealth NE 1 0 11 0 13 6 27144 Geisinger 0 10 0 4 19 11 37650 Aetna 1 2 2 4 10 2 122Northeast MCOs 2 12 13 8 42 19 769

Asian

41 AmeriHealth NE 1 3 19 4 17 2 83444 Geisinger 1 15 3 23 26 14 2,00050 Aetna 0 1 1 2 5 0 518Northeast MCOs 2 19 23 29 48 16 3,352

White

41 AmeriHealth NE 141 1,130 5,501 708 1,471 691 67,98544 Geisinger 469 4,194 857 2,318 4,976 3,285 142,96850 Aetna 133 889 526 584 1,039 524 32,897Northeast MCOs 743 6,213 6,884 3,610 7,486 4,500 243,850





Unknown


MCO TOTAL41 AmeriHealth NE 725 6,551 7,234 4,167 8,373 4,605 91,88544 Geisinger 480 4,392 900 2,690 5,357 3,449 182,01250 Aetna 143 949 566 658 1,156 551 43,675

TOTAL 774 6,526 7,185 4,146 8,157 4,734 317,572

20

ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY

Southeast




09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast

Other/Unknown

42 United 7 5 2 10 44 6843 Aetna 10 6 6 14 25 6145 Health Partners 11 5 6 13 41 7647 Keystone 19 8 22 39 77 165Southeast MCOs 47 24 36 76 187 370

Non-Hispanic

42 United 4,717 9,448 7,783 7,440 44,842 74,23043 Aetna 6,479 6,123 8,974 9,352 30,728 61,65645 Health Partners 10,339 2,436 7,708 9,050 131,931 161,46447 Keystone 35,711 18,000 64,264 47,851 209,070 374,896Southeast MCOs 57,246 36,007 88,729 73,693 416,571 672,246

Hispanic

42 United 661 3,274 508 1,175 6,569 12,18743 Aetna 636 1,173 516 961 4,407 7,69345 Health Partners 1,711 294 701 1,131 62,893 66,73047 Keystone 4,597 4,214 4,165 6,827 28,798 48,601Southeast MCOs 7,605 8,955 5,890 10,094 102,667 135,211

TOTAL 64,898 44,986 94,655 83,863 519,425 807,827

21

ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTYMandatory March 2020

Southwest


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

Other/Unknown


Non-Hispanic

31 Gateway 53,504 979 9,927 631 5,206 4,403 3,382 3,41332 United 19,925 592 2,255 985 3,121 1,145 4,579 8,21034 UPMC 96,752 9,478 12,888 5,782 14,022 13,657 14,853 18,93659 Aetna 7,934 403 1,202 622 1,921 869 2,560 712Southwest MCOs 178,115 11,452 26,272 8,020 24,270 20,074 25,374 31,271

Hispanic

31 Gateway 891 10 134 4 85 81 75 2632 United 469 9 77 10 51 32 144 5834 UPMC 2,611 84 238 75 202 281 209 20659 Aetna 204 7 39 4 37 21 53 26Southwest MCOs 4,175 110 488 93 375 415 481 316

TOTAL 182,383 11,567 26,770 8,114 24,648 20,499 25,861 31,594

22


Southwest cont.



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

Other/Unknown

31 Gateway 0 0 0 0 1 1 3332 United 0 0 0 0 4 5 2434 UPMC 1 0 1 3 2 16 10259 Aetna 0 0 0 0 1 2 13Southwest MCOs 1 0 1 3 8 24 172

Non-Hispanic

31 Gateway 705 2,115 6,185 1,503 4,982 9,999 106,93432 United 2,830 1,618 1,479 2,497 4,950 7,105 61,29134 UPMC 3,294 8,716 8,519 6,510 18,608 31,005 263,02059 Aetna 315 595 720 889 1,457 2,058 22,257Southwest MCOs 7,144 13,044 16,903 11,399 29,997 50,167 453,502

Hispanic

31 Gateway 4 16 60 17 84 106 1,59332 United 12 29 42 34 77 112 1,15634 UPMC 24 103 264 71 312 410 5,09059 Aetna 3 19 25 11 58 40 547Southwest MCOs 43 167 391 133 531 668 8,386

TOTAL 7,188 13,211 17,295 11,535 30,536 50,859 462,060

23


Lehigh/Capital


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

Other/Unknown


Non-Hispanic

51 Gateway 3,365 7,124 10,223 19,640 1,007 170 39252 United 3,469 4,982 3,426 8,313 1,495 363 60453 Aetna 1,096 4,903 3,877 6,945 7,236 758 1,02954 UPMC 1,107 6,257 2,744 5,970 420 505 3,23157 AmeriHealth 1,174 14,755 4,366 4,743 9,538 647 1,553Lehigh/Capital MCOs 10,211 38,021 24,636 45,611 19,696 2,443 6,809

Hispanic

51 Gateway 208 6,096 907 5,881 109 4 652 United 786 2,948 407 1,813 162 1 853 Aetna 128 1,978 252 1,153 678 12 1054 UPMC 154 2,441 205 930 36 6 3257 AmeriHealth 145 24,783 455 1,550 1,840 21 17Lehigh/Capital MCOs 1,421 38,246 2,226 11,327 2,825 44 73

TOTAL 11,636 76,290 26,881 56,962 22,536 2,488 6,882

24


Lehigh/Capital cont.



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

Other/Unknown


Non-Hispanic

51 Gateway 16,275 8,307 9,461 7,377 3,090 16,852 103,28352 United 7,425 1,302 2,904 2,164 614 15,240 52,30153 Aetna 2,816 1,354 1,776 1,965 753 6,932 41,44054 UPMC 8,430 1,528 3,465 2,140 499 6,992 43,28857 AmeriHealth 18,179 1,602 18,322 16,709 1,028 10,514 103,130Lehigh/Capital MCOs 53,125 14,093 35,928 30,355 5,984 56,530 343,442

Hispanic

51 Gateway 4,532 5,079 11,064 3,937 75 2,751 40,64952 United 2,918 584 2,301 530 31 5,105 17,59453 Aetna 591 478 1,250 464 36 1,263 8,29354 UPMC 2,023 620 1,715 576 16 1,344 10,09857 AmeriHealth 10,398 1,657 19,572 7,131 19 3,736 71,324Lehigh/Capital MCOs 20,462 8,418 35,902 12,638 177 14,199 147,958

TOTAL 73,629 22,517 71,859 43,018 6,163 70,751 491,612

25


Northwest


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

Other/Unknown


Non-Hispanic

35 UPMC 742 4,213 9,643 11,606 3,526 29,696 57536 Gateway 34 635 1,151 896 406 11,168 7037 AmeriHealth 100 511 1,939 939 282 5,096 6656 Aetna 44 569 1,696 1,029 291 8,870 50Northwest MCOs 920 5,928 14,429 14,470 4,505 54,830 761

Hispanic

35 UPMC 23 38 83 145 46 2,198 236 Gateway 0 1 5 7 1 1,205 437 AmeriHealth 7 3 20 12 6 406 056 Aetna 0 15 22 9 6 858 1Northwest MCOs 30 57 130 173 59 4,667 7

TOTAL 950 5,988 14,561 14,648 4,564 59,504 768

26


Northwest cont.



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

Other/Unknown


Non-Hispanic

35 UPMC 6,361 5,863 13,528 1,776 6,685 4,489 98,70336 Gateway 743 216 3,328 45 685 625 20,00237 AmeriHealth 312 1,160 2,002 1,138 894 700 15,13956 Aetna 391 623 1,903 64 876 427 16,833Northwest MCOs 7,807 7,862 20,761 3,023 9,140 6,241 150,677

Hispanic

35 UPMC 80 66 177 22 86 34 3,00036 Gateway 3 1 34 2 10 8 1,28137 AmeriHealth 3 6 27 11 14 7 52256 Aetna 2 1 19 0 9 6 948Northwest MCOs 88 74 257 35 119 55 5,751

TOTAL 7,897 7,936 21,027 3,059 9,262 6,297 156,461

27


Northeast



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

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 3,038 7,038 2,283 1,104 1,413 674 6,198 11,63044 Geisinger 4,285 2,050 5,747 4,693 6,594 1,491 25,066 34,22950 Aetna 3,156 877 2,341 682 1,083 574 4,718 6,692Northeast MCOs 10,479 9,965 10,371 6,479 9,090 2,739 35,982 52,551

Hispanic

41 AmeriHealth NE 36 756 70 36 69 102 1,536 6,72244 Geisinger 69 196 129 94 294 143 5,397 10,68150 Aetna 44 85 60 19 64 56 990 1,657Northeast MCOs 149 1,037 259 149 427 301 7,923 19,060

TOTAL 10,635 11,005 10,641 6,628 9,517 3,043 43,925 71,629

28


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 4,703 1,934 12,115 328 3,070 2,323 8,004 1,10044 Geisinger 14,149 4,113 8,925 1,443 9,780 4,455 12,046 2,99550 Aetna 1,593 1,411 3,765 272 3,067 1,092 2,561 784Northeast MCOs 20,445 7,458 24,805 2,043 15,917 7,870 22,611 4,879

Hispanic

41 AmeriHealth NE 126 77 2,848 20 331 478 1,420 4844 Geisinger 275 137 2,258 69 889 584 1,295 11050 Aetna 43 105 1,101 11 272 200 244 19Northeast MCOs 444 319 6,207 100 1,492 1,262 2,959 177

TOTAL 20,898 7,778 31,028 2,143 17,410 9,141 25,571 5,058

29


Northeast cont.



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

Other/Unknown


Non-Hispanic

41 AmeriHealth NE 150 1,158 5,658 736 1,549 719 76,92544 Geisinger 469 4,290 895 2,481 5,149 3,368 158,71350 Aetna 141 929 555 633 1,092 547 38,565Northeast MCOs 760 6,377 7,108 3,850 7,790 4,634 274,203

Hispanic


TOTAL 774 6,526 7,185 4,146 8,157 4,734 317,572

PLAN MAKE UP BY AGE GROUP AND GENDERMandatory March 2020


SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL

< 21 YrsFemale 20,329 16,320 55,797 115,580 208,026Male 21,147 17,815 57,502 124,997 221,461Total 41,476 34,135 113,299 240,577 429,487

22-45 YrsFemale 16,378 12,651 47,765 77,823 154,617Male 14,874 12,642 28,859 45,028 101,403Total 31,252 25,293 76,624 122,851 256,020


Over 64 YrsFemale 360 302 993 1,706 3,361Male 261 212 616 1,030 2,119Total 621 514 1,609 2,736 5,480

TOTAL 86,485 69,410 228,270 423,662 807,827

SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL




Over 64 YrsFemale 123 62 392 29 606Male 81 46 238 24 389Total 204 108 630 53 995

TOTAL 108,560 62,471 268,212 22,817 462,060



LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL

< 21 YrsFemale 41,277 19,210 12,405 13,469 48,605 134,966Male 43,956 20,485 13,382 14,554 51,213 143,590Total 85,233 39,695 25,787 28,023 99,818 278,556

22-45 YrsFemale 27,543 13,184 10,310 10,607 34,458 96,102Male 13,048 7,995 6,888 6,991 16,496 51,418Total 40,591 21,179 17,198 17,598 50,954 147,520

46-64 YrsFemale 10,275 4,812 3,373 4,071 13,707 36,238Male 7,235 3,944 3,218 3,491 9,113 27,001Total 17,510 8,756 6,591 7,562 22,820 63,239

Over 64 YrsFemale 415 190 113 134 628 1,480Male 228 116 73 100 300 817Total 643 306 186 234 928 2,297

TOTAL 143,977 69,936 49,762 53,417 174,520 491,612

NORTHWEST

35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL




Over 64 YrsFemale 52 8 13 11 84Male 53 8 11 14 86Total 105 16 24 25 170

TOTAL 101,721 21,285 15,669 17,786 156,461



NORTHEAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTALFemale 23,323 46,757 10,747 80,827

< 21 Yrs Male 24,671 49,444 11,475 85,590

Total 47,994 96,201 22,222 166,417

Female 18,662 36,355 8,803 63,820

22-45 Yrs Male 10,984 20,911 6,326 38,221

Total 29,646 57,266 15,129 102,041

Female 7,922 16,053 3,366 27,341

46-64 Yrs Male 6,054 12,016 2,865 20,935

Total 13,976 28,069 6,231 48,276

Female 183 314 54 551

Over 64 Yrs Male 86 162 39 287

Total 269 476 93 838

TOTAL 91,885 182,012 43,675 317,572

PLAN MAKE UP BY AGE GROUP

33



SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL< 21 Yrs 41,476 34,135 113,299 240,577 429,48722-45 Yrs 31,252 25,293 76,624 122,851 256,02046-64 Yrs 13,136 9,468 36,738 57,498 116,840Over 64 Yrs 621 514 1,609 2,736 5,480

TOTAL 86,485 69,410 228,270 423,662 807,827SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL< 21 Yrs 57,738 32,003 135,084 9,722 234,54722-45 Yrs 34,143 20,783 86,671 9,275 150,87246-64 Yrs 16,475 9,577 45,827 3,767 75,646Over 64 Yrs 204 108 630 53 995

TOTAL 108,560 62,471 268,212 22,817 462,060LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL< 21 Yrs 85,233 39,695 25,787 28,023 99,818 278,55622-45 Yrs 40,591 21,179 17,198 17,598 50,954 147,52046-64 Yrs 17,510 8,756 6,591 7,562 22,820 63,239Over 64 Yrs 643 306 186 234 928 2,297

TOTAL 143,977 69,936 49,762 53,417 174,520 491,612

PLAN MAKE UP BY AGE GROUP

34



NORTHWEST35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL

< 21 Yrs 54,395 11,054 7,363 8,912 81,72422-45 Yrs 31,736 7,118 5,630 6,283 50,76746-64 Yrs 15,485 3,097 2,652 2,566 23,800Over 64 Yrs 105 16 24 25 170

TOTAL 101,721 21,285 15,669 17,786 156,461NORTHEAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL< 21 Yrs 47,994 96,201 22,222 166,41722-45 Yrs 29,646 57,266 15,129 102,04146-64 Yrs 13,976 28,069 6,231 48,276Over 64 Yrs 269 476 93 838

TOTAL 91,885 182,012 43,675 317,572

TANF/HB/MAGI (Ages 21+)

11%

TANF/HB/MAGI (Ages 1-20)

39%

Under Age 13%

Disabled/BC&C14%

Newly Eligible (45+)10%

Newly Eligible (19-44)

22%

Source: Bureau of Fiscal Management

AID CATEGORY DISTRIBUTION

Southeast Southwest

Lehigh/Capital

1st Quarter 2019

35

HealthChoices Enrollment

NorthwestNortheast

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


11%


40%

Under Age 13%

Disabled/BC&C14%



23%


11%


37%

Under Age 13%

Disabled/BC&C17%



22%


11%


42%

Under Age 13%

Disabled/BC&C15%



20%


11%


39%

Under Age 13%

Disabled/BC&C18%



21%

Source: Maximus

March 2020

36

HealthChoices Enrollment

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

PCP SELECTION

March 2020

Zone Percentage

Southeast 92.8%

Southwest 94.0%

Lehigh/Capital 93.2%

Northwest 93.6%

Northeast 92.5%

Total 93.2%

Medical Assistance Transportation Program

Based on Data Submittedby Each County

37

MATP

38

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%

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

40

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.

Northwest

MATP

41

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%

Northeast

MATP

42

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%

Useful Information

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

43

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

Documents

BMCO Monthly Physical Health Managed Care Program … · 2020. 5. 13. · BMCO. Monthly Physical Health Managed Care Program Enrollment Report. NOTE: This report contains the number