DATA BOOK FOR BEHAVIORAL HEALTH: MAINSTREAM PLANS AND

DATA BOOK FOR BEHAVIORAL HEALTH: MAINSTREAM PLANS AND HEALTH AND RECOVERY PLANS (HARPS) STATE OF NEW YORK DRAFT DECEMBER 5, 2013

DATA BOOK FOR BEHAVIORAL HEALTH CARVE-IN ANDHEALTH AND RECOVERY PLANS (HARPS)

STATE OF NEW YORK

MERCER i

CONTENTS

1. Introduction ............................................................................................................... 1• Overview ............................................................................................................. 1• Purpose of this Data Book ................................................................................... 2• Contents of this Data Book .................................................................................. 2• Caveats ............................................................................................................... 3

2. Covered Services ...................................................................................................... 4• BH FFS and Encounter Data ............................................................................... 4• Acute Care FFS and Encounter Data .................................................................. 7• Excluded Services ............................................................................................... 9

3. Covered Populations ............................................................................................... 10• Premium Group ................................................................................................. 10• HARP Eligibility Requirements........................................................................... 10• FFS Eligibility..................................................................................................... 11

4. Adjustment Considerations for Capitation Rate Range Development ...................... 13• Adjustments to the Base Data ........................................................................... 13• Consideration for Additional Base Data ............................................................. 14• Adjustments for the Premium Calculation .......................................................... 14

5. HARP Data Book Pages ......................................................................................... 16• Report Descriptions ........................................................................................... 16

6. BH Carve-In (Non-HARP) Data Book Pages ........................................................... 37• Report Descriptions ........................................................................................... 37

Appendix A: Risk Factors ............................................................................................ 68


STATE OF NEW YORK

MERCER 1

1IntroductionOverviewThe State of New York (State) Department of Health (DOH) has contracted with MercerGovernment Human Services Consulting (Mercer) to provide rate and program support on theBehavioral Health (BH) benefits that will become the responsibility of the Medicaid ManagedCare (MMC) program.

Currently, the State’s managed care programs cover some BH benefits. However, the Office ofMental Health (OMH) and the Office of Alcoholism and Substance Abuse Services (OASAS)currently provide BH services outside of the managed care programs through a variety ofcommunity programs. The State, along with the Medicaid Redesign Team BH Work Group, isworking to redesign the BH system and bring about a reallocation of resources. Part of theobjective of this redesign is to provide for more effective care coordination by bringing most ofthese BH benefits, currently operating in a largely unmanaged fee-for-service (FFS) system intothe managed care program.

The State is taking a multi-pronged approach to the incorporation of BH services in managedcare. This approach is as follows:

• MMC health plans: For all Adults served in MMC health plans throughout the State, thequalified plan will integrate all Medicaid State Plan covered services for Mental Illness,Substance Use Disorders (SUDs) and Physical Health conditions. Plans must meet thecriteria contained in the request for qualification (RFQ) to qualify to administer the BHbenefit.

• HARPs: For Adult populations meeting the serious mental illness (SMI) and SUD targetingcriteria and risk factors, the State will enroll individuals in specialty lines of business withinthe qualified MMC health plans statewide. These specialty lines of business will be calledHARPs. Within the HARPs, an enhanced benefit package in addition to the State Planservices will be offered for enrolled individuals who meet both targeting and needs-basedcriteria for functional limitations. The needs-based criteria are in addition to any targeting andrisk factors required for HARP eligibility. The enhanced benefit package will help maintainparticipants in home- and community-based settings. These enhanced benefit packages willbe provided by the qualified full-benefit HARPs.

• HARPs will have an integrated premium established for this BH population. They will havespecialized staffing requirements and qualifications along with focused BH performancemetrics and incentives to achieve health, wellness, recovery and community inclusion for thispopulation.


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Purpose of this Data BookThe intent of this Data Book is to provide interested parties with historical cost and utilizationdata on BH and non-BH services from both the experience of the MMC program, as well as theState’s FFS program for the HARP population. This Data Book also provides historical cost andutilization data on BH services from the MMC program experience and FFS program forpopulations enrolled in the MMC plans who are not identified in the HARP population. NewYork’s DOH, in conjunction with OMH and OASAS provided consultation to Mercer on thecovered services and covered population criteria for the Data Book. The data in this Data Bookwill be used in development of the integrated premium for the HARP premium group and the BHcomponent of the rates for MMC plans, once appropriate adjustments and additional data areconsidered, as outlined in Section 4 of this Data Book.

Contents of this Data BookThis Data Book contains demographic, cost and utilization data related to Adult (21 and over)BH, as well as non-BH services for HARP eligibles. Please note the following concerning thisData Book:

• The FFS and encounter cost and utilization information in this Data Book has beensummarized from information contained in the State’s Medicaid Management InformationSystems (MMIS)

• Contractors are cautioned that direct comparisons between this Data Book and the State’sFFS and encounter data cannot be made (Please refer to Sections 2 and 3 for coveredservices and populations)

This Data Book information has been summarized for the following year (based on date ofservice):

• Calendar Year (CY) 2011 paid through September 30, 2013

Although this Data Book only includes a single year of data, at least one additional year of costand utilization data will be considered in premium development, as further described in Section 4of this Data Book.

This Data Book contains information for nine regions in New York, which are consistent with thecurrent MMC rate regions. The counties comprising the rate regions are shown in Table 1 below.

Table 1: Region/County MappingRegion Counties

Central Cayuga, Chenango, Columbia, Cortland, Delaware, Greene, Madison, Onondaga,Otsego, Schoharie, Tompkins

Finger Lakes Allegany, Broome, Cattaraugus, Chautauqua, Chemung, Livingston, Ontario, Schuyler,Seneca, Steuben, Tioga, Wayne, Yates


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Region Counties

Long Island Nassau, SuffolkMid-Hudson Dutchess, Orange, Sullivan, UlsterNew York City New York CityNortheast Albany, Fulton, Montgomery, Rensselaer, Saratoga, Schenectady, Warren, WashingtonNorthern Metro Putnam, Rockland, WestchesterUtica-Adirondack Clinton, Essex, Franklin, Hamilton, Herkimer, Jefferson, Lewis, Oneida, Oswego, Saint

LawrenceWestern Erie, Genesee, Monroe, Niagara, Orleans, Wyoming

CaveatsThis document assumes the reader is familiar with the New York State Medicaid program,Medicaid eligibility rules and actuarial rating techniques. It is intended for the State, the Centersfor Medicare & Medicaid Services (CMS) and the plans and should not be relied upon by otherparties. Other readers should seek the advice of actuaries or other qualified professionalscompetent in the area of actuarial rate projections to understand the technical nature of thesedata. This document should only be reviewed in its entirety. The State and Mercer provide noguarantee, either written or implied, that this Data Book is 100% accurate or error-free.

This document is being provided for informational purposes only. The State and Mercerreserve the right to refine it as they see fit for release of the final RFQ.


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MERCER 4

2Covered ServicesThis Data Book includes summaries by service group (SG). For recipients in the non-HARPpremium groups, the BH premium will be calculated as a separate premium component withinthe MMC premium (BH benefits already covered by MMC will be accounted for in the BHpremium development). For recipients included in the HARP premium group, the HARPpremium will include both the BH benefits and the covered Acute Care services, representing anintegrated premium. The HARP premium will also include enhanced BH benefits for membersmeeting functional criteria, discussed later in this document.

Some BH services are currently provided in the MMC plans and are, therefore, included in theencounter data. Other services, however, are only provided through the State’s FFS system, forwhich claims data are available.

Based on discussions with the State, Mercer applied logic to summarize the BH portion of thebase data from the FFS claims data and managed care encounter data. The BH SGs wereidentified primarily using rate code, procedure code, provider specialty code, diagnosis relatedgroup (DRG) and/or invoice type fields, as shown below. Please note that the services describedbelow are limited to Medicaid-funded services. The State anticipates that some services thatwere not historically Medicaid funded will be added to the State Plan prior to the implementationof HARPs. In these cases, an adjustment will be made to the capitation rate ranges, described inSection 4.

The SGs listed in Section 5 are described in the following tables.

BH FFS and Encounter DataTable 2 shows the technical specifications of the SGs for the BH services that will be includedfor both the HARP premium group and the non-HARP premium groups.

Table 2: Behavioral Health Service Group LogicService Group Service Subgroup

Inpatient Psych – voluntarily or involuntarily admitted to ahospital or clinic to receive Psychiatric care.

GeneralIP 28


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Service Group Service SubgroupInpatient Drug & Alcohol (D&A) - Chemical dependenceinpatient rehabilitation services provide intensive managementof chemical dependence symptoms and medicalmanagement/monitoring of physical or mental complicationsfrom chemical dependence to clients who cannot be effectivelyserved as outpatients and who are not in need of medicaldetoxification or Acute Care.

Inpatient Rehab – HospitalInpatient Rehab – Freestanding

Intensive Psychiatric Rehabilitation Program (IPRT) – a timelimited rehabilitative program for adults and/or adolescentswhich focuses on building skills and developing communitysupports to assist individuals to attain a specific residential,learning, working or social goal(s).

IPRT

Emergency Room - Diagnostic and Treatment Center Services(Freestanding Clinic), Hospital-based emergency room services.

Emergency Room

Outpatient Psych – periodic visits to a Psychiatrist forconsultation in his or her office, or at a community-basedOutpatient clinic.

Prepaid Mental Health PlanGeneralClinicOP Psych PractitionerOP Psych ProviderIntegrated Services (OMH)

Outpatient D&A - assist individuals who suffer from chemicalabuse or dependence and their family members and/orsignificant others. Include outpatient rehabilitation serviceswhich are designed to serve individuals with more chronicconditions who have inadequate support systems, and eitherhave substantial deficits in functional skills or have health careneeds requiring attention or monitoring by health care staff.

OP Chemical DependenceRehab – HospitalOP Chemical DependenceRehab – FreestandingMethadone/LAAM/BuprenorphClinic – HospitalClinic – FreestandingIntegrated Services (OASAS)OP D&A (w/ any rate code)OP D&A (w/o rate codes)Medical VisitsProcedure Based


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MERCER 6

Service Group Service Subgroup

Detox – a medical regimen conducted under the supervision ofa physician to systematically reduce the amount of the addictivesubstance in a patient’s body, provide reasonable control ofactive withdrawal symptoms and/or avert life threateningmedical crisis related to the addictive substance.

Scatter Bed – DetoxMedically Supervised InpatientWithdrawalInpatient Hospital Detox(Medically Managed InpatientWithdrawal)Medically Supervised OutpatientWithdrawal

Assertive Community Treatment (ACT) – an evidence-basedpractice model designed to provide treatment, rehabilitation andsupport services to individuals who are diagnosed with an SMIand whose needs have not been well met by more traditionalMH services.

ACT

Personalized Recovery Oriented Services (PROS) – acomprehensive recovery oriented program for individuals withsevere and persistent mental illness. The goal of the program isto integrate treatment, support, and rehabilitation in a mannerthat facilitates the individual's recovery. Goals for individuals inthe program are to: improve functioning, reduce Inpatientutilization, reduce emergency services, reduce contact with thecriminal justice system, increase employment, attain higherlevels of education, and secure preferred housing. There arefour components in the PROS program: CommunityRehabilitation and Support; Intensive Rehabilitation; OngoingRehabilitation and Support; and Clinical Treatment, an optionalcomponent of a PROS program.

PROS

Continuing Day Treatment (CDT) – a program which providesseriously mentally ill adults with the skills and supportsnecessary to remain in the community and or work toward amore independent level of functioning. Participants often attendseveral days per week with visits lasting more than an hour.

CDT

Partial Hospitalization – a program for adults or adolescentswhich provides active treatment designed to stabilize orameliorate acute symptoms in a person who would otherwiseneed hospitalization.

Partial Hospitalization

Comprehensive Psychiatric Emergency Program (CPEP) – ahospital based program which offers/provides access to crisisoutreach, intervention, and residential services; and/or providesbeds for the extended observation (up to 72 hours) to adultswho need emergency MH services.

General


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Service Group Service Subgroup

Targeted Case Management (TCM) – provides directassistance to adult and children consumers of the BH system,including problem resolution, advocacy and referral to otherappropriate services.

Intensive Case MgmtSupportive Case MgmtBlended Case Mgmt

Health Home – a care management service model whereby allof an individual's caregivers communicate with one another sothat all of a patient's needs are addressed in a comprehensivemanner. This is done primarily through a "care manager" whooversees and provides access to all of the services an individualneeds to assure that they receive everything necessary to stayhealthy, out of the emergency room and out of the hospital.

OMHDOHOASAS

Assessment – an evidence-based approach to identifyingpatients who use alcohol and other drugs at risky levels with thegoal of early intervention before more severe consequencesoccur, reducing and preventing related health consequences,disease, accidents and injuries.

Screening, Brief Intervention andReferral to Treatment (SBIRT)

To accommodate situations in which service subgroups overlapped based on the BH logic inTable 2, a hierarchy was used to determine the final BH SGs for purposes of this Data Book.This hierarchy is outlined in Table 3 below.

Table 3: Behavioral Health Service HierarchyOrder Description

1 Service Subgroups for specific services defined based on rate code only: IPRT, PROS, ACT,CDT, Partial Hospitalization, CPEP, TCM, Health Home

2 All Detox subgroups3 Inpatient D&A Subgroups4 Inpatient Psych Subgroups5 Emergency Room6 Outpatient Psych and Outpatient D&A Subgroups (excluding Procedure Based Outpatient D&A)7 SBIRT8 Procedure Based Subgroup

Acute Care FFS and Encounter DataThe premium for HARP enrollees will also include Acute Care benefits. The Acute Caregroupings are generally consistent with the service groupings used in the Medicaid ManagedCare Operating Reports (MMCORs) submitted quarterly by the MMC plans. The data wassummarized to align as closely with the MMCOR SGs as possible. For any claims that do notmeet the BH service criteria, the service logic in Table 4 is used to assign the Acute Care SGsfor all of the HARP services that will be included in the HARP benefit package.


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Table 4: Acute Care Service LogicService Group

Nursing Facility - room and board and ancillary services while confined to a rehabilitativenursing facility.Ambulatory Surgery - medically necessary visits to an ambulatory surgery center or outpatienthospital facility.Inpatient Acute - room and board and ancillary services while confined to an Acute Carehospital.Clinic – a program for adults, adolescents, and/or children which provides an array of treatmentservices for assessment and/or symptom reduction or management. Services include, but arenot limited to, individual and group therapies. The purpose of such services is to enhance theperson's continuing functioning in the community. The intensity of services and number/durationof visits may vary.Emergency Room - Diagnostic and Treatment Center Services (Freestanding Clinic), Hospital-based emergency room services.Primary Care - Includes care provided by primary care physicians. Primary care providersinclude pediatricians, internists, OB/GYN, family practitioners, general practitioners, physicianextenders (PA, NP, CNW, etc.), and nurses who are acting as independent practitioners.Physician Specialist - includes other physician services not listed under Primary Care.Test Lab X-Ray – lab and x-ray services.Pharmacy – prescription drugs.Dental – services provided by a dentist.Other Outpatient – other services provided in an outpatient setting not included above.


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Excluded ServicesTable 5 below describes the claims-based exclusions from the BH service package and theAcute Care service package.

Table 5: Exclusions from the HARP Service PackageExclusion

Community Residence RehabilitationFFS Services provided to individuals ages 22-64 in an Institution for Mental DiseaseResidential Rehabilitation Services for YouthMaternity servicesAll services, such as blood factor products, that are specifically excluded from the MMC benefitpackageGraduate Medical Education (GME) payments will continue to be made directly to providers;therefore, claims associated with managed care encounters for GME payments were excludedfrom the dataWraparound payments will continue to be made to Federally Qualified Health Centers (FQHC)and Rural Health Clinics (RHC) outside of the capitation rate; as a result, the wraparoundpayments associated with managed care encounters for FQHCs and RHCs were excluded fromthe data


STATE OF NEW YORK

MERCER 10

3Covered PopulationsThis Data Book is summarized according to the premium groups listed below. The premiumgroups are primarily based on premium group (PG) or recipient aid category (RA) code detailand represent the premium groups in place during the historical data period. These separatecategories have been established to account for differential service utilization and per membercosts across the Medicaid population covered under the contract. This facilitates the capitationpayment structure which differentiates the payment based on the premium group and in somecases, age of the Medicaid eligible. The HARP experience has been analyzed separately toaccount for differential service utilization and per member costs for HARP eligibles as comparedto the rest of the Medicaid population covered under the contract. This experience representsindividuals who could be enrolled in a HARP upon implementation. For individuals enrolled in aHARP, NYS will establish appropriate premium group(s) and an integrated capitation paymentwill be determined for each premium group. For non-HARP individuals, the premium groups willbe aligned with those in place during the contract rate period.

Premium Group• BH Carve-In (Non-HARP) includes:

Temporary Assistance to Needy Families (TANF)/Safety Net (SN) adults age 21 yearsand older

Supplemental Security Income (SSI) Family Health Plus (FHPlus)

• HARP includes: Adult populations ages 21 years and older meeting the SMI and SUD targeting and

functional criteria

HARP Eligibility RequirementsMedicaid beneficiaries who are eligible for MMC health plans may also be eligible for enrollmentin HARPs. Individuals must meet the targeting criteria below and risk factors outlined by theState and included in Appendix A. The State has chosen to define HARP targeting criteria as:

• Medicaid enrolled individuals over 20 years of age (21 and over)• SMI/SUD diagnoses• Eligible to be enrolled in MMC health plans• Not Medicaid/Medicare enrolled ("duals")• Not participating or enrolled in a program with the Office for People with Developmental

Disabilities (OPWDD) (i.e., participating in an OPWDD program)


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MERCER 11

For purposes of this Data Book, the HARP-eligible population was determined based on arecipient’s HARP status as of the end of CY 2011. It is anticipated that for implementation of theHARP program, individuals will be identified as potentially needing HARP services on the basisof historical service use or completion of a HARP eligibility screen. For implementation, HARPrecipients will be identified by a more recent period of utilization to be further described by theState. In order to develop an actuarially equivalent base data for this population, additional dataand additional HARP members will be reviewed as described in Section 4.

FFS EligibilityThis Data Book includes membership for populations that are currently eligible for managed careas well as FFS membership for some populations that have transitioned or will transition intomanaged care by January 2015. To determine which portions of historical FFS eligibility wouldhave been qualified for MMC coverage, Mercer used enrollment information provided by theState.

The State provided eligibility lists for the November 2010 – October 2011 and January 2012 –December 2012 time periods. Both lists include all Medicaid eligibles in New York. For eacheligible in the list, their last month of eligibility in that time period was used to provide a"snapshot" of their eligibility characteristics. Based on this information, the State created cohortswho have transitioned or will transition to managed care, although they may have been in FFSduring some or all of the base data period (CY 2011). The population cohorts with the followingenrollment statuses were included in this Data Book:

• Individuals who were enrolled in an MMC health plan, Family Health Plus (FHP) health plan,HIV Special Needs Plan (HIVSNP)

• Individuals who were enrolled in FFS, but enrolled in an MMC health plan, FHP health planor HIVSNP during the first five months following their last month of eligibility in the enrollmentsnapshot

• Individuals who were subject to mandatory enrollment in an MMC plan as of April 1, 2012,including Homeless (Non Duals), Chronic Illness Demonstration Project, End Stage RenalDisease (Non Duals), Low Birth Weight (Non Duals)

• Individuals who were subject to mandatory enrollment in an MMC plan as of September 1,2012, including Look Alikes (Non Duals)

• Individuals who were subject to mandatory enrollment in an MMC plan as of April 1, 2013,including Local Departments of Social Services Placed (Non-Per Diem) Foster Care (NonDuals), Working Disabled (Non Duals), Long Term Home Health Care Program (Non Duals)

• Individuals who will be subject to mandatory enrollment in an MMC plan as of January 1,2015 in New York City (NYC) and July 1, 2015 in Rest of State (ROS) including the LongTerm LT Chemical Abuse Program (Non Duals)

Any individuals who were enrolled in FFS in the historical data and met one of the criteria listedabove, but were found to have a qualifying exclusion or exemption were removed from this DataBook.


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Additional populations that are excluded from this Data Book base data are as follows:

• Medicare Dual Eligibles• Medicaid enrolled individuals less than 21 years of age• Individuals enrolled in Managed Long Term Care plans• Some legal and illegal aliens• Excluded Medicaid Coverage Codes, including Presumptive Eligibility, Emergency Services

Only coverage, and coverage for only limited benefits• Excluded Medicaid Aid Category Codes, including recipients enrolled in specialty cancer

treatment programs• Excluded Principal Provider Codes, including skilled nursing facilities• Excluded Recipient Fiscal County Codes

97 OMH 98 OPWDD 99 Medicaid Buy-in

Additionally, Non-Dual Adults residing in State Operated Psych Centers or OMH County areexcluded from this Data Book.

Individuals that may be newly eligible through the Affordable Care Act have not been included inthis Data Book.


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MERCER 13

4Adjustment Considerations for Capitation Rate RangeDevelopmentThe premiums will include all services covered by the State’s current MMC contractors, as wellas the addition of certain Inpatient MH/SUD, Outpatient MH/SUD and community servicescurrently covered in FFS. Historical experience for Inpatient MH/SUD, Outpatient MH/SUD andcommunity services is reflected in the FFS data included in this Data Book. In addition to the CY2011 data included in this Data Book, Mercer will also review at least one additional year ofhistorical FFS and encounter cost and utilization information in developing integrated premiumsfor HARP eligibles and the BH component of the rates for non-HARP premium groups. Mercerwill develop actuarially sound rate ranges and certify that the final premiums are actuariallysound using the data presented in this Data Book.

Adjustments to the Base DataMercer reviewed the FFS and encounter data to ensure they were appropriate for thepopulations and services to be covered. The following expenditures have already been excludedfrom the data presented in this Data Book, so no further adjustments will be necessary:

• Recipients’ spend-down expenses• Third Party Liability recoveries• Co-payments, coinsurance and deductibles• Disproportionate Share Hospital payments

The following adjustments will be applied to the historical data in order to arrive at base data thatare complete and reflect the appropriate services and populations. These adjustments are notreflected in this Data Book:

• Development of estimates of claims that have been incurred, but not reported, as of thecut-off of claim payments for FFS and encounters

• Adjustments for completeness of reported encounters in relation to health plan financials• Removal of GME payments pertaining to FFS Inpatient claims• Removal of FQHC/RHC cost settlements from the FFS data pertaining to FFS claims• Adjustments to the FFS data to reflect recoupments for Comprehensive Outpatient Program

services/Community Support programs not reflected in MMIS data• Anomalies may exist in the data; therefore, all of the historical data are considered when

setting the rates. At least one additional year of data will be blended with the CY 2011 dataas part of premium development.


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Consideration for Additional Base DataIn addition to the CY 2011 data included in this Data Book, Mercer will also consider at least oneadditional year of data as part of premium development. This would be used to developpremiums for an actuarially equivalent population to the HARP eligibles to be enrolled uponimplementation. Including population refinements for the HARP population to more closelyrepresent the HARP enrollment criteria could result in upward or downward adjustments to theCY 2011 data displayed in this Data Book. Population refinements could include individualsidentified as HARP in the prior year and/or the subsequent year, whereas the data in this DataBook only includes costs for individuals identified as HARP in the current year. For the non-HARP premium groups, the population refinements for the HARP population will also have animpact on the BH component of the non-HARP premiums, as some experience categorized as“non-HARP” in this Data Book may be re-categorized as “HARP” when the population definitionis refined for purposes of premium development.

Adjustments for the Premium CalculationAfter the above adjustments are made, Mercer will consider additional adjustments to calculatethe capitation rate ranges. Mercer makes adjustments to the base data to project the historicalexperience into the contract period. These adjustments are required under 42 CFR §438.6(c)and reviewed by CMS in approving rates for Medicaid managed care programs.

Adjustments that may be made in order to develop actuarial sound rates, and which are notreflected in this Data Book, may include, but are not limited to:

• Adjustments for program changes occurring between the beginning of the base data periodand the end of the contract period.

As applicable, program change adjustments that have been applied in the developmentof MMC rates will be review and applied in the development of HARP rates. Theseadjustments may include:

Pricing acuity adjustments such as Inpatient pricing changes and “PrescriberPrevails”.

Benefit limits imposed as a result of various Medicaid Redesign Team initiatives. New benefit adjustments such as Pharmacy and Personal Care.

Additional program change adjustments specific to BH services will also be considered inthe development of the HARP rates and the BH component of the non-HARP ratesincluding the addition of benefits, such as Rehabilitation services for residential SUDtreatment supports provided to Medicaid-eligible Adults, which were historically State-funded, but are added to the State Plan prior to the implementation of the HARP and BHCarve-In.

Additional program change adjustments due to the Affordable Care Act, including, butnot limited to, changes to the FHPlus premium group, will be considered in thedevelopment of the HARP rates and the BH component of the non-HARP rates.


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Adjustments to reflect the estimated cost of 1915(i)-like services for HARP eligiblesmeeting functional assessment criteria as proposed in the State’s 1115 waiveramendment. Until actual plan experience is available, HARP rates will be developedbased on estimates of 1915(i)-like service utilization. Mercer will also consider potentialState Plan service offsets that may result from utilization of the enhanced benefits

Adjustments for any material new program changes that arise prior to the implementationof these rates, as necessary.

• Adjustments for utilization and unit cost trend between the base period and the contractperiod. Trends may be developed in light of the following sources as deemed appropriate:

Historical FFS and encounter data trends Consumer Price Index data Prevailing trends in other Medicaid managed care programs regionally and nationally

• Differences in expected costs associated with the FFS and managed care delivery channelsand/or expectations around managed care efficiencies. These may include, but are notlimited to:

Adjustments to the utilization rates for certain services based on expected changes inusage patterns that occur when benefits are provided in a managed care environment asopposed to FFS. For example, under managed care, Inpatient utilization typicallydecreases while certain Outpatient services may increase.

Adjustments to the unit costs for certain services based on the anticipated changes inutilization patterns.

In developing such adjustments, Mercer will review the experience of other Medicaid BHmanaged care programs. Consideration will also be given to the influence of proposedrequirements that HARPs contract with all OMH and OASAS licensed or certifiedproviders that currently serve five or more of their members in the course of developingthese types of adjustments.

• Rates will also include provisions for appropriate non-medical expenses. This includes costsassociated with:

Administrative functions such as claims processing, utilization management, andprovider network development and maintenance.

Contractually required care management activities including enrollee assessments andthe development and maintenance of appropriate care plans for HARP enrollees.

Underwriting gain, also known as the cost of capital. As allowed by CMS regulations, amounts associated with applicable taxes to be

considered.


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5HARP Data Book PagesReport DescriptionsClaim cost and utilization reports summarized by region for the HARP premium group appear inthis section of this Data Book.

At the top of each page, the region, category of aid and age group description are included tohelp the user identify each premium group. Below this information, the member months (MMs)associated with each population (managed care or FFS-only) are displayed. The cost andutilization is further split between managed care and FFS and then shown for the totalpopulation.

Each summary contains the following columns of information:

• Service Group: As described in Section 2, each of the covered services is listed• Dollars: Total expenditures for each service• Utilization Per 1,000: Annual utilization for each service, divided by total MMs and

multiplied by 12,000• Unit Cost: Average cost of each service line item; dollars divided by the utilization of

services delivered• Per Member Per Month (PMPM): PMPM costs based on the historical encounter and FFS

experience; dollars divided by total MMs

State of New York Behavioral Health Carve-In/HARP Data BookCentral HARP BH

Draft & Confidential

Region: CENTRALPremium Group: HARPAge Group: Age 21+

Managed Care (MC) Member MonthsServices reported in Fee for Service (FFS) and MC data for MC enrollees

BH Service Group Dollars Util/1,000 Unit Cost PMPM

IP Psych - FFS 3,105,812$ 1,327 712.51$ 78.77$

IP Psych - ENC 3,192,196$ 920 1,056.32$ 80.96$

IP D&A - FFS 373,917$ 269 423.46$ 9.48$

IPRT - FFS 51,880$ 180 87.49$ 1.32$

ER-BH - FFS 1,840$ 11 52.58$ 0.05$

ER-BH - ENC 382,640$ 701 166.15$ 9.70$

OP Psych - FFS 5,775,356$ 7,476 235.12$ 146.48$

OP Psych - ENC 703,050$ 3,243 65.98$ 17.83$

OP D&A - FFS 2,107,315$ 8,530 75.19$ 53.45$

OP D&A - ENC 425,055$ 124 1,046.93$ 10.78$

Detox - FFS 116,587$ 52 677.83$ 2.96$

Detox - ENC 942,147$ 663 432.77$ 23.90$

ACT - FFS 457,866$ 981 142.11$ 11.61$

PROS - FFS 167,390$ 119 429.21$ 4.25$

CDT - FFS 831,888$ 3,144 80.54$ 21.10$

Partial Hospitalization - FFS 2,421$ 4 172.92$ 0.06$

CPEP - FFS 180,104$ 112 489.41$ 4.57$

TCM - FFS 1,272,151$ 835 463.95$ 32.27$

Health Home - FFS -$ 0 -$ -$

Assessment - FFS -$ 0 -$ -$

Assessment - ENC -$ 0 -$ -$

Managed Care BH Subtotal 20,089,615$ 28,688 509.53$

Fee for Service Member MonthsServices reported in Fee for Service (FFS) data for FFS-only enrollees


IP Psych - FFS 3,388,329$ 3,719 699.92$ 216.91$

IP D&A - FFS 1,754,684$ 2,766 487.41$ 112.33$

IPRT - FFS 59,280$ 333 136.59$ 3.79$

ER-BH - FFS 156,043$ 1,008 118.94$ 9.99$

OP Psych - FFS 1,850,747$ 7,865 180.77$ 118.48$

OP D&A - FFS 1,560,727$ 11,215 106.91$ 99.91$

Detox - FFS 851,802$ 764 856.94$ 54.53$

ACT - FFS 80,621$ 406 152.40$ 5.16$

PROS - FFS 39,059$ 87 345.65$ 2.50$

CDT - FFS 196,081$ 1,758 85.70$ 12.55$


CPEP - FFS 123,778$ 199 477.91$ 7.92$

TCM - FFS 359,394$ 562 490.98$ 23.01$



FFS BH Subtotal 10,423,022$ 30,696 667.24$

Member MonthsTotal


Inpatient Psych 9,686,337$ 2,664 792.53$ 175.96$

Inpatient D&A 2,128,601$ 977 474.82$ 38.67$

IPRT 111,160$ 224 108.24$ 2.02$

Emergency Room 540,523$ 796 148.09$ 9.82$

Outpatient Psych 8,329,152$ 9,909 183.23$ 151.30$

Outpatient D&A 4,093,097$ 9,380 95.12$ 74.35$

Detox 1,910,536$ 729 571.50$ 34.71$

ACT 538,487$ 818 143.56$ 9.78$

PROS 206,449$ 110 410.43$ 3.75$

CDT 1,027,969$ 2,750 81.47$ 18.67$

Partial Hospitalization 4,897$ 7 144.04$ 0.09$

CPEP 303,882$ 137 484.66$ 5.52$

TCM 1,631,545$ 757 469.64$ 29.64$

Health Home -$ 0 -$ -$

Assessment -$ 0 -$ -$

MC and FFS BH Total 30,512,636$ 29,258 554.28$

55,049

CY 2011

39,428

CY 2011

CY 201115,621

Mercer Government Human Services Consulting 17 12/5/2013

State of New York Behavioral Health Carve-In/HARP Data BookCentral HARP Acute


Region: CENTRALPremium Group: HARPAge Group: Age 21+


Acute Care Service Group Dollars Util/1,000 Unit Cost PMPM

Nursing Facility - FFS 273$ 0 272.70$ 0.01$

Nursing Facility - ENC 1,741,852$ 2,340 226.57$ 44.18$

Inpatient Acute - FFS 22,816$ 71 97.51$ 0.58$

Inpatient Acute - ENC 9,611,170$ 2,134 1,370.67$ 243.77$

Ambulatory Surgery - FFS 6,046$ 1 1,511.38$ 0.15$

Ambulatory Surgery - ENC 1,055,070$ 982 327.15$ 26.76$

Clinic - FFS 46,765$ 95 150.37$ 1.19$

Clinic - ENC 492,055$ 1,837 81.52$ 12.48$

Emergency Room - FFS -$ - -$ -$

Emergency Room - ENC 193,256$ 13 4,494.33$ 4.90$

Other Outpatient - FFS 1,381,006$ 4,557 92.24$ 35.03$

Other Outpatient - ENC 3,262,466$ 9,703 102.33$ 82.74$

Physician Specialist - FFS 52$ 1 25.79$ 0.00$

Physician Specialist - ENC 2,683,528$ 7,110 114.88$ 68.06$

Primary Care - FFS 288$ 2 36.02$ 0.01$

Primary Care - ENC 2,422,054$ 6,426 114.71$ 61.43$

Pharmacy - FFS 11,295,897$ 37,690 91.22$ 286.49$

Pharmacy - ENC 4,139,554$ 14,374 87.65$ 104.99$

Tests, Lab and X-rays - FFS 5,993$ 15 122.30$ 0.15$

Tests, Lab and X-rays - ENC 2,062,549$ 18,653 33.65$ 52.31$

Dental - FFS 632,974$ 2,755 69.93$ 16.05$

Dental - ENC 175,174$ 605 88.16$ 4.44$

Managed Care Acute Care Subtotal 41,230,836$ 109,363 1,045.72$



Nursing Facility - FFS 676,656$ 2,335 222.58$ 43.32$

Inpatient Acute - FFS 4,911,879$ 2,335 1,615.75$ 314.44$

Ambulatory Surgery - FFS 334,199$ 741 346.32$ 21.39$

Clinic - FFS 266,700$ 1,560 131.31$ 17.07$

Emergency Room - FFS 53,539$ 124 332.54$ 3.43$


Physician Specialist - FFS 286,097$ 3,771 58.28$ 18.31$

Primary Care - FFS 210,339$ 3,673 43.99$ 13.47$

Pharmacy - FFS 5,866,675$ 46,845 96.20$ 375.56$

Tests, Lab and X-rays - FFS 280,682$ 11,902 18.12$ 17.97$

Dental - FFS 267,514$ 3,153 65.17$ 17.13$

FFS Acute Care Subtotal 15,762,993$ 93,453 $1,009.09

Member Months

Total


Nursing Facility 2,418,781$ 2,339 225.44$ 43.94$

Inpatient Acute 14,545,865$ 2,242 1,414.14$ 264.23$

Ambulatory Surgery 1,395,315$ 914 332.69$ 25.35$

Clinic 805,520$ 1,826 96.15$ 14.63$

Emergency Room 246,795$ 44 1,209.78$ 4.48$

Other Outpatient 7,252,186$ 15,041 105.11$ 131.74$

Physician Specialist 2,969,676$ 6,163 105.04$ 53.95$

Primary Care 2,632,681$ 5,647 101.64$ 47.82$

Pharmacy 21,302,125$ 50,583 91.80$ 386.97$

Tests, Lab and X-rays 2,349,224$ 16,748 30.58$ 42.68$

Dental 1,075,662$ 3,301 71.03$ 19.54$

MC and FFS Acute Care Total 56,993,829$ 104,848 1,035.33$

MC and FFS All Services Total 87,506,465$ 134,106 1,589.61$

CY 2011

55,049

CY 2011

15,621

39,428

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookFinger Lakes HARP BH


Region: FINGER LAKESPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 2,462,499$ 1,064 617.48$ 54.73$

IP Psych - ENC 2,163,482$ 636 907.50$ 48.09$

IP D&A - FFS 838,005$ 651 343.44$ 18.63$

IPRT - FFS 1,783$ 5 99.05$ 0.04$

ER-BH - FFS 33,924$ 90 100.07$ 0.75$

ER-BH - ENC 232,178$ 419 147.79$ 5.16$

OP Psych - FFS 5,127,273$ 7,444 183.72$ 113.96$

OP Psych - ENC 567,134$ 2,041 74.12$ 12.61$

OP D&A - FFS 1,173,949$ 4,214 74.30$ 26.09$

OP D&A - ENC 314,521$ 598 140.35$ 6.99$

Detox - FFS 289,366$ 113 685.70$ 6.43$

Detox - ENC 384,349$ 242 424.23$ 8.54$

ACT - FFS 763,716$ 1,163 175.16$ 16.97$

PROS - FFS 800,477$ 604 353.72$ 17.79$

CDT - FFS 195,184$ 799 65.17$ 4.34$


CPEP - FFS 2,960$ 2 493.41$ 0.07$

TCM - FFS 1,315,837$ 771 454.99$ 29.25$



Assessment - ENC 3,569$ 9 104.96$ 0.08$




IP Psych - FFS 3,451,881$ 3,483 635.94$ 184.56$

IP D&A - FFS 2,291,858$ 3,816 385.38$ 122.54$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 166,328$ 1,018 104.81$ 8.89$

OP Psych - FFS 2,313,547$ 8,974 165.42$ 123.70$

OP D&A - FFS 997,043$ 8,469 75.53$ 53.31$

Detox - FFS 887,711$ 640 890.38$ 47.46$

ACT - FFS 254,657$ 1,061 153.96$ 13.62$

PROS - FFS 159,295$ 303 336.78$ 8.52$

CDT - FFS 322,240$ 2,932 70.51$ 17.23$


CPEP - FFS 72,837$ 103 455.23$ 3.89$

TCM - FFS 443,639$ 579 491.29$ 23.72$



FFS BH Subtotal 11,367,278$ 31,406 607.78$

Member MonthsTotal


Inpatient Psych 8,077,863$ 2,223 684.56$ 126.82$

Inpatient D&A 3,129,862$ 1,580 373.18$ 49.14$

IPRT 1,783$ 3 99.05$ 0.03$

Emergency Room 432,429$ 659 123.66$ 6.79$


Outpatient D&A 2,485,512$ 5,886 79.56$ 39.02$

Detox 1,561,426$ 438 671.58$ 24.51$

ACT 1,018,373$ 1,133 169.33$ 15.99$

PROS 959,772$ 515 350.79$ 15.07$

CDT 517,424$ 1,425 68.40$ 8.12$


CPEP 75,797$ 31 456.61$ 1.19$

TCM 1,759,476$ 715 463.63$ 27.62$


Assessment 3,569$ 6 104.96$ 0.06$


CY 2011

44,991

CY 201118,703

CY 201163,694


State of New York Behavioral Health Carve-In/HARP Data BookFinger Lakes HARP Acute


Region: FINGER LAKESPremium Group: HARPAge Group: Age 21+



Nursing Facility - FFS 231,654$ 271 228.01$ 5.15$


Inpatient Acute - FFS 1,052,383$ 159 1,768.71$ 23.39$



Ambulatory Surgery - ENC 1,658,805$ 1,676 264.01$ 36.87$

Clinic - FFS 24,512$ 43 150.38$ 0.54$

Clinic - ENC 123,557$ 1,228 26.84$ 2.75$





Physician Specialist - FFS 84,697$ 397 56.88$ 1.88$


Primary Care - FFS 43,220$ 262 44.06$ 0.96$

Primary Care - ENC 2,258,795$ 6,519 92.41$ 50.21$

Pharmacy - FFS 14,105,735$ 42,172 89.21$ 313.52$

Pharmacy - ENC 4,117,886$ 12,843 85.52$ 91.53$



Dental - FFS 723,153$ 2,360 81.74$ 16.07$

Dental - ENC 50,035$ 172 77.57$ 1.11$

Managed Care Acute Care Subtotal 43,334,504$ 104,136 963.18$






Clinic - FFS 131,623$ 614 137.54$ 7.04$




Primary Care - FFS 343,522$ 4,522 48.74$ 18.37$

Pharmacy - FFS 7,494,574$ 49,097 97.94$ 400.72$


Dental - FFS 309,133$ 2,727 72.72$ 16.53$

FFS Acute Care Subtotal 17,617,660$ 93,052 $941.97

Member Months

Total



Inpatient Acute 13,341,557$ 1,708 1,471.93$ 209.46$

Ambulatory Surgery 2,247,465$ 1,471 287.84$ 35.29$

Clinic 279,692$ 1,078 48.87$ 4.39$

Emergency Room 149,866$ 51 553.01$ 2.35$



Primary Care 2,645,537$ 6,118 81.47$ 41.54$

Pharmacy 25,718,195$ 53,277 90.95$ 403.78$


Dental 1,082,320$ 2,589 78.75$ 16.99$

MC and FFS Acute Care Total 60,952,165$ 100,881 956.95$


CY 2011

63,694

CY 2011

18,703

44,991

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookLong Island HARP BH


Region: LONG ISLANDPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 12,060,047$ 3,239 674.95$ 182.21$

IP Psych - ENC 8,363,731$ 1,694 894.90$ 126.36$

IP D&A - FFS 1,440,445$ 484 539.29$ 21.76$

IPRT - FFS 24,715$ 43 104.28$ 0.37$

ER-BH - FFS 7,543$ 28 48.98$ 0.11$

ER-BH - ENC 831,394$ 1,056 142.68$ 12.56$

OP Psych - FFS 11,017,559$ 9,229 216.43$ 166.46$

OP Psych - ENC 1,104,995$ 2,626 76.29$ 16.69$

OP D&A - FFS 4,031,230$ 8,926 81.88$ 60.90$

OP D&A - ENC 1,759,079$ 155 2,055.00$ 26.58$

Detox - FFS 159,106$ 34 846.31$ 2.40$

Detox - ENC 2,660,597$ 963 501.15$ 40.20$

ACT - FFS 2,304,721$ 2,038 204.99$ 34.82$

PROS - FFS 3,262,832$ 1,297 455.96$ 49.30$

CDT - FFS 247,364$ 609 73.69$ 3.74$


CPEP - FFS 3,447$ 1 492.37$ 0.05$

TCM - FFS 4,224,666$ 1,608 476.45$ 63.83$



Assessment - ENC 331$ 2 36.78$ 0.01$




IP Psych - FFS 11,063,150$ 12,475 517.62$ 538.09$

IP D&A - FFS 6,619,861$ 7,369 524.30$ 321.98$

IPRT - FFS 882$ 5 110.25$ 0.04$

ER-BH - FFS 432,126$ 1,830 137.84$ 21.02$

OP Psych - FFS 2,448,834$ 6,301 226.83$ 119.11$

OP D&A - FFS 3,900,170$ 16,013 142.16$ 189.70$

Detox - FFS 3,720,179$ 2,561 847.81$ 180.94$

ACT - FFS 467,405$ 1,325 205.81$ 22.73$

PROS - FFS 1,122,415$ 1,513 433.03$ 54.59$

CDT - FFS 75,118$ 653 67.13$ 3.65$


CPEP - FFS 18,255$ 27 388.40$ 0.89$

TCM - FFS 1,009,970$ 1,163 506.76$ 49.12$



FFS BH Subtotal 30,959,240$ 51,591 1,505.80$

Member MonthsTotal


Inpatient Psych 31,486,928$ 6,721 648.05$ 362.97$

Inpatient D&A 8,060,307$ 2,116 526.92$ 92.92$

IPRT 25,597$ 34 104.48$ 0.30$

Emergency Room 1,271,062$ 1,261 139.43$ 14.65$


Outpatient D&A 9,690,479$ 10,724 125.00$ 111.71$

Detox 6,539,882$ 1,367 661.60$ 75.39$

ACT 2,772,126$ 1,869 205.13$ 31.96$

PROS 4,385,247$ 1,348 449.86$ 50.55$

CDT 322,482$ 619 72.05$ 3.72$


CPEP 21,701$ 7 401.88$ 0.25$

TCM 5,234,636$ 1,502 482.01$ 60.34$


Assessment 331$ 1 36.78$ 0.00$


86,749

CY 2011

66,189

CY 2011

CY 201120,560


State of New York Behavioral Health Carve-In/HARP Data BookLong Island HARP Acute


Region: LONG ISLANDPremium Group: HARPAge Group: Age 21+



Nursing Facility - FFS -$ - -$ -$


Inpatient Acute - FFS -$ - -$ -$




Clinic - FFS 50,865$ 50 183.63$ 0.77$

Clinic - ENC 1,703,847$ 811 380.83$ 25.74$







Primary Care - FFS 634$ 2 48.79$ 0.01$

Primary Care - ENC 2,870,760$ 6,992 74.44$ 43.37$

Pharmacy - FFS 20,414,422$ 34,836 106.24$ 308.43$

Pharmacy - ENC 6,687,779$ 12,466 97.26$ 101.04$



Dental - FFS 2,285$ 2 207.71$ 0.03$

Dental - ENC 1,088,147$ 8,444 23.36$ 16.44$







Clinic - FFS 614,017$ 2,519 142.27$ 29.86$




Primary Care - FFS 252,210$ 3,022 48.72$ 12.27$

Pharmacy - FFS 7,319,919$ 35,372 120.78$ 356.03$


Dental - FFS 426,260$ 3,238 76.83$ 20.73$


Member Months

Total



Inpatient Acute 34,046,096$ 2,908 1,619.39$ 392.47$


Clinic 2,368,729$ 1,254 261.25$ 27.31$

Emergency Room 705,026$ 67 1,450.67$ 8.13$



Primary Care 3,123,604$ 6,052 71.39$ 36.01$

Pharmacy 34,422,121$ 44,475 107.06$ 396.80$


Dental 1,516,692$ 7,212 29.09$ 17.48$



CY 2011

86,749

CY 2011

20,560

66,189

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookMid-Hudson HARP BH


Region: MID-HUDSONPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 3,828,799$ 1,885 775.22$ 121.79$

IP Psych - ENC 1,914,761$ 478 1,530.58$ 60.91$

IP D&A - FFS 549,818$ 442 475.21$ 17.49$

IPRT - FFS 57,943$ 99 222.86$ 1.84$

ER-BH - FFS 307$ 3 43.92$ 0.01$

ER-BH - ENC 248,879$ 863 110.12$ 7.92$

OP Psych - FFS 5,178,457$ 8,819 224.14$ 164.72$

OP Psych - ENC 571,942$ 3,424 63.76$ 18.19$

OP D&A - FFS 2,110,104$ 10,026 80.34$ 67.12$

OP D&A - ENC 140,922$ 184 292.37$ 4.48$

Detox - FFS 12,214$ 7 678.54$ 0.39$

Detox - ENC 924,117$ 857 411.82$ 29.40$

ACT - FFS 174,796$ 390 170.87$ 5.56$

PROS - FFS 330,436$ 332 379.81$ 10.51$

CDT - FFS 543,508$ 2,811 73.81$ 17.29$


CPEP - FFS 581$ 1 290.39$ 0.02$

TCM - FFS 1,860,284$ 1,844 385.15$ 59.17$







IP Psych - FFS 4,111,131$ 6,632 695.98$ 384.65$

IP D&A - FFS 1,797,101$ 3,761 536.45$ 168.14$

IPRT - FFS 17,439$ 81 242.20$ 1.63$

ER-BH - FFS 198,375$ 1,717 129.74$ 18.56$

OP Psych - FFS 1,809,798$ 7,592 267.64$ 169.33$

OP D&A - FFS 1,639,522$ 20,800 88.50$ 153.40$

Detox - FFS 1,079,982$ 1,562 776.41$ 101.05$

ACT - FFS 267,982$ 1,802 166.97$ 25.07$

PROS - FFS 76,250$ 237 361.37$ 7.13$

CDT - FFS 311,703$ 4,903 71.38$ 29.16$


CPEP - FFS 2,709$ 9 338.69$ 0.25$

TCM - FFS 434,773$ 1,114 438.28$ 40.68$



FFS BH Subtotal 11,791,031$ 50,599 1,103.20$

Member MonthsTotal


Inpatient Psych 9,854,691$ 3,446 814.64$ 233.94$

Inpatient D&A 2,346,919$ 1,284 520.73$ 55.71$

IPRT 75,381$ 95 227.05$ 1.79$

Emergency Room 447,562$ 1,081 117.90$ 10.62$


Outpatient D&A 3,890,548$ 12,897 85.93$ 92.36$

Detox 2,016,312$ 1,041 551.96$ 47.86$

ACT 442,778$ 749 168.48$ 10.51$

PROS 406,686$ 308 376.21$ 9.65$

CDT 855,211$ 3,342 72.90$ 20.30$


CPEP 3,290$ 3 329.03$ 0.08$

TCM 2,295,057$ 1,658 394.20$ 54.48$




42,125

CY 2011

31,437

CY 2011

CY 201110,688


State of New York Behavioral Health Carve-In/HARP Data BookMid-Hudson HARP Acute


Region: MID-HUDSONPremium Group: HARPAge Group: Age 21+







Ambulatory Surgery - FFS -$ - -$ -$


Clinic - FFS 16,096$ 39 156.27$ 0.51$

Clinic - ENC 345,107$ 2,256 58.38$ 10.98$







Primary Care - FFS 3,344$ 5 278.69$ 0.11$

Primary Care - ENC 1,350,325$ 5,894 87.46$ 42.95$

Pharmacy - FFS 10,871,842$ 41,610 99.74$ 345.83$

Pharmacy - ENC 3,905,397$ 15,422 96.66$ 124.23$



Dental - FFS 57,861$ 315 70.05$ 1.84$

Dental - ENC 529,977$ 2,924 69.20$ 16.86$







Clinic - FFS 590,054$ 3,858 171.73$ 55.21$




Primary Care - FFS 103,204$ 2,336 49.59$ 9.66$

Pharmacy - FFS 4,277,541$ 45,345 105.91$ 400.22$


Dental - FFS 183,845$ 3,189 64.73$ 17.20$


Member Months

Total



Inpatient Acute 12,480,536$ 2,020 1,760.05$ 296.27$


Clinic 951,257$ 2,692 100.66$ 22.58$

Emergency Room 217,906$ 62 999.57$ 5.17$



Primary Care 1,456,873$ 4,995 83.09$ 34.58$

Pharmacy 19,054,780$ 54,067 100.40$ 452.34$


Dental 771,683$ 3,226 68.14$ 18.32$



CY 2011

42,125

CY 2011

10,688

31,437

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookNew York City HARP BH


Region: NEW YORK CITYPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 130,166,513$ 3,329 771.01$ 213.92$

IP Psych - ENC 53,334,180$ 745 1,411.52$ 87.65$

IP D&A - FFS 5,225,731$ 183 564.46$ 8.59$

IPRT - FFS 339,058$ 68 98.48$ 0.56$

ER-BH - FFS 24,260$ 14 33.46$ 0.04$

ER-BH - ENC 3,593,684$ 490 144.55$ 5.91$

OP Psych - FFS 108,241,734$ 12,956 164.76$ 177.88$

OP Psych - ENC 9,412,564$ 3,802 48.82$ 15.47$

OP D&A - FFS 43,335,666$ 7,751 110.26$ 71.22$

OP D&A - ENC 3,651,350$ 112 644.43$ 6.00$

Detox - FFS 540,085$ 11 994.63$ 0.89$

Detox - ENC 11,556,767$ 473 481.55$ 18.99$

ACT - FFS 15,581,819$ 949 323.81$ 25.61$

PROS - FFS 9,262,840$ 417 437.63$ 15.22$

CDT - FFS 11,142,114$ 2,857 76.92$ 18.31$

Partial Hospitalization - FFS 1,335,132$ 113 233.99$ 2.19$

CPEP - FFS 772,270$ 32 469.18$ 1.27$

TCM - FFS 18,828,513$ 679 546.69$ 30.94$


Assessment - FFS 41$ 0 41.00$ 0.00$

Assessment - ENC 27,826$ 9 60.49$ 0.05$




IP Psych - FFS 133,622,313$ 11,001 726.94$ 666.42$

IP D&A - FFS 22,848,606$ 2,344 583.30$ 113.95$

IPRT - FFS 42,781$ 25 101.14$ 0.21$

ER-BH - FFS 4,748,552$ 1,846 153.92$ 23.68$

OP Psych - FFS 21,864,301$ 8,613 151.92$ 109.04$

OP D&A - FFS 36,204,753$ 17,480 123.96$ 180.56$

Detox - FFS 65,482,397$ 4,502 870.56$ 326.58$

ACT - FFS 3,794,295$ 798 284.56$ 18.92$

PROS - FFS 1,243,255$ 190 391.70$ 6.20$

CDT - FFS 2,932,051$ 2,404 73.01$ 14.62$


CPEP - FFS 2,156,808$ 323 399.04$ 10.76$

TCM - FFS 4,147,845$ 428 580.04$ 20.69$


Assessment - FFS 18,610$ 6 177.24$ 0.09$

FFS BH Subtotal 299,520,058$ 50,079 1,493.80$

Member MonthsTotal


Inpatient Psych 317,123,005$ 5,791 812.25$ 391.99$

Inpatient D&A 28,074,337$ 718 579.70$ 34.70$

IPRT 381,838$ 57 98.77$ 0.47$

Emergency Room 8,366,496$ 837 148.24$ 10.34$


Outpatient D&A 83,191,769$ 10,246 120.44$ 102.83$

Detox 77,579,249$ 1,480 777.65$ 95.89$

ACT 19,376,114$ 912 315.29$ 23.95$

PROS 10,506,095$ 361 431.64$ 12.99$

CDT 14,074,165$ 2,744 76.07$ 17.40$

Partial Hospitalization 1,748,625$ 114 227.48$ 2.16$

CPEP 2,929,078$ 105 415.41$ 3.62$

TCM 22,976,358$ 617 552.42$ 28.40$


Assessment 46,477$ 8 82.11$ 0.06$


809,004

CY 2011

608,495

CY 2011

CY 2011200,509


State of New York Behavioral Health Carve-In/HARP Data BookNew York City HARP Acute


Region: NEW YORK CITYPremium Group: HARPAge Group: Age 21+





Inpatient Acute - FFS 335,024$ 35 186.54$ 0.55$




Clinic - FFS 3,054,026$ 322 187.21$ 5.02$

Clinic - ENC 7,854,886$ 2,112 73.35$ 12.91$


Emergency Room - ENC 2,936,776$ 12 4,935.76$ 4.83$





Primary Care - FFS 9,558$ 2 93.70$ 0.02$

Primary Care - ENC 29,296,246$ 6,315 91.48$ 48.15$

Pharmacy - FFS 276,253,501$ 49,779 109.44$ 453.99$

Pharmacy - ENC 91,356,890$ 17,004 105.95$ 150.14$



Dental - FFS 3,474,146$ 1,090 62.87$ 5.71$

Dental - ENC 5,773,851$ 3,669 31.04$ 9.49$




Nursing Facility - FFS 9,430,916$ 2,296 245.80$ 47.03$


Ambulatory Surgery - FFS 3,700,331$ 550 403.00$ 18.45$

Clinic - FFS 14,368,134$ 5,074 169.47$ 71.66$

Emergency Room - FFS 9,836,215$ 637 924.63$ 49.06$


Physician Specialist - FFS 3,850,516$ 4,594 50.16$ 19.20$

Primary Care - FFS 2,654,703$ 3,198 49.67$ 13.24$

Pharmacy - FFS 112,360,021$ 50,342 133.58$ 560.37$

Tests, Lab and X-rays - FFS 5,132,050$ 17,745 17.31$ 25.60$

Dental - FFS 5,434,168$ 5,174 62.86$ 27.10$


Member Months

Total



Inpatient Acute 366,867,840$ 2,892 1,881.37$ 453.48$


Clinic 25,277,046$ 3,088 121.42$ 31.24$

Emergency Room 12,824,107$ 168 1,130.67$ 15.85$



Primary Care 31,960,508$ 5,544 85.51$ 39.51$

Pharmacy 479,970,413$ 62,709 113.53$ 593.29$


Dental 14,682,164$ 4,861 44.80$ 18.15$

MC and FFS Acute Care Total 1,192,737,466$ 126,239 1,474.33$

MC and FFS All Services Total 1,918,629,671$ 164,968 2,371.59$

CY 2011

809,004

CY 2011

200,509

608,495

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookNortheast HARP BH


Region: NORTHEASTPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 3,514,966$ 1,513 709.38$ 89.41$

IP Psych - ENC 2,681,506$ 787 1,040.55$ 68.21$

IP D&A - FFS 206,030$ 252 250.04$ 5.24$

IPRT - FFS 76,739$ 248 94.39$ 1.95$

ER-BH - FFS 3,950$ 23 53.38$ 0.10$

ER-BH - ENC 392,324$ 1,036 115.59$ 9.98$

OP Psych - FFS 5,259,410$ 8,015 200.31$ 133.79$

OP Psych - ENC 484,158$ 2,335 63.31$ 12.32$

OP D&A - FFS 1,969,800$ 8,027 74.91$ 50.11$

OP D&A - ENC 278,199$ 139 610.08$ 7.08$

Detox - FFS 117,837$ 49 731.90$ 3.00$

Detox - ENC 319,274$ 290 336.43$ 8.12$

ACT - FFS 392,460$ 741 161.71$ 9.98$

PROS - FFS 395,619$ 320 377.14$ 10.06$

CDT - FFS 476,486$ 2,688 54.10$ 12.12$


CPEP - FFS 1,072$ 1 357.45$ 0.03$

TCM - FFS 989,673$ 549 550.43$ 25.17$







IP Psych - FFS 2,893,084$ 4,956 571.53$ 236.04$

IP D&A - FFS 470,945$ 1,457 316.50$ 38.42$

IPRT - FFS 26,006$ 258 98.51$ 2.12$

ER-BH - FFS 201,874$ 1,739 113.67$ 16.47$

OP Psych - FFS 1,652,821$ 8,379 193.13$ 134.85$

OP D&A - FFS 1,343,671$ 15,086 87.20$ 109.62$

Detox - FFS 966,717$ 1,614 586.24$ 78.87$

ACT - FFS 99,007$ 615 157.65$ 8.08$

PROS - FFS 34,057$ 82 405.44$ 2.78$

CDT - FFS 161,264$ 2,715 58.16$ 13.16$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 337,756$ 544 607.47$ 27.56$



FFS BH Subtotal 8,191,300$ 37,475 668.30$

Member MonthsTotal


Inpatient Psych 9,089,556$ 2,931 721.74$ 176.26$

Inpatient D&A 676,974$ 538 292.81$ 13.13$

IPRT 102,745$ 251 95.40$ 1.99$

Emergency Room 598,148$ 1,220 114.06$ 11.60$


Outpatient D&A 3,591,670$ 9,811 85.19$ 69.65$

Detox 1,403,827$ 642 508.82$ 27.22$

ACT 491,467$ 711 160.87$ 9.53$

PROS 429,676$ 264 379.24$ 8.33$

CDT 637,750$ 2,695 55.07$ 12.37$


CPEP 1,072$ 1 357.45$ 0.02$

TCM 1,327,429$ 548 563.90$ 25.74$




51,569

CY 2011

39,312

CY 2011

CY 201112,257


State of New York Behavioral Health Carve-In/HARP Data BookNortheast HARP Acute


Region: NORTHEASTPremium Group: HARPAge Group: Age 21+





Inpatient Acute - FFS 9,279$ 2 1,546.43$ 0.24$




Clinic - FFS 72,122$ 134 163.91$ 1.83$

Clinic - ENC 327,412$ 549 182.10$ 8.33$







Primary Care - FFS 943$ 3 94.29$ 0.02$

Primary Care - ENC 1,311,395$ 6,641 60.28$ 33.36$

Pharmacy - FFS 12,360,763$ 38,164 98.87$ 314.43$

Pharmacy - ENC 4,547,000$ 14,844 93.51$ 115.66$



Dental - FFS 607,805$ 2,389 77.65$ 15.46$

Dental - ENC 168,608$ 443 116.12$ 4.29$







Clinic - FFS 301,810$ 2,427 121.75$ 24.62$

Emergency Room - FFS 52,136$ 12 4,344.67$ 4.25$



Primary Care - FFS 149,458$ 3,276 44.67$ 12.19$

Pharmacy - FFS 5,599,867$ 49,687 110.34$ 456.87$


Dental - FFS 190,440$ 2,662 70.04$ 15.54$


Member Months

Total



Inpatient Acute 12,841,086$ 2,156 1,386.13$ 249.01$


Clinic 701,344$ 1,098 148.68$ 13.60$

Emergency Room 104,586$ 4 5,810.34$ 2.03$



Primary Care 1,461,796$ 5,843 58.21$ 28.35$

Pharmacy 22,507,630$ 52,218 100.30$ 436.46$


Dental 966,853$ 2,792 80.58$ 18.75$



CY 2011

51,569

CY 2011

12,257

39,312

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookNorthern Metro HARP BH


Region: NORTHERN METROPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 6,790,049$ 2,776 869.63$ 201.16$

IP Psych - ENC 3,901,604$ 760 1,824.03$ 115.59$

IP D&A - FFS 1,190,904$ 860 492.11$ 35.28$

IPRT - FFS 72,705$ 247 104.61$ 2.15$

ER-BH - FFS 1,569$ 14 39.23$ 0.05$

ER-BH - ENC 254,033$ 753 120.00$ 7.53$

OP Psych - FFS 8,755,448$ 10,942 284.48$ 259.39$

OP Psych - ENC 595,442$ 3,307 64.01$ 17.64$

OP D&A - FFS 3,490,277$ 13,253 93.63$ 103.40$

OP D&A - ENC 232,109$ 119 690.80$ 6.88$

Detox - FFS 46,440$ 18 928.81$ 1.38$

Detox - ENC 1,022,867$ 710 512.20$ 30.30$

ACT - FFS 1,063,707$ 1,637 230.99$ 31.51$

PROS - FFS 210,626$ 171 436.98$ 6.24$

CDT - FFS 1,851,782$ 6,901 95.39$ 54.86$


CPEP - FFS 9,900$ 7 495.00$ 0.29$

TCM - FFS 1,406,061$ 1,087 459.95$ 41.66$



Assessment - ENC 174$ 2 28.92$ 0.01$




IP Psych - FFS 8,278,858$ 10,428 860.41$ 747.73$

IP D&A - FFS 2,388,614$ 4,916 526.59$ 215.73$

IPRT - FFS 20,345$ 223 98.76$ 1.84$

ER-BH - FFS 183,303$ 1,492 133.12$ 16.56$

OP Psych - FFS 2,843,934$ 10,165 303.22$ 256.86$

OP D&A - FFS 1,819,126$ 19,105 103.20$ 164.30$

Detox - FFS 1,612,429$ 2,221 786.93$ 145.63$

ACT - FFS 343,875$ 1,755 212.40$ 31.06$

PROS - FFS 44,820$ 124 393.15$ 4.05$

CDT - FFS 480,224$ 5,095 102.15$ 43.37$


CPEP - FFS 16,075$ 39 446.54$ 1.45$

TCM - FFS 416,532$ 941 479.88$ 37.62$


Assessment - FFS 28,252$ 26 1,177.18$ 2.55$

FFS BH Subtotal 18,522,371$ 56,964 1,672.90$

Member MonthsTotal


Inpatient Psych 18,970,511$ 5,239 969.42$ 423.20$

Inpatient D&A 3,579,518$ 1,862 514.59$ 79.85$

IPRT 93,050$ 241 103.27$ 2.08$

Emergency Room 438,905$ 946 124.19$ 9.79$


Outpatient D&A 5,541,512$ 14,788 100.31$ 123.62$

Detox 2,681,737$ 1,097 654.72$ 59.83$

ACT 1,407,582$ 1,666 226.15$ 31.40$

PROS 255,445$ 160 428.60$ 5.70$

CDT 2,332,006$ 6,455 96.71$ 52.02$


CPEP 25,975$ 15 463.85$ 0.58$

TCM 1,822,593$ 1,051 464.35$ 40.66$


Assessment 28,426$ 8 947.53$ 0.63$

MC and FFS BH Total 49,485,020$ 47,024 1,103.94$

44,826

CY 2011

33,754

CY 2011

CY 201111,072


State of New York Behavioral Health Carve-In/HARP Data BookNorthern Metro HARP Acute


Region: NORTHERN METROPremium Group: HARPAge Group: Age 21+




Nursing Facility - ENC 891,606$ 1,579 200.72$ 26.41$




Ambulatory Surgery - ENC 738,955$ 717 366.54$ 21.89$

Clinic - FFS 34,029$ 71 170.14$ 1.01$

Clinic - ENC 311,607$ 2,180 50.82$ 9.23$

Emergency Room - FFS 308$ 1 153.77$ 0.01$






Primary Care - FFS 124$ 3 13.74$ 0.00$

Primary Care - ENC 1,232,610$ 4,628 94.68$ 36.52$

Pharmacy - FFS 11,478,607$ 39,685 102.83$ 340.07$

Pharmacy - ENC 3,851,593$ 14,065 97.36$ 114.11$



Dental - FFS 9,777$ 39 88.88$ 0.29$

Dental - ENC 556,926$ 3,991 49.61$ 16.50$







Clinic - FFS 631,293$ 3,986 171.64$ 57.02$




Primary Care - FFS 144,813$ 3,121 50.28$ 13.08$

Pharmacy - FFS 5,845,739$ 51,111 123.96$ 527.97$


Dental - FFS 198,675$ 2,957 72.83$ 17.94$


Member Months

Total



Inpatient Acute 15,465,990$ 2,657 1,558.29$ 345.02$

Ambulatory Surgery 938,752$ 670 374.90$ 20.94$

Clinic 976,928$ 2,680 97.60$ 21.79$

Emergency Room 624,330$ 180 927.68$ 13.93$



Primary Care 1,377,547$ 4,259 86.59$ 30.73$

Pharmacy 21,175,939$ 53,098 106.76$ 472.40$


Dental 765,378$ 3,765 54.42$ 17.07$



CY 2011

44,826

CY 2011

11,072

33,754

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookUtica-Adirondack HARP BH


Region: UTICA-ADIRONDACKPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 1,508,747$ 920 687.67$ 52.74$

IP Psych - ENC 1,661,874$ 745 935.21$ 58.09$

IP D&A - FFS 113,377$ 112 426.23$ 3.96$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 419$ 3 59.83$ 0.01$

ER-BH - ENC 227,625$ 647 147.62$ 7.96$

OP Psych - FFS 3,419,386$ 6,482 221.29$ 119.53$

OP Psych - ENC 494,336$ 3,208 64.64$ 17.28$

OP D&A - FFS 1,091,014$ 6,563 69.74$ 38.14$

OP D&A - ENC 129,206$ 56 971.47$ 4.52$

Detox - FFS 5,377$ 3 896.17$ 0.19$

Detox - ENC 408,951$ 467 367.10$ 14.30$

ACT - FFS 460,381$ 1,267 152.44$ 16.09$

PROS - FFS 55,793$ 76 306.55$ 1.95$

CDT - FFS 184,273$ 1,207 64.03$ 6.44$


CPEP - FFS 2,955$ 3 492.50$ 0.10$

TCM - FFS 1,140,798$ 1,234 387.76$ 39.88$



Assessment - ENC 1,359$ 11 52.29$ 0.05$




IP Psych - FFS 4,700,760$ 2,846 687.85$ 163.13$

IP D&A - FFS 1,644,876$ 1,540 444.92$ 57.08$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 204,797$ 739 115.44$ 7.11$

OP Psych - FFS 7,981,182$ 7,502 443.01$ 276.97$

OP D&A - FFS 1,500,377$ 8,115 77.00$ 52.07$

Detox - FFS 1,218,687$ 554 916.31$ 42.29$

ACT - FFS 153,238$ 366 174.13$ 5.32$

PROS - FFS 199,508$ 238 348.79$ 6.92$

CDT - FFS 52,029$ 464 46.66$ 1.81$

Partial Hospitalization - FFS -$ 0 -$ -$

CPEP - FFS 11,070$ 10 442.82$ 0.38$

TCM - FFS 700,534$ 569 512.46$ 24.31$



FFS BH Subtotal 18,367,058$ 22,944 637.39$

Member MonthsTotal


Inpatient Psych 7,871,382$ 2,258 728.49$ 137.08$

Inpatient D&A 1,758,252$ 828 443.67$ 30.62$

IPRT -$ 0 -$ -$

Emergency Room 432,841$ 694 130.26$ 7.54$


Outpatient D&A 2,720,597$ 7,369 77.15$ 47.38$

Detox 1,633,015$ 512 666.54$ 28.44$

ACT 613,619$ 815 157.34$ 10.69$

PROS 255,300$ 158 338.59$ 4.45$

CDT 236,302$ 834 59.18$ 4.12$


CPEP 14,025$ 6 452.43$ 0.24$

TCM 1,841,332$ 900 427.32$ 32.07$


Assessment 1,359$ 5 52.29$ 0.02$


57,423

CY 2011

28,607

CY 2011

CY 201128,816


State of New York Behavioral Health Carve-In/HARP Data BookUtica-Adirondack HARP Acute


Region: UTICA-ADIRONDACKPremium Group: HARPAge Group: Age 21+








Ambulatory Surgery - ENC 792,497$ 999 332.70$ 27.70$

Clinic - FFS 191,526$ 486 165.39$ 6.70$

Clinic - ENC 88,367$ 244 152.09$ 3.09$



Other Outpatient - FFS 884,398$ 5,844 63.48$ 30.92$




Primary Care - FFS 446$ 5 40.51$ 0.02$

Primary Care - ENC 1,598,241$ 7,035 95.30$ 55.87$

Pharmacy - FFS 8,385,088$ 40,145 87.62$ 293.11$

Pharmacy - ENC 2,782,897$ 14,469 80.68$ 97.28$

Tests, Lab and X-rays - FFS 915$ 9 43.55$ 0.03$


Dental - FFS 415,705$ 2,410 72.35$ 14.53$

Dental - ENC 136,739$ 574 99.88$ 4.78$







Clinic - FFS 352,751$ 1,236 118.89$ 12.24$




Primary Care - FFS 303,253$ 2,645 47.74$ 10.52$

Pharmacy - FFS 10,871,203$ 54,321 83.34$ 377.26$


Dental - FFS 497,783$ 2,669 77.67$ 17.27$

FFS Acute Care Subtotal 23,451,998$ 93,999 $813.85

Member Months

Total



Inpatient Acute 10,502,187$ 1,401 1,567.02$ 182.89$


Clinic 632,644$ 983 134.43$ 11.02$

Emergency Room 115,767$ 14 1,754.04$ 2.02$



Primary Care 1,901,940$ 4,834 82.21$ 33.12$

Pharmacy 22,039,188$ 54,467 84.56$ 383.80$


Dental 1,050,227$ 2,826 77.66$ 18.29$

MC and FFS Acute Care Total 50,903,070$ 101,250 886.46$


CY 2011

57,423

CY 2011

28,816

28,607

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookWestern HARP BH


Region: WESTERNPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 10,452,265$ 1,842 542.33$ 83.22$

IP Psych - ENC 7,996,558$ 797 959.05$ 63.67$

IP D&A - FFS 2,952,838$ 833 338.74$ 23.51$

IPRT - FFS 105,451$ 89 113.14$ 0.84$

ER-BH - FFS 118,534$ 107 106.02$ 0.94$

ER-BH - ENC 940,550$ 470 191.29$ 7.49$

OP Psych - FFS 10,954,507$ 8,166 128.17$ 87.22$

OP Psych - ENC 2,054,492$ 3,467 56.61$ 16.36$

OP D&A - FFS 7,726,416$ 8,781 84.07$ 61.52$

OP D&A - ENC 440,734$ 316 133.11$ 3.51$

Detox - FFS 681,454$ 87 751.33$ 5.43$

Detox - ENC 1,818,222$ 376 461.59$ 14.48$

ACT - FFS 1,197,813$ 652 175.61$ 9.54$

PROS - FFS 3,349,842$ 878 364.59$ 26.67$

CDT - FFS 1,266,448$ 1,937 62.46$ 10.08$


CPEP - FFS 110,555$ 21 491.36$ 0.88$

TCM - FFS 3,714,595$ 832 426.67$ 29.58$


Assessment - FFS 4,114$ 2 242.00$ 0.03$

Assessment - ENC 4,297$ 3 134.29$ 0.03$




IP Psych - FFS 6,796,160$ 6,506 539.55$ 292.55$

IP D&A - FFS 3,377,503$ 4,596 379.62$ 145.39$

IPRT - FFS 13,604$ 57 122.56$ 0.59$

ER-BH - FFS 313,961$ 1,370 118.34$ 13.51$

OP Psych - FFS 2,200,510$ 7,878 144.29$ 94.72$

OP D&A - FFS 2,217,197$ 13,379 85.60$ 95.44$

Detox - FFS 1,519,547$ 838 936.26$ 65.41$

ACT - FFS 238,708$ 779 158.29$ 10.28$

PROS - FFS 408,292$ 606 347.78$ 17.58$

CDT - FFS 133,308$ 1,037 66.42$ 5.74$


CPEP - FFS 246,263$ 260 489.59$ 10.60$

TCM - FFS 616,346$ 682 466.93$ 26.53$


Assessment - FFS 5,883$ 12 245.10$ 0.25$

FFS BH Subtotal 18,130,944$ 38,168 780.46$

Member MonthsTotal


Inpatient Psych 25,244,983$ 3,242 627.88$ 169.63$

Inpatient D&A 6,330,342$ 1,420 359.39$ 42.54$

IPRT 119,055$ 84 114.15$ 0.80$

Emergency Room 1,373,045$ 701 158.04$ 9.23$


Outpatient D&A 10,384,347$ 9,766 85.74$ 69.78$

Detox 4,019,223$ 522 621.31$ 27.01$

ACT 1,436,521$ 672 172.47$ 9.65$

PROS 3,758,134$ 836 362.68$ 25.25$

CDT 1,399,756$ 1,797 62.81$ 9.41$


CPEP 356,818$ 59 490.14$ 2.40$

TCM 4,330,941$ 808 431.97$ 29.10$


Assessment 14,294$ 6 195.81$ 0.10$


148,822

CY 2011

125,591

CY 2011

CY 201123,231


State of New York Behavioral Health Carve-In/HARP Data BookWestern HARP Acute


Region: WESTERNPremium Group: HARPAge Group: Age 21+









Clinic - FFS 133,129$ 113 112.73$ 1.06$

Clinic - ENC 901,291$ 2,368 36.37$ 7.18$







Primary Care - FFS 55,298$ 110 48.04$ 0.44$

Primary Care - ENC 5,939,600$ 6,049 93.81$ 47.29$

Pharmacy - FFS 36,538,299$ 42,638 81.88$ 290.93$

Pharmacy - ENC 10,482,147$ 12,408 80.72$ 83.46$



Dental - FFS 2,071,535$ 2,325 85.15$ 16.49$

Dental - ENC 251,990$ 328 73.36$ 2.01$







Clinic - FFS 546,202$ 2,093 134.80$ 23.51$




Primary Care - FFS 248,725$ 2,702 47.56$ 10.71$

Pharmacy - FFS 9,848,476$ 46,359 109.74$ 423.94$


Dental - FFS 407,096$ 2,500 84.11$ 17.52$


Member Months

Total



Inpatient Acute 40,091,833$ 2,174 1,486.87$ 269.39$


Clinic 1,580,622$ 2,420 52.66$ 10.62$

Emergency Room 334,718$ 24 1,130.80$ 2.25$



Primary Care 6,243,623$ 5,620 89.59$ 41.95$

Pharmacy 56,868,921$ 53,690 85.41$ 382.13$


Dental 2,730,621$ 2,629 83.75$ 18.35$



CY 2011

148,822

CY 2011

23,231

125,591

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookAll Regions HARP BH


Region: All RegionsPremium Group: HARPAge Group: Age 21+



IP Psych - FFS 173,889,698$ 2,761 742.45$ 170.85$

IP Psych - ENC 85,209,894$ 809 1,241.78$ 83.72$

IP D&A - FFS 12,891,065$ 338 450.17$ 12.67$

IPRT - FFS 730,273$ 82 104.46$ 0.72$

ER-BH - FFS 192,346$ 29 76.97$ 0.19$

ER-BH - ENC 7,103,306$ 575 145.58$ 6.98$

OP Psych - FFS 163,729,130$ 11,099 173.92$ 160.87$

OP Psych - ENC 15,988,112$ 3,483 54.11$ 15.71$

OP D&A - FFS 67,035,772$ 8,058 98.08$ 65.86$

OP D&A - ENC 7,371,174$ 164 530.80$ 7.24$

Detox - FFS 1,968,466$ 29 797.92$ 1.93$

Detox - ENC 20,037,290$ 503 469.98$ 19.69$

ACT - FFS 22,397,279$ 1,000 263.99$ 22.01$

PROS - FFS 17,835,854$ 504 417.25$ 17.52$

CDT - FFS 16,739,047$ 2,597 75.99$ 16.45$


CPEP - FFS 1,083,844$ 27 474.75$ 1.06$

TCM - FFS 34,752,578$ 829 494.52$ 34.14$


Assessment - FFS 4,155$ 0 230.83$ 0.00$

Assessment - ENC 37,556$ 7 66.24$ 0.04$




IP Psych - FFS 178,305,665$ 8,978 697.93$ 522.19$

IP D&A - FFS 43,194,049$ 2,928 518.46$ 126.50$

IPRT - FFS 180,336$ 53 118.80$ 0.53$

ER-BH - FFS 6,605,359$ 1,616 143.62$ 19.34$

OP Psych - FFS 44,965,674$ 8,326 189.80$ 131.69$

OP D&A - FFS 51,182,585$ 15,613 115.21$ 149.89$

Detox - FFS 77,339,451$ 3,150 862.78$ 226.50$

ACT - FFS 5,699,788$ 844 237.21$ 16.69$

PROS - FFS 3,326,950$ 299 391.08$ 9.74$

CDT - FFS 4,664,017$ 2,218 73.91$ 13.66$


CPEP - FFS 2,647,796$ 226 410.96$ 7.75$

TCM - FFS 8,466,789$ 558 533.11$ 24.80$


Assessment - FFS 52,745$ 5 344.74$ 0.15$

FFS BH Subtotal 427,272,303$ 44,948 1,251.32$

Member MonthsTotal


Inpatient Psych 437,405,257$ 4,929 783.45$ 321.80$

Inpatient D&A 56,085,113$ 988 500.99$ 41.26$

IPRT 910,609$ 75 107.02$ 0.67$

Emergency Room 13,901,011$ 859 142.89$ 10.23$


Outpatient D&A 125,589,531$ 10,079 110.01$ 92.40$

Detox 99,345,207$ 1,190 737.30$ 73.09$

ACT 28,097,067$ 961 258.08$ 20.67$

PROS 21,162,804$ 452 412.91$ 15.57$

CDT 21,403,064$ 2,502 75.53$ 15.75$


CPEP 3,731,640$ 77 427.65$ 2.75$

TCM 43,219,367$ 761 501.64$ 31.80$


Assessment 94,455$ 7 127.99$ 0.07$

MC and FFS BH Total 1,078,174,833$ 36,013 793.21$

1,359,261

CY 2011

1,017,804

CY 2011

CY 2011341,457


State of New York Behavioral Health Carve-In/HARP Data BookAll Regions HARP Acute


Region: All RegionsPremium Group: HARPAge Group: Age 21+









Clinic - FFS 3,623,071$ 238 179.84$ 3.56$

Clinic - ENC 12,148,128$ 1,903 75.27$ 11.94$


Emergency Room - ENC 4,288,757$ 11 4,656.63$ 4.21$





Primary Care - FFS 113,855$ 27 49.57$ 0.11$

Primary Care - ENC 48,280,026$ 6,304 90.30$ 47.44$

Pharmacy - FFS 401,704,154$ 45,815 103.37$ 394.68$

Pharmacy - ENC 131,871,143$ 15,555 99.95$ 129.56$

Tests, Lab and X-rays - FFS 1,002,530$ 320 36.92$ 0.98$


Dental - FFS 7,995,239$ 1,321 71.38$ 7.86$

Dental - ENC 8,731,448$ 3,070 33.53$ 8.58$

Managed Care Acute Care Subtotal 1,205,960,631$ 121,055 1,184.87$





Ambulatory Surgery - FFS 6,800,808$ 620 385.56$ 19.92$

Clinic - FFS 17,802,583$ 3,820 163.78$ 52.14$

Emergency Room - FFS 10,980,158$ 440 877.01$ 32.16$


Physician Specialist - FFS 6,540,026$ 4,329 53.09$ 19.15$

Primary Care - FFS 4,410,227$ 3,175 48.82$ 12.92$

Pharmacy - FFS 169,484,014$ 49,122 121.25$ 496.36$

Tests, Lab and X-rays - FFS 8,036,625$ 16,338 17.29$ 23.54$

Dental - FFS 7,914,913$ 4,214 66.02$ 23.18$


Member Months

Total



Inpatient Acute 520,182,991$ 2,607 1,761.42$ 382.70$


Clinic 33,573,782$ 2,562 115.67$ 24.70$

Emergency Room 15,323,101$ 120 1,128.86$ 11.27$



Primary Care 52,804,108$ 5,538 84.18$ 38.85$

Pharmacy 703,059,311$ 58,293 106.48$ 517.24$


Dental 24,641,600$ 4,346 50.06$ 18.13$

MC and FFS Acute Care Total 1,780,237,861$ 119,157 1,309.71$

MC and FFS All Services Total 2,858,412,694$ 155,170 2,102.92$

CY 2011

1,359,261

CY 2011

341,457

1,017,804

CY 2011



STATE OF NEW YORK

MERCER 37

6BH Carve-In (Non-HARP) Data Book PagesReport DescriptionsClaim cost and utilization reports summarized by region and premium group for the BH Carve-Inappear in this section of this Data Book.

At the top of each page, the region, category of aid and age group description are included tohelp the user identify each premium group. Below this information, the member months (MMs)associated with each population (managed care or FFS-only) are displayed. The cost andutilization is further split between managed care and FFS and then shown for the totalpopulation.

Each summary contains the following columns of information:

• Service Group: As described in Section 2, each of the covered services is listed• Dollars: Total expenditures for each service• Utilization Per 1,000: Annual utilization for each service, divided by total MMs and

multiplied by 12,000• Unit Cost: Average cost of each service line item; dollars divided by the utilization of

services delivered• Per Member Per Month (PMPM): PMPM costs based on the historical encounter and FFS

experience; dollars divided by total MMs

State of New York Behavioral Health Carve-In/HARP Data BookCentral FHPlus


Region: CENTRALCategory of Aid: FHPlusAge Group: Age 21+



IP Psych - FFS -$ 0 -$ -$

IP Psych - ENC 239,723$ 13 1,507.69$ 1.62$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 68,115$ 31 178.31$ 0.46$

OP Psych - FFS 724$ 0 180.97$ 0.00$

OP Psych - ENC 771,936$ 972 64.55$ 5.23$

OP D&A - FFS -$ 0 -$ -$

OP D&A - ENC 159,248$ 124 104.63$ 1.08$

Detox - FFS -$ 0 -$ -$

Detox - ENC 65,650$ 11 486.29$ 0.44$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 977$ 1 54.31$ 0.01$




IP Psych - FFS 444$ 6 444.03$ 0.22$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 179$ 12 89.48$ 0.09$

OP Psych - FFS 834$ 83 59.56$ 0.41$

OP D&A - FFS 219$ 36 36.47$ 0.11$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS 11$ 6 10.89$ 0.01$

TCM - FFS -$ 0 -$ -$



FFS BH Subtotal 1,687$ 142 0.83$

Member MonthsTotal


Inpatient Psych 240,167$ 13 1,501.04$ 1.60$

Inpatient D&A -$ 0 -$ -$

IPRT -$ 0 -$ -$

Emergency Room 68,294$ 31 177.85$ 0.46$

Outpatient Psych 773,494$ 960 64.59$ 5.17$

Outpatient D&A 159,467$ 123 104.36$ 1.07$

Detox 65,650$ 11 486.29$ 0.44$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT -$ 0 -$ -$

Partial Hospitalization -$ 0 -$ -$

CPEP 11$ 0 10.89$ 0.00$

TCM -$ 0 -$ -$


Assessment 977$ 1 54.31$ 0.01$


CY 2011

CY 2011

CY 2011

147,656

2,023

149,679


State of New York Behavioral Health Carve-In/HARP Data BookCentral TANF_SN Adult


Region: CENTRALPremium Group: TANF/SN ADULTAge Group: Age 21+



IP Psych - FFS 15,141$ 0 15,141.31$ 0.04$

IP Psych - ENC 1,470,679$ 28 1,694.33$ 4.02$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS 18,955$ 4 157.95$ 0.05$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 428,313$ 70 201.37$ 1.17$

OP Psych - FFS 1,220,466$ 526 76.20$ 3.34$

OP Psych - ENC 2,771,533$ 1,364 66.69$ 7.58$

OP D&A - FFS 6,104,313$ 2,621 76.48$ 16.70$

OP D&A - ENC 217,284$ 38 187.64$ 0.59$

Detox - FFS -$ 0 -$ -$

Detox - ENC 533,691$ 46 383.67$ 1.46$

ACT - FFS -$ 0 -$ -$

PROS - FFS 20,638$ 3 268.03$ 0.06$

CDT - FFS 173,181$ 83 68.61$ 0.47$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 92,355$ 7 459.48$ 0.25$







IP Psych - FFS 786,368$ 86 861.30$ 6.18$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 75,625$ 64 111.54$ 0.59$

OP Psych - FFS 1,610,781$ 930 163.43$ 12.67$

OP D&A - FFS 2,256,402$ 2,581 82.50$ 17.74$

Detox - FFS 186,874$ 24 744.52$ 1.47$

ACT - FFS 16,141$ 9 161.41$ 0.13$

PROS - FFS 467$ 0 155.67$ 0.00$

CDT - FFS 43,103$ 54 75.75$ 0.34$


CPEP - FFS 119,643$ 23 480.49$ 0.94$

TCM - FFS 20,981$ 4 466.24$ 0.16$



FFS BH Subtotal 5,117,814$ 3,777 40.24$

Member MonthsTotal


Inpatient Psych 2,272,188$ 43 1,275.08$ 4.61$


IPRT 18,955$ 3 157.95$ 0.04$

Emergency Room 503,938$ 68 179.66$ 1.02$


Outpatient D&A 8,577,998$ 2,639 79.19$ 17.41$

Detox 720,565$ 40 438.83$ 1.46$

ACT 16,141$ 2 161.41$ 0.03$

PROS 21,105$ 2 263.81$ 0.04$

CDT 216,283$ 75 69.93$ 0.44$


CPEP 119,643$ 6 480.49$ 0.24$

TCM 113,336$ 6 460.72$ 0.23$




365,482

492,662

127,180

CY 2011

CY 2011

CY 2011


State of New York Behavioral Health Carve-In/HARP Data BookCentral SSI


Region: CENTRALPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 315,029$ 70 775.93$ 4.53$

IP Psych - ENC 49,954$ 16 531.42$ 0.72$

IP D&A - FFS 9,248$ 4 440.39$ 0.13$

IPRT - FFS 3,472$ 5 115.73$ 0.05$

ER-BH - FFS 135$ 1 45.09$ 0.00$

ER-BH - ENC 30,519$ 40 130.42$ 0.44$

OP Psych - FFS 1,719,977$ 984 301.86$ 24.76$

OP Psych - ENC 56,564$ 133 73.65$ 0.81$

OP D&A - FFS 441,080$ 885 86.13$ 6.35$

OP D&A - ENC 22,751$ 3 1,197.43$ 0.33$

Detox - FFS -$ 0 -$ -$

Detox - ENC 13,767$ 2 1,058.99$ 0.20$

ACT - FFS 5,286$ 7 132.15$ 0.08$

PROS - FFS 8,649$ 4 376.04$ 0.12$

CDT - FFS 72,088$ 161 77.26$ 1.04$


CPEP - FFS 30,615$ 11 493.80$ 0.44$

TCM - FFS 90,522$ 33 471.47$ 1.30$







IP Psych - FFS 105,864$ 80 645.52$ 4.31$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS 83$ 1 27.81$ 0.00$

ER-BH - FFS 6,647$ 24 135.64$ 0.27$

OP Psych - FFS 237,629$ 744 156.23$ 9.68$

OP D&A - FFS 138,062$ 592 114.01$ 5.63$

Detox - FFS -$ 0 -$ -$

ACT - FFS 2,968$ 10 148.40$ 0.12$

PROS - FFS 140$ 0 140.00$ 0.01$

CDT - FFS 32,048$ 182 85.92$ 1.31$


CPEP - FFS 4,435$ 4 492.81$ 0.18$

TCM - FFS 9,255$ 10 440.71$ 0.38$



FFS BH Subtotal 537,131$ 1,649 21.88$

Member MonthsTotal


Inpatient Psych 470,847$ 85 709.11$ 5.01$

Inpatient D&A 9,248$ 3 440.39$ 0.10$

IPRT 3,555$ 4 107.74$ 0.04$

Emergency Room 37,301$ 37 130.42$ 0.40$


Outpatient D&A 601,893$ 811 94.77$ 6.40$

Detox 13,767$ 2 1,058.99$ 0.15$

ACT 8,254$ 8 137.57$ 0.09$

PROS 8,789$ 3 366.21$ 0.09$

CDT 104,135$ 167 79.74$ 1.11$


CPEP 35,051$ 9 493.67$ 0.37$

TCM 99,777$ 27 468.44$ 1.06$




CY 2011

CY 2011

CY 2011

69,471

94,015

24,544


State of New York Behavioral Health Carve-In/HARP Data BookFinger Lakes FHPlus


Region: FINGER LAKESPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 284,039$ 18 1,251.27$ 1.92$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 40,854$ 28 119.46$ 0.28$

OP Psych - FFS -$ 0 -$ -$

OP Psych - ENC 629,160$ 792 64.38$ 4.25$

OP D&A - FFS 138$ 0 138.00$ 0.00$

OP D&A - ENC 296,424$ 221 108.70$ 2.00$

Detox - FFS -$ 0 -$ -$

Detox - ENC 20,765$ 4 423.78$ 0.14$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 4,112$ 4 83.91$ 0.03$





IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 476$ 17 95.24$ 0.14$

OP Psych - FFS 5,783$ 269 73.20$ 1.64$

OP D&A - FFS 451$ 41 37.61$ 0.13$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS 1,623$ 20 270.50$ 0.46$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$




Member MonthsTotal


Inpatient Psych 284,039$ 18 1,251.27$ 1.87$


IPRT -$ 0 -$ -$

Emergency Room 41,331$ 27 119.11$ 0.27$


Outpatient D&A 297,014$ 217 108.40$ 1.96$

Detox 20,765$ 4 423.78$ 0.14$

ACT -$ 0 -$ -$

PROS 1,623$ 0 270.50$ 0.01$

CDT -$ 0 -$ -$


CPEP -$ 0 -$ -$

TCM -$ 0 -$ -$


Assessment 4,112$ 4 83.91$ 0.03$


CY 2011

CY 2011

CY 2011

148,107

151,625

3,518


State of New York Behavioral Health Carve-In/HARP Data BookFinger Lakes TANF_SN Adult


Region: FINGER LAKESPremium Group: TANF/SN ADULTAge Group: Age 21+



IP Psych - FFS 117,619$ 7 573.75$ 0.33$

IP Psych - ENC 1,041,622$ 36 977.13$ 2.90$

IP D&A - FFS 29,098$ 1 765.75$ 0.08$

IPRT - FFS 1,843$ 1 122.88$ 0.01$

ER-BH - FFS 16,934$ 5 117.60$ 0.05$

ER-BH - ENC 200,137$ 49 136.24$ 0.56$

OP Psych - FFS 2,277,416$ 718 105.84$ 6.34$

OP Psych - ENC 2,083,135$ 1,040 66.89$ 5.80$

OP D&A - FFS 3,155,692$ 1,413 74.54$ 8.78$

OP D&A - ENC 717,427$ 206 116.52$ 2.00$

Detox - FFS 49,625$ 1 1,417.86$ 0.14$

Detox - ENC 278,211$ 28 326.54$ 0.77$

ACT - FFS 4,492$ 1 224.60$ 0.01$

PROS - FFS 120,363$ 13 301.66$ 0.33$

CDT - FFS 89,824$ 42 71.01$ 0.25$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 156,881$ 12 427.47$ 0.44$



Assessment - ENC 4,742$ 2 70.78$ 0.01$




IP Psych - FFS 890,381$ 110 750.74$ 6.87$

IP D&A - FFS 8,185$ 5 143.59$ 0.06$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 90,724$ 76 110.37$ 0.70$

OP Psych - FFS 1,841,037$ 1,204 141.61$ 14.21$

OP D&A - FFS 1,513,973$ 1,994 70.29$ 11.68$

Detox - FFS 232,203$ 24 907.04$ 1.79$

ACT - FFS 2,834$ 2 134.95$ 0.02$

PROS - FFS 15,670$ 5 265.59$ 0.12$

CDT - FFS 39,022$ 46 78.36$ 0.30$


CPEP - FFS 51,931$ 11 432.76$ 0.40$

TCM - FFS 37,748$ 7 483.95$ 0.29$


Assessment - FFS 3,630$ 5 67.22$ 0.03$

FFS BH Subtotal 4,731,622$ 3,493 36.51$

Member MonthsTotal


Inpatient Psych 2,049,623$ 60 834.20$ 4.19$

Inpatient D&A 37,283$ 2 392.45$ 0.08$

IPRT 1,843$ 0 122.88$ 0.00$

Emergency Room 307,795$ 60 126.40$ 0.63$


Outpatient D&A 5,387,092$ 1,718 76.93$ 11.02$

Detox 560,040$ 28 489.97$ 1.15$

ACT 7,326$ 1 178.68$ 0.01$

PROS 136,033$ 11 297.02$ 0.28$

CDT 128,845$ 43 73.08$ 0.26$


CPEP 51,931$ 3 432.76$ 0.11$

TCM 194,629$ 11 437.37$ 0.40$


Assessment 8,372$ 3 69.19$ 0.02$


CY 2011

CY 2011

CY 2011359,440

489,042

129,602


State of New York Behavioral Health Carve-In/HARP Data BookFinger Lakes SSI


Region: FINGER LAKESPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 274,409$ 75 596.54$ 3.74$

IP Psych - ENC 24,671$ 17 239.52$ 0.34$

IP D&A - FFS 17,370$ 9 321.67$ 0.24$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 3,788$ 5 114.78$ 0.05$

ER-BH - ENC 46,277$ 49 154.77$ 0.63$

OP Psych - FFS 1,133,182$ 860 215.47$ 15.43$

OP Psych - ENC 52,266$ 136 62.97$ 0.71$

OP D&A - FFS 193,872$ 364 86.98$ 2.64$

OP D&A - ENC 212,632$ 142 244.40$ 2.90$

Detox - FFS 41,736$ 12 571.73$ 0.57$

Detox - ENC 5,997$ 1 999.57$ 0.08$

ACT - FFS 63,175$ 59 176.47$ 0.86$

PROS - FFS 125,091$ 53 386.08$ 1.70$

CDT - FFS 25,314$ 62 66.97$ 0.34$


CPEP - FFS 989$ 0 494.33$ 0.01$

TCM - FFS 119,444$ 43 455.89$ 1.63$



Assessment - ENC 102$ 0 34.05$ 0.00$




IP Psych - FFS 83,690$ 67 504.16$ 2.83$

IP D&A - FFS 6,815$ 1 3,407.25$ 0.23$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 13,537$ 39 141.02$ 0.46$

OP Psych - FFS 246,638$ 628 159.22$ 8.33$

OP D&A - FFS 103,453$ 567 73.89$ 3.49$

Detox - FFS 34,545$ 12 1,151.51$ 1.17$

ACT - FFS 4,324$ 13 139.48$ 0.15$

PROS - FFS 11,552$ 17 275.05$ 0.39$

CDT - FFS 19,673$ 124 64.29$ 0.66$


CPEP - FFS 5,881$ 5 490.05$ 0.20$

TCM - FFS 17,854$ 20 364.37$ 0.60$



FFS BH Subtotal 547,962$ 1,493 18.51$

Member MonthsTotal


Inpatient Psych 382,769$ 85 525.06$ 3.72$

Inpatient D&A 24,185$ 7 431.87$ 0.23$

IPRT -$ 0 -$ -$

Emergency Room 63,602$ 50 148.60$ 0.62$

Outpatient Psych 1,432,085$ 890 187.49$ 13.90$

Outpatient D&A 509,957$ 524 113.35$ 4.95$

Detox 82,279$ 13 754.85$ 0.80$

ACT 67,499$ 45 173.52$ 0.66$

PROS 136,643$ 43 373.34$ 1.33$

CDT 44,987$ 80 65.77$ 0.44$


CPEP 6,869$ 2 490.66$ 0.07$

TCM 137,298$ 36 441.47$ 1.33$


Assessment 102$ 0 34.05$ 0.00$


CY 2011

CY 2011

CY 201173,417

103,027

29,610


State of New York Behavioral Health Carve-In/HARP Data BookLong Island FHPlus


Region: LONG ISLANDPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 610,879$ 16 1,177.03$ 1.55$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 108,713$ 23 142.67$ 0.28$

OP Psych - FFS 592$ 0 197.37$ 0.00$

OP Psych - ENC 1,897,140$ 675 85.33$ 4.80$

OP D&A - FFS 1,036$ 0 94.19$ 0.00$

OP D&A - ENC 329,415$ 71 140.84$ 0.83$

Detox - FFS -$ 0 -$ -$

Detox - ENC 76,743$ 5 438.53$ 0.19$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS 223$ 0 55.83$ 0.00$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 401$ 0 36.42$ 0.00$

Managed Care BH Subtotal 3,025,143$ 792 7.66$




IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$


OP D&A - FFS 874$ 60 97.06$ 0.49$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS 446$ 13 223.00$ 0.25$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 503$ 7 503.00$ 0.28$




Member MonthsTotal


Inpatient Psych 610,879$ 16 1,177.03$ 1.54$


IPRT -$ 0 -$ -$

Emergency Room 108,713$ 23 142.67$ 0.27$


Outpatient D&A 331,324$ 71 140.45$ 0.84$

Detox 76,743$ 5 438.53$ 0.19$

ACT -$ 0 -$ -$

PROS 446$ 0 223.00$ 0.00$

CDT 223$ 0 55.83$ 0.00$


CPEP -$ 0 -$ -$

TCM 503$ 0 503.00$ 0.00$


Assessment 401$ 0 36.42$ 0.00$

MC and FFS BH Total 3,026,966$ 788 7.63$

CY 2011

CY 2011

CY 2011

394,996

396,790

1,794


State of New York Behavioral Health Carve-In/HARP Data BookLong Island TANF_SN Adult


Region: LONG ISLANDPremium Group: TANF/SN ADULTAge Group: Age 21+



IP Psych - FFS 7,578$ 0 360.84$ 0.01$

IP Psych - ENC 3,093,353$ 43 1,138.94$ 4.08$

IP D&A - FFS 1,918$ 0 68.49$ 0.00$

IPRT - FFS 1,487$ 0 92.93$ 0.00$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 503,947$ 57 141.20$ 0.67$

OP Psych - FFS 2,816,823$ 412 108.26$ 3.72$

OP Psych - ENC 5,213,836$ 956 86.38$ 6.88$

OP D&A - FFS 12,754,468$ 2,379 84.94$ 16.84$

OP D&A - ENC 949,864$ 80 188.99$ 1.25$

Detox - FFS -$ 0 -$ -$

Detox - ENC 859,636$ 29 461.92$ 1.14$

ACT - FFS 69,051$ 6 184.63$ 0.09$

PROS - FFS 392,012$ 14 459.57$ 0.52$

CDT - FFS 7,887$ 2 67.41$ 0.01$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 190,792$ 7 459.74$ 0.25$



Assessment - ENC 1,323$ 0 47.27$ 0.00$




IP Psych - FFS 2,309,185$ 308 576.00$ 14.77$

IP D&A - FFS 23,888$ 6 284.38$ 0.15$

IPRT - FFS 1,084$ 1 90.30$ 0.01$

ER-BH - FFS 141,790$ 81 134.65$ 0.91$

OP Psych - FFS 1,037,194$ 462 172.21$ 6.63$

OP D&A - FFS 4,647,724$ 3,902 91.41$ 29.72$

Detox - FFS 1,025,159$ 91 860.03$ 6.56$

ACT - FFS 6,940$ 3 173.50$ 0.04$

PROS - FFS 58,449$ 11 420.50$ 0.37$

CDT - FFS 5,012$ 4 96.39$ 0.03$


CPEP - FFS 2,056$ 0 411.11$ 0.01$

TCM - FFS 34,935$ 6 485.21$ 0.22$



FFS BH Subtotal 9,325,955$ 4,895 59.64$

Member MonthsTotal


Inpatient Psych 5,410,116$ 89 801.97$ 5.92$

Inpatient D&A 25,805$ 1 230.41$ 0.03$

IPRT 2,570$ 0 91.80$ 0.00$

Emergency Room 645,737$ 61 139.71$ 0.71$


Outpatient D&A 18,352,057$ 2,706 89.07$ 20.08$

Detox 1,884,794$ 40 617.36$ 2.06$

ACT 75,991$ 5 183.55$ 0.08$

PROS 450,461$ 13 454.09$ 0.49$

CDT 12,900$ 2 76.33$ 0.01$


CPEP 2,056$ 0 411.11$ 0.00$

TCM 225,727$ 6 463.51$ 0.25$


Assessment 1,323$ 0 47.27$ 0.00$


CY 2011

CY 2011

CY 2011

757,366

913,743

156,377


State of New York Behavioral Health Carve-In/HARP Data BookLong Island SSI


Region: LONG ISLANDPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 1,222,354$ 144 736.36$ 8.86$

IP Psych - ENC 151,536$ 38 349.97$ 1.10$

IP D&A - FFS 51,194$ 6 721.04$ 0.37$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 895$ 2 38.93$ 0.01$

ER-BH - ENC 72,852$ 41 153.37$ 0.53$

OP Psych - FFS 2,002,601$ 896 194.43$ 14.52$

OP Psych - ENC 166,987$ 137 105.75$ 1.21$

OP D&A - FFS 1,239,836$ 1,068 100.97$ 8.99$

OP D&A - ENC 107,630$ 10 978.45$ 0.78$

Detox - FFS 5,719$ 1 816.99$ 0.04$

Detox - ENC 21,108$ 3 620.84$ 0.15$

ACT - FFS 226,902$ 98 201.51$ 1.64$

PROS - FFS 493,054$ 86 498.03$ 3.57$

CDT - FFS 27,170$ 34 68.61$ 0.20$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 399,386$ 75 463.32$ 2.89$



Assessment - ENC 188$ 1 23.47$ 0.00$




IP Psych - FFS 518,447$ 246 1,020.56$ 20.90$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 10,737$ 40 130.94$ 0.43$

OP Psych - FFS 190,384$ 546 168.78$ 7.67$

OP D&A - FFS 412,239$ 1,758 113.44$ 16.62$

Detox - FFS 32,769$ 13 1,213.67$ 1.32$

ACT - FFS 24,050$ 69 168.18$ 0.97$

PROS - FFS 75,238$ 76 479.23$ 3.03$

CDT - FFS -$ 0 -$ -$


CPEP - FFS 492$ 0 491.59$ 0.02$

TCM - FFS 57,655$ 54 519.41$ 2.32$



FFS BH Subtotal 1,323,871$ 2,811 53.36$

Member MonthsTotal


Inpatient Psych 1,892,337$ 192 727.54$ 11.63$

Inpatient D&A 51,194$ 5 721.04$ 0.31$

IPRT -$ 0 -$ -$

Emergency Room 84,485$ 43 145.66$ 0.52$


Outpatient D&A 1,759,704$ 1,181 109.82$ 10.81$

Detox 59,596$ 5 876.42$ 0.37$

ACT 250,952$ 94 197.76$ 1.54$

PROS 568,293$ 85 495.46$ 3.49$

CDT 27,170$ 29 68.61$ 0.17$


CPEP 492$ 0 491.59$ 0.00$

TCM 457,041$ 72 469.72$ 2.81$


Assessment 188$ 1 23.47$ 0.00$


CY 2011

CY 2011

CY 2011137,961

162,772

24,811


State of New York Behavioral Health Carve-In/HARP Data BookMid-Hudson FHPlus


Region: MID-HUDSONPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 215,941$ 14 1,553.53$ 1.79$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 36,897$ 34 107.26$ 0.31$

OP Psych - FFS 249$ 0 124.34$ 0.00$

OP Psych - ENC 798,407$ 1,310 60.66$ 6.62$

OP D&A - FFS 319$ 0 79.65$ 0.00$

OP D&A - ENC 149,994$ 214 69.76$ 1.24$

Detox - FFS -$ 0 -$ -$

Detox - ENC 66,669$ 15 432.91$ 0.55$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$








IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 45$ 14 44.57$ 0.05$

OP Psych - FFS 128$ 14 128.36$ 0.14$

OP D&A - FFS 3,385$ 704 65.10$ 3.82$

Detox - FFS 4,623$ 14 4,622.99$ 5.22$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$




Member MonthsTotal


Inpatient Psych 215,941$ 14 1,553.53$ 1.78$


IPRT -$ 0 -$ -$

Emergency Room 36,941$ 34 107.08$ 0.30$

Outpatient Psych 798,784$ 1,301 60.67$ 6.58$

Outpatient D&A 153,698$ 218 69.67$ 1.27$

Detox 71,292$ 15 459.95$ 0.59$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT -$ 0 -$ -$


CPEP -$ 0 -$ -$

TCM -$ 0 -$ -$




CY 2011

CY 2011

CY 2011

120,523

121,409

886


State of New York Behavioral Health Carve-In/HARP Data BookMid-Hudson TANF_SN Adult


Region: MID-HUDSONPremium Group: TANF/SN ADULTAge Group: Age 21+




IP Psych - ENC 1,225,788$ 25 1,897.50$ 3.93$

IP D&A - FFS 11,684$ 3 153.73$ 0.04$

IPRT - FFS 30,594$ 8 144.31$ 0.10$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 204,125$ 71 110.46$ 0.65$

OP Psych - FFS 1,583,346$ 524 116.32$ 5.08$

OP Psych - ENC 2,542,922$ 1,527 64.11$ 8.16$

OP D&A - FFS 5,891,503$ 2,824 80.32$ 18.90$

OP D&A - ENC 318,339$ 77 158.93$ 1.02$

Detox - FFS -$ 0 -$ -$

Detox - ENC 448,589$ 43 398.04$ 1.44$

ACT - FFS -$ 0 -$ -$

PROS - FFS 82,968$ 9 351.56$ 0.27$

CDT - FFS 35,787$ 20 68.43$ 0.11$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 118,145$ 11 399.14$ 0.38$



Assessment - ENC 178$ 0 22.28$ 0.00$




IP Psych - FFS 654,050$ 200 706.32$ 11.74$

IP D&A - FFS 5,316$ 2 531.55$ 0.10$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 65,618$ 116 121.51$ 1.18$

OP Psych - FFS 850,609$ 936 195.77$ 15.27$

OP D&A - FFS 2,244,467$ 5,598 86.39$ 40.30$

Detox - FFS 233,827$ 57 882.37$ 4.20$

ACT - FFS 2,750$ 4 152.78$ 0.05$

PROS - FFS 19,425$ 12 340.78$ 0.35$

CDT - FFS 17,333$ 58 64.68$ 0.31$


CPEP - FFS 575$ 0 287.65$ 0.01$

TCM - FFS 23,564$ 12 428.44$ 0.42$



FFS BH Subtotal 4,152,879$ 7,056 74.57$

Member MonthsTotal


Inpatient Psych 1,879,837$ 51 1,195.83$ 5.12$

Inpatient D&A 16,999$ 3 197.66$ 0.05$

IPRT 30,594$ 7 144.31$ 0.08$

Emergency Room 269,742$ 78 112.96$ 0.73$


Outpatient D&A 8,454,309$ 3,310 83.43$ 23.01$

Detox 682,416$ 45 490.24$ 1.86$

ACT 2,750$ 1 152.78$ 0.01$

PROS 102,392$ 10 349.46$ 0.28$

CDT 53,121$ 26 67.16$ 0.14$


CPEP 575$ 0 287.65$ 0.00$

TCM 141,709$ 11 403.73$ 0.39$


Assessment 178$ 0 22.28$ 0.00$


CY 2011

CY 2011

CY 2011

311,749

367,441

55,692


State of New York Behavioral Health Carve-In/HARP Data BookMid-Hudson SSI


Region: MID-HUDSONPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 224,043$ 67 791.67$ 4.40$

IP Psych - ENC 67,013$ 19 817.23$ 1.32$

IP D&A - FFS 858$ 0 428.91$ 0.02$

IPRT - FFS 38,247$ 38 234.64$ 0.75$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 38,026$ 79 113.51$ 0.75$

OP Psych - FFS 1,136,022$ 1,055 253.75$ 22.32$

OP Psych - ENC 79,077$ 249 74.81$ 1.55$

OP D&A - FFS 532,506$ 1,316 95.41$ 10.46$

OP D&A - ENC 43,369$ 18 563.23$ 0.85$

Detox - FFS -$ 0 -$ -$

Detox - ENC 12,777$ 7 425.91$ 0.25$

ACT - FFS 49,955$ 77 152.30$ 0.98$

PROS - FFS 29,710$ 19 362.32$ 0.58$

CDT - FFS 29,814$ 95 73.61$ 0.59$


CPEP - FFS 497$ 0 497.06$ 0.01$

TCM - FFS 150,898$ 87 410.05$ 2.96$







IP Psych - FFS 116,950$ 152 726.40$ 9.18$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 6,466$ 45 134.71$ 0.51$

OP Psych - FFS 237,641$ 867 258.31$ 18.66$

OP D&A - FFS 170,287$ 1,545 103.90$ 13.37$

Detox - FFS 23,883$ 13 1,705.92$ 1.88$

ACT - FFS 10,496$ 69 143.78$ 0.82$

PROS - FFS -$ 0 -$ -$

CDT - FFS 3,712$ 45 77.33$ 0.29$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 21,802$ 46 444.94$ 1.71$



FFS BH Subtotal 591,237$ 2,782 46.43$

Member MonthsTotal


Inpatient Psych 408,006$ 99 775.68$ 6.41$

Inpatient D&A 858$ 0 428.91$ 0.01$

IPRT 38,247$ 31 234.64$ 0.60$

Emergency Room 44,493$ 72 116.17$ 0.70$


Outpatient D&A 746,162$ 1,376 102.26$ 11.73$

Detox 36,660$ 8 833.19$ 0.58$

ACT 60,451$ 76 150.75$ 0.95$

PROS 29,710$ 15 362.32$ 0.47$

CDT 33,526$ 85 74.01$ 0.53$


CPEP 497$ 0 497.06$ 0.01$

TCM 172,700$ 79 414.15$ 2.71$




CY 2011

CY 2011

CY 201150,900

63,634

12,734


State of New York Behavioral Health Carve-In/HARP Data BookNew York City FHPlus


Region: NEW YORK CITYPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 1,632,536$ 5 1,422.07$ 0.56$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 323,697$ 9 144.64$ 0.11$

OP Psych - FFS 21,921$ 1 104.89$ 0.01$

OP Psych - ENC 7,121,486$ 410 71.87$ 2.45$

OP D&A - FFS 54,320$ 2 105.89$ 0.02$

OP D&A - ENC 929,793$ 38 101.02$ 0.32$

Detox - FFS -$ 0 -$ -$

Detox - ENC 102,839$ 1 372.60$ 0.04$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS 2,593$ 0 172.88$ 0.00$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 8,073$ 1 36.36$ 0.00$





IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 240$ 1 240.13$ 0.03$

OP Psych - FFS 1,022$ 13 113.61$ 0.12$

OP D&A - FFS 3,900$ 67 84.79$ 0.47$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS 492$ 1 491.59$ 0.06$

TCM - FFS -$ 0 -$ -$




Member MonthsTotal


Inpatient Psych 1,632,536$ 5 1,422.07$ 0.56$


IPRT -$ 0 -$ -$

Emergency Room 323,937$ 9 144.68$ 0.11$


Outpatient D&A 988,014$ 40 101.20$ 0.34$

Detox 102,839$ 1 372.60$ 0.04$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT 2,593$ 0 172.88$ 0.00$


CPEP 492$ 0 491.59$ 0.00$

TCM -$ 0 -$ -$


Assessment 8,073$ 1 36.36$ 0.00$


CY 2011

CY 2011

CY 2011

2,902,451

2,910,698

8,247


State of New York Behavioral Health Carve-In/HARP Data BookNew York City TANF_SN Adult


Region: NEW YORK CITYPremium Group: TANF/SN ADULTAge Group: Age 21+



IP Psych - FFS 135,787$ 0 767.16$ 0.01$

IP Psych - ENC 18,824,252$ 13 1,763.40$ 1.94$

IP D&A - FFS 7,144$ 0 82.11$ 0.00$

IPRT - FFS 71,870$ 1 89.84$ 0.01$

ER-BH - FFS 137$ 0 45.57$ 0.00$

ER-BH - ENC 2,432,386$ 21 144.42$ 0.25$

OP Psych - FFS 14,370,230$ 228 77.99$ 1.48$

OP Psych - ENC 38,900,379$ 735 65.54$ 4.01$

OP D&A - FFS 88,952,361$ 1,046 105.24$ 9.18$

OP D&A - ENC 3,928,919$ 41 117.39$ 0.41$

Detox - FFS 10,664$ 0 533.20$ 0.00$

Detox - ENC 2,216,003$ 7 402.69$ 0.23$

ACT - FFS 64,820$ 0 316.20$ 0.01$

PROS - FFS 293,733$ 1 370.41$ 0.03$

CDT - FFS 844,043$ 13 82.17$ 0.09$


CPEP - FFS 497$ 0 497.06$ 0.00$

TCM - FFS 504,035$ 1 588.83$ 0.05$



Assessment - ENC 74,849$ 2 44.08$ 0.01$




IP Psych - FFS 18,523,399$ 195 797.98$ 12.94$

IP D&A - FFS 37,982$ 1 622.65$ 0.03$

IPRT - FFS 10,022$ 1 100.22$ 0.01$

ER-BH - FFS 1,018,334$ 55 154.48$ 0.71$

OP Psych - FFS 13,988,966$ 825 142.11$ 9.77$

OP D&A - FFS 49,842,075$ 4,099 101.92$ 34.81$

Detox - FFS 9,144,037$ 82 930.69$ 6.39$

ACT - FFS 16,934$ 0 564.47$ 0.01$

PROS - FFS 77,786$ 2 377.60$ 0.05$

CDT - FFS 473,462$ 60 66.44$ 0.33$


CPEP - FFS 785,307$ 15 429.60$ 0.55$

TCM - FFS 92,034$ 1 575.21$ 0.06$


Assessment - FFS 20,668$ 1 165.34$ 0.01$

FFS BH Subtotal 94,234,566$ 5,344 65.82$

Member MonthsTotal


Inpatient Psych 37,483,438$ 37 1,100.35$ 3.37$

Inpatient D&A 45,125$ 0 304.90$ 0.00$

IPRT 81,892$ 1 90.99$ 0.01$

Emergency Room 3,450,857$ 25 147.24$ 0.31$


Outpatient D&A 142,723,356$ 1,475 104.35$ 12.83$

Detox 11,370,704$ 17 740.86$ 1.02$

ACT 81,754$ 0 347.89$ 0.01$

PROS 371,518$ 1 371.89$ 0.03$

CDT 1,317,505$ 19 75.73$ 0.12$


CPEP 785,804$ 2 429.64$ 0.07$

TCM 596,069$ 1 586.68$ 0.05$


Assessment 95,517$ 2 52.40$ 0.01$


CY 2011

CY 2011

CY 2011

9,694,169

11,125,959

1,431,790


State of New York Behavioral Health Carve-In/HARP Data BookNew York City SSI


Region: NEW YORK CITYPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 6,974,472$ 82 762.74$ 5.19$

IP Psych - ENC 1,373,752$ 21 575.51$ 1.02$

IP D&A - FFS 62,595$ 1 470.64$ 0.05$

IPRT - FFS 40,857$ 4 86.02$ 0.03$

ER-BH - FFS 1,682$ 1 29.00$ 0.00$

ER-BH - ENC 374,103$ 23 144.83$ 0.28$

OP Psych - FFS 22,398,734$ 1,090 183.49$ 16.67$

OP Psych - ENC 3,261,587$ 393 74.07$ 2.43$

OP D&A - FFS 31,813,888$ 2,344 121.18$ 23.67$

OP D&A - ENC 695,581$ 19 327.64$ 0.52$

Detox - FFS 27,926$ 0 1,329.83$ 0.02$

Detox - ENC 451,450$ 9 441.73$ 0.34$

ACT - FFS 592,315$ 18 288.93$ 0.44$

PROS - FFS 516,557$ 10 445.31$ 0.38$

CDT - FFS 882,704$ 103 76.88$ 0.66$


CPEP - FFS 61,550$ 1 459.33$ 0.05$

TCM - FFS 1,006,242$ 17 517.88$ 0.75$


Assessment - FFS 62$ 0 62.00$ 0.00$

Assessment - ENC 17,293$ 3 46.86$ 0.01$




IP Psych - FFS 1,601,990$ 128 726.53$ 7.74$

IP D&A - FFS 37,043$ 4 529.18$ 0.18$

IPRT - FFS 1,008$ 1 91.64$ 0.00$

ER-BH - FFS 117,184$ 44 155.42$ 0.57$

OP Psych - FFS 3,134,200$ 1,193 152.22$ 15.14$

OP D&A - FFS 9,448,515$ 4,617 118.59$ 45.63$

Detox - FFS 905,036$ 49 1,076.14$ 4.37$

ACT - FFS 52,065$ 18 171.83$ 0.25$

PROS - FFS 38,316$ 5 430.51$ 0.19$

CDT - FFS 154,701$ 149 60.24$ 0.75$


CPEP - FFS 51,789$ 7 442.64$ 0.25$

TCM - FFS 97,274$ 10 582.48$ 0.47$


Assessment - FFS 12,573$ 4 184.90$ 0.06$

FFS BH Subtotal 15,669,118$ 6,231 75.67$

Member MonthsTotal


Inpatient Psych 9,950,215$ 106 724.39$ 6.42$

Inpatient D&A 99,638$ 2 490.83$ 0.06$

IPRT 41,865$ 4 86.14$ 0.03$

Emergency Room 492,970$ 26 145.20$ 0.32$


Outpatient D&A 41,957,984$ 2,664 121.86$ 27.05$

Detox 1,384,412$ 15 734.83$ 0.89$

ACT 644,380$ 18 273.85$ 0.42$

PROS 554,872$ 10 444.25$ 0.36$

CDT 1,037,405$ 109 73.84$ 0.67$


CPEP 113,339$ 2 451.55$ 0.07$

TCM 1,103,516$ 16 522.99$ 0.71$


Assessment 29,928$ 3 68.33$ 0.02$


CY 2011

CY 2011

CY 20111,343,894

1,550,971

207,077


State of New York Behavioral Health Carve-In/HARP Data BookNortheast FHPlus


Region: NORTHEASTPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 322,625$ 21 1,316.84$ 2.30$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 64,193$ 41 132.90$ 0.46$


OP Psych - ENC 762,259$ 958 68.10$ 5.44$

OP D&A - FFS 2,058$ 2 85.76$ 0.01$

OP D&A - ENC 110,671$ 141 67.40$ 0.79$

Detox - FFS -$ 0 -$ -$

Detox - ENC 19,827$ 5 309.80$ 0.14$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$








IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

OP Psych - FFS 2,691$ 364 70.81$ 2.15$

OP D&A - FFS 452$ 58 75.35$ 0.36$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$




Member MonthsTotal


Inpatient Psych 322,625$ 21 1,316.84$ 2.28$


IPRT -$ 0 -$ -$

Emergency Room 64,193$ 41 132.90$ 0.45$


Outpatient D&A 113,181$ 142 67.69$ 0.80$

Detox 19,827$ 5 309.80$ 0.14$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT -$ 0 -$ -$


CPEP -$ 0 -$ -$

TCM -$ 0 -$ -$




CY 2011

CY 2011

CY 2011

140,185

141,437

1,252


State of New York Behavioral Health Carve-In/HARP Data BookNortheast TANF_SN Adult


Region: NORTHEASTPremium Group: TANF/SN ADULTAge Group: Age 21+




IP Psych - ENC 1,855,390$ 45 1,290.26$ 4.86$

IP D&A - FFS 5,474$ 1 171.07$ 0.01$

IPRT - FFS 24,198$ 8 95.64$ 0.06$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 361,842$ 95 120.05$ 0.95$

OP Psych - FFS 737,599$ 323 71.74$ 1.93$

OP Psych - ENC 2,437,848$ 1,074 71.37$ 6.39$

OP D&A - FFS 5,384,096$ 2,286 74.07$ 14.11$

OP D&A - ENC 240,659$ 54 140.65$ 0.63$

Detox - FFS -$ 0 -$ -$

Detox - ENC 266,746$ 28 304.50$ 0.70$

ACT - FFS -$ 0 -$ -$

PROS - FFS 91,584$ 8 366.34$ 0.24$

CDT - FFS 78,014$ 47 52.50$ 0.20$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 49,725$ 3 456.19$ 0.13$







IP Psych - FFS 669,641$ 181 600.57$ 9.07$

IP D&A - FFS 1,569$ 1 196.12$ 0.02$

IPRT - FFS 698$ 1 99.68$ 0.01$

ER-BH - FFS 86,427$ 109 129.00$ 1.17$

OP Psych - FFS 697,667$ 762 148.66$ 9.45$

OP D&A - FFS 1,959,004$ 4,234 75.17$ 26.52$

Detox - FFS 207,942$ 53 639.82$ 2.82$

ACT - FFS -$ 0 -$ -$

PROS - FFS 15,284$ 6 424.56$ 0.21$

CDT - FFS 29,621$ 90 53.76$ 0.40$


CPEP - FFS 2,460$ 1 492.08$ 0.03$

TCM - FFS 15,827$ 3 791.35$ 0.21$



FFS BH Subtotal 3,706,318$ 5,464 50.18$

Member MonthsTotal


Inpatient Psych 2,525,031$ 67 989.04$ 5.55$

Inpatient D&A 7,043$ 1 176.08$ 0.02$

IPRT 24,896$ 7 95.75$ 0.05$

Emergency Room 448,270$ 97 121.68$ 0.98$


Outpatient D&A 7,583,760$ 2,647 75.49$ 16.65$

Detox 474,688$ 32 395.24$ 1.04$

ACT -$ 0 -$ -$

PROS 106,868$ 8 373.67$ 0.23$

CDT 107,635$ 54 52.84$ 0.24$


CPEP 2,460$ 0 492.08$ 0.01$

TCM 65,552$ 3 508.16$ 0.14$




CY 2011

CY 2011

CY 2011

381,502

455,360

73,858


State of New York Behavioral Health Carve-In/HARP Data BookNortheast SSI


Region: NORTHEASTPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 281,153$ 71 739.88$ 4.37$

IP Psych - ENC 109,644$ 33 626.54$ 1.70$

IP D&A - FFS 1,584$ 1 316.80$ 0.02$

IPRT - FFS 18,471$ 29 118.41$ 0.29$

ER-BH - FFS 156$ 1 51.89$ 0.00$

ER-BH - ENC 51,313$ 78 122.47$ 0.80$

OP Psych - FFS 1,273,649$ 1,048 226.51$ 19.79$

OP Psych - ENC 78,720$ 154 95.19$ 1.22$

OP D&A - FFS 439,778$ 978 83.78$ 6.83$

OP D&A - ENC 33,886$ 5 1,303.30$ 0.53$

Detox - FFS -$ 0 -$ -$

Detox - ENC 6,114$ 3 436.72$ 0.09$

ACT - FFS 113,529$ 122 173.06$ 1.76$

PROS - FFS 22,915$ 14 305.54$ 0.36$

CDT - FFS 54,997$ 181 56.64$ 0.85$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 110,916$ 38 549.09$ 1.72$



Assessment - ENC 126$ 1 25.25$ 0.00$




IP Psych - FFS 162,221$ 149 714.63$ 8.86$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 12,579$ 65 127.06$ 0.69$

OP Psych - FFS 205,773$ 734 183.73$ 11.24$

OP D&A - FFS 178,246$ 1,293 90.34$ 9.73$

Detox - FFS 17,253$ 13 862.63$ 0.94$

ACT - FFS 6,952$ 20 224.26$ 0.38$

PROS - FFS 6,410$ 14 305.25$ 0.35$

CDT - FFS 13,647$ 159 56.16$ 0.75$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 24,450$ 25 643.42$ 1.34$



FFS BH Subtotal 629,356$ 2,480 34.36$

Member MonthsTotal


Inpatient Psych 553,019$ 113 707.19$ 6.69$

Inpatient D&A 1,584$ 1 316.80$ 0.02$

IPRT 18,471$ 23 118.41$ 0.22$

Emergency Room 64,048$ 76 122.93$ 0.77$


Outpatient D&A 651,909$ 1,052 89.94$ 7.88$

Detox 23,367$ 5 687.25$ 0.28$

ACT 120,481$ 100 175.37$ 1.46$

PROS 29,326$ 14 305.47$ 0.35$

CDT 68,644$ 176 56.54$ 0.83$


CPEP -$ 0 -$ -$

TCM 135,366$ 35 564.03$ 1.64$


Assessment 126$ 1 25.25$ 0.00$


CY 2011

CY 2011

CY 201164,374

82,688

18,314


State of New York Behavioral Health Carve-In/HARP Data BookNorthern Metro FHPlus


Region: NORTHERN METROPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 292,375$ 8 2,416.32$ 1.58$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 37,866$ 20 124.56$ 0.20$

OP Psych - FFS 35$ 0 35.16$ 0.00$

OP Psych - ENC 972,740$ 985 63.87$ 5.24$

OP D&A - FFS 1,663$ 1 127.90$ 0.01$

OP D&A - ENC 136,622$ 62 141.72$ 0.74$

Detox - FFS -$ 0 -$ -$

Detox - ENC 40,518$ 6 465.72$ 0.22$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 217$ 0 36.09$ 0.00$




IP Psych - FFS 17,793$ 401 659.02$ 22.02$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 67$ 15 66.52$ 0.08$

OP Psych - FFS 3,516$ 134 390.71$ 4.35$

OP D&A - FFS 761$ 134 84.61$ 0.94$

Detox - FFS 4,421$ 15 4,421.13$ 5.47$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



FFS BH Subtotal 26,559$ 698 32.87$

Member MonthsTotal


Inpatient Psych 310,169$ 10 2,095.73$ 1.66$


IPRT -$ 0 -$ -$

Emergency Room 37,932$ 20 124.37$ 0.20$


Outpatient D&A 139,046$ 63 141.02$ 0.75$

Detox 44,939$ 6 510.67$ 0.24$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT -$ 0 -$ -$


CPEP -$ 0 -$ -$

TCM -$ 0 -$ -$


Assessment 217$ 0 36.09$ 0.00$


CY 2011

CY 2011

CY 2011

185,568

186,376

808


State of New York Behavioral Health Carve-In/HARP Data BookNorthern Metro TANF_SN Adult


Region: NORTHERN METROPremium Group: TANF/SN ADULTAge Group: Age 21+




IP Psych - ENC 2,313,420$ 23 2,653.00$ 5.04$

IP D&A - FFS 16,636$ 1 297.07$ 0.04$

IPRT - FFS 8,917$ 2 108.75$ 0.02$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 187,706$ 41 118.50$ 0.41$

OP Psych - FFS 3,331,147$ 599 145.17$ 7.25$

OP Psych - ENC 2,997,587$ 1,229 63.70$ 6.52$

OP D&A - FFS 8,692,638$ 2,522 90.03$ 18.92$

OP D&A - ENC 622,084$ 60 269.18$ 1.35$

Detox - FFS -$ 0 -$ -$

Detox - ENC 380,427$ 20 491.51$ 0.83$

ACT - FFS 15,527$ 2 204.30$ 0.03$

PROS - FFS 19,388$ 1 380.15$ 0.04$

CDT - FFS 223,245$ 64 91.53$ 0.49$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 64,026$ 4 450.89$ 0.14$



Assessment - ENC 2,300$ 1 65.71$ 0.01$




IP Psych - FFS 1,175,736$ 260 729.82$ 15.82$

IP D&A - FFS 10,761$ 4 467.86$ 0.14$

IPRT - FFS 199$ 0 66.45$ 0.00$

ER-BH - FFS 58,484$ 73 130.25$ 0.79$

OP Psych - FFS 1,293,921$ 894 233.81$ 17.41$

OP D&A - FFS 2,540,043$ 4,575 89.65$ 34.18$

Detox - FFS 325,035$ 73 722.30$ 4.37$

ACT - FFS -$ 0 -$ -$

PROS - FFS 1,143$ 1 228.60$ 0.02$

CDT - FFS 28,882$ 58 79.78$ 0.39$


CPEP - FFS 8,345$ 3 490.90$ 0.11$

TCM - FFS 8,145$ 3 407.25$ 0.11$


Assessment - FFS 11,884$ 5 383.35$ 0.16$

FFS BH Subtotal 5,527,834$ 6,038 74.39$

Member MonthsTotal


Inpatient Psych 3,489,156$ 56 1,405.22$ 6.54$

Inpatient D&A 27,397$ 2 346.80$ 0.05$

IPRT 9,117$ 2 107.26$ 0.02$

Emergency Room 246,190$ 46 121.10$ 0.46$


Outpatient D&A 11,854,764$ 2,860 93.20$ 22.21$

Detox 705,461$ 28 576.36$ 1.32$

ACT 15,527$ 2 204.30$ 0.03$

PROS 20,531$ 1 366.62$ 0.04$

CDT 252,127$ 63 90.01$ 0.47$


CPEP 8,345$ 0 490.90$ 0.02$

TCM 72,171$ 4 445.50$ 0.14$


Assessment 14,184$ 1 214.90$ 0.03$


CY 2011

CY 2011

CY 2011

459,467

533,778

74,311


State of New York Behavioral Health Carve-In/HARP Data BookNorthern Metro SSI


Region: NORTHERN METROPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 679,129$ 149 825.19$ 10.27$

IP Psych - ENC 115,485$ 19 1,099.86$ 1.75$

IP D&A - FFS 14,936$ 4 678.89$ 0.23$

IPRT - FFS 5,103$ 11 86.50$ 0.08$

ER-BH - FFS 91$ 0 45.35$ 0.00$

ER-BH - ENC 35,930$ 49 133.07$ 0.54$

OP Psych - FFS 1,557,063$ 1,015 278.35$ 23.54$

OP Psych - ENC 49,538$ 119 75.29$ 0.75$

OP D&A - FFS 1,071,517$ 1,758 110.56$ 16.20$

OP D&A - ENC 156,391$ 30 959.46$ 2.36$

Detox - FFS -$ 0 -$ -$

Detox - ENC 16,759$ 5 620.71$ 0.25$

ACT - FFS 64,427$ 56 207.83$ 0.97$

PROS - FFS 10,459$ 5 387.37$ 0.16$

CDT - FFS 234,942$ 430 99.22$ 3.55$


CPEP - FFS 1,486$ 1 495.24$ 0.02$

TCM - FFS 120,414$ 45 485.54$ 1.82$



Assessment - ENC 1,763$ 6 51.84$ 0.03$




IP Psych - FFS 371,368$ 450 834.54$ 31.27$

IP D&A - FFS 13,652$ 34 401.54$ 1.15$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 7,331$ 65 114.54$ 0.62$

OP Psych - FFS 415,564$ 1,191 352.47$ 34.99$

OP D&A - FFS 316,452$ 2,850 112.18$ 26.65$

Detox - FFS 49,673$ 62 814.31$ 4.18$

ACT - FFS 3,792$ 16 237.00$ 0.32$

PROS - FFS -$ 0 -$ -$

CDT - FFS 22,704$ 214 107.09$ 1.91$


CPEP - FFS 2,005$ 6 334.22$ 0.17$

TCM - FFS 12,919$ 34 379.97$ 1.09$


Assessment - FFS 19,133$ 47 407.09$ 1.61$

FFS BH Subtotal 1,236,295$ 4,986 104.10$

Member MonthsTotal


Inpatient Psych 1,165,982$ 211 849.22$ 14.94$

Inpatient D&A 28,588$ 9 510.50$ 0.37$

IPRT 5,103$ 9 86.50$ 0.07$

Emergency Room 43,351$ 52 129.02$ 0.56$


Outpatient D&A 1,544,360$ 1,949 121.83$ 19.79$

Detox 66,432$ 14 754.91$ 0.85$

ACT 68,219$ 50 209.26$ 0.87$

PROS 10,459$ 4 387.37$ 0.13$

CDT 257,646$ 397 99.86$ 3.30$


CPEP 3,491$ 1 387.89$ 0.04$

TCM 133,333$ 43 472.81$ 1.71$


Assessment 20,896$ 12 257.98$ 0.27$


CY 2011

CY 2011

CY 201166,156

78,032

11,876


State of New York Behavioral Health Carve-In/HARP Data BookUtica-Adirondack FHPlus


Region: UTICA-ADIRONDACKPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 225,901$ 21 855.69$ 1.49$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 53,995$ 29 149.16$ 0.36$

OP Psych - FFS 64$ 0 31.75$ 0.00$

OP Psych - ENC 633,929$ 752 66.58$ 4.17$

OP D&A - FFS -$ 0 -$ -$

OP D&A - ENC 79,260$ 67 93.58$ 0.52$

Detox - FFS -$ 0 -$ -$

Detox - ENC 24,644$ 6 328.59$ 0.16$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 310$ 0 51.64$ 0.00$




IP Psych - FFS 3,150$ 74 315.03$ 1.94$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 63$ 7 62.69$ 0.04$

OP Psych - FFS 3,076$ 266 85.45$ 1.89$

OP D&A - FFS 705$ 148 35.23$ 0.43$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$




Member MonthsTotal


Inpatient Psych 229,052$ 21 835.95$ 1.49$


IPRT -$ 0 -$ -$

Emergency Room 54,058$ 28 148.92$ 0.35$


Outpatient D&A 79,965$ 68 92.23$ 0.52$

Detox 24,644$ 6 328.59$ 0.16$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT -$ 0 -$ -$


CPEP -$ 0 -$ -$

TCM -$ 0 -$ -$


Assessment 310$ 0 51.64$ 0.00$


CY 2011

CY 2011

CY 2011

151,935

153,562

1,627


State of New York Behavioral Health Carve-In/HARP Data BookUtica-Adirondack TANF_SN Adult


Region: UTICA-ADIRONDACKPremium Group: TANF/SN ADULTAge Group: Age 21+




IP Psych - ENC 866,170$ 35 1,181.68$ 3.43$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 162,776$ 54 143.41$ 0.64$

OP Psych - FFS 479,923$ 417 54.74$ 1.90$

OP Psych - ENC 1,641,327$ 1,145 68.10$ 6.50$

OP D&A - FFS 2,647,439$ 1,812 69.44$ 10.48$

OP D&A - ENC 108,554$ 31 167.78$ 0.43$

Detox - FFS -$ 0 -$ -$

Detox - ENC 283,515$ 45 301.29$ 1.12$

ACT - FFS -$ 0 -$ -$

PROS - FFS 10,981$ 2 296.77$ 0.04$

CDT - FFS 11,876$ 10 53.98$ 0.05$


CPEP - FFS -$ 0 -$ -$

TCM - FFS 126,184$ 14 417.83$ 0.50$



Assessment - ENC 905$ 1 50.26$ 0.00$




IP Psych - FFS 799,564$ 85 683.97$ 4.85$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 105,526$ 67 114.58$ 0.64$

OP Psych - FFS 2,092,318$ 781 194.91$ 12.68$

OP D&A - FFS 1,849,262$ 1,774 75.82$ 11.21$

Detox - FFS 355,694$ 31 827.19$ 2.16$

ACT - FFS -$ 0 -$ -$

PROS - FFS 11,840$ 4 236.80$ 0.07$

CDT - FFS 9,560$ 16 43.65$ 0.06$


CPEP - FFS 9,354$ 1 492.30$ 0.06$

TCM - FFS 41,239$ 6 463.36$ 0.25$



FFS BH Subtotal 5,274,355$ 2,765 31.97$

Member MonthsTotal


Inpatient Psych 1,665,734$ 55 875.78$ 3.99$


IPRT -$ 0 -$ -$

Emergency Room 268,302$ 59 130.50$ 0.64$


Outpatient D&A 4,605,255$ 1,815 72.91$ 11.03$

Detox 639,209$ 39 466.24$ 1.53$

ACT -$ 0 -$ -$

PROS 22,821$ 3 262.31$ 0.05$

CDT 21,436$ 13 48.83$ 0.05$


CPEP 9,354$ 1 492.30$ 0.02$

TCM 167,423$ 11 428.19$ 0.40$


Assessment 905$ 1 50.26$ 0.00$


CY 2011

CY 2011

CY 2011

252,547

417,537

164,990


State of New York Behavioral Health Carve-In/HARP Data BookUtica-Adirondack SSI


Region: UTICA-ADIRONDACKPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 258,459$ 75 888.17$ 5.52$

IP Psych - ENC 61,270$ 23 680.78$ 1.31$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 119$ 1 59.30$ 0.00$

ER-BH - ENC 30,825$ 58 137.00$ 0.66$

OP Psych - FFS 751,308$ 832 231.46$ 16.05$

OP Psych - ENC 34,631$ 101 87.67$ 0.74$

OP D&A - FFS 89,496$ 326 70.47$ 1.91$

OP D&A - ENC 50,394$ 2 7,199.20$ 1.08$

Detox - FFS -$ 0 -$ -$

Detox - ENC 5,740$ 2 717.50$ 0.12$

ACT - FFS 57,317$ 94 155.75$ 1.22$

PROS - FFS -$ 0 -$ -$

CDT - FFS 27,773$ 80 88.73$ 0.59$


CPEP - FFS 983$ 1 491.59$ 0.02$

TCM - FFS 117,193$ 53 563.43$ 2.50$



Assessment - ENC 239$ 1 59.66$ 0.01$




IP Psych - FFS 153,047$ 54 721.92$ 3.28$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 15,181$ 34 115.89$ 0.33$

OP Psych - FFS 1,555,501$ 746 536.01$ 33.31$

OP D&A - FFS 151,015$ 411 94.50$ 3.23$

Detox - FFS 37,047$ 11 841.99$ 0.79$

ACT - FFS 7,386$ 16 115.41$ 0.16$

PROS - FFS 25,701$ 21 313.43$ 0.55$

CDT - FFS 473$ 3 47.35$ 0.01$


CPEP - FFS 1,078$ 1 359.28$ 0.02$

TCM - FFS 32,618$ 20 423.61$ 0.70$



FFS BH Subtotal 1,979,048$ 1,316 42.38$

Member MonthsTotal


Inpatient Psych 472,775$ 76 797.26$ 5.06$


IPRT -$ 0 -$ -$

Emergency Room 46,125$ 46 128.84$ 0.49$


Outpatient D&A 290,906$ 369 101.18$ 3.11$

Detox 42,787$ 7 822.83$ 0.46$

ACT 64,703$ 55 149.78$ 0.69$

PROS 25,701$ 11 313.43$ 0.27$

CDT 28,246$ 41 87.45$ 0.30$


CPEP 2,061$ 1 412.20$ 0.02$

TCM 149,811$ 37 525.65$ 1.60$


Assessment 239$ 1 59.66$ 0.00$


CY 2011

CY 2011

CY 201146,798

93,499

46,701


State of New York Behavioral Health Carve-In/HARP Data BookWestern FHPlus


Region: WESTERNPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 556,958$ 19 1,218.73$ 1.95$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 120,199$ 24 206.17$ 0.42$

OP Psych - FFS 47$ 0 47.12$ 0.00$

OP Psych - ENC 1,740,182$ 1,154 63.28$ 6.08$

OP D&A - FFS 138$ 0 138.00$ 0.00$

OP D&A - ENC 336,615$ 185 76.19$ 1.18$

Detox - FFS -$ 0 -$ -$

Detox - ENC 79,398$ 6 518.94$ 0.28$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 3,531$ 2 84.07$ 0.01$




IP Psych - FFS 225$ 16 75.00$ 0.10$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 520$ 11 259.96$ 0.23$

OP Psych - FFS 6,056$ 328 99.28$ 2.71$

OP D&A - FFS 2,355$ 161 78.49$ 1.05$

Detox - FFS -$ 0 -$ -$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS -$ 0 -$ -$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$




Member MonthsTotal


Inpatient Psych 557,183$ 19 1,211.27$ 1.93$


IPRT -$ 0 -$ -$

Emergency Room 120,719$ 24 206.36$ 0.42$


Outpatient D&A 339,108$ 185 76.22$ 1.18$

Detox 79,398$ 6 518.94$ 0.28$

ACT -$ 0 -$ -$

PROS -$ 0 -$ -$

CDT -$ 0 -$ -$


CPEP -$ 0 -$ -$

TCM -$ 0 -$ -$


Assessment 3,531$ 2 84.07$ 0.01$


CY 2011

CY 2011

CY 2011

286,075

288,307

2,232


State of New York Behavioral Health Carve-In/HARP Data BookWestern TANF_SN Adult


Region: WESTERNPremium Group: TANF/SN ADULTAge Group: Age 21+



IP Psych - FFS 140,545$ 3 608.42$ 0.16$

IP Psych - ENC 3,645,602$ 46 1,072.87$ 4.09$

IP D&A - FFS 12,086$ 1 215.82$ 0.01$

IPRT - FFS 45,093$ 5 112.73$ 0.05$

ER-BH - FFS 25,689$ 3 111.21$ 0.03$

ER-BH - ENC 943,214$ 65 195.12$ 1.06$

OP Psych - FFS 4,257,160$ 965 59.34$ 4.77$

OP Psych - ENC 8,341,223$ 1,741 64.46$ 9.35$

OP D&A - FFS 18,241,065$ 3,000 81.79$ 20.45$

OP D&A - ENC 1,169,652$ 189 83.04$ 1.31$

Detox - FFS 138,366$ 3 649.61$ 0.16$

Detox - ENC 1,010,609$ 30 456.88$ 1.13$

ACT - FFS 689$ 0 114.83$ 0.00$

PROS - FFS 608,481$ 24 341.46$ 0.68$

CDT - FFS 94,668$ 21 61.51$ 0.11$


CPEP - FFS 29,119$ 1 493.54$ 0.03$

TCM - FFS 266,214$ 8 430.77$ 0.30$


Assessment - FFS 1,546$ 0 257.68$ 0.00$

Assessment - ENC 12,430$ 2 89.43$ 0.01$




IP Psych - FFS 1,417,751$ 195 556.20$ 9.02$

IP D&A - FFS 16,650$ 5 268.55$ 0.11$

IPRT - FFS 4,941$ 3 112.30$ 0.03$

ER-BH - FFS 143,299$ 89 123.53$ 0.91$

OP Psych - FFS 1,772,965$ 1,030 131.49$ 11.28$

OP D&A - FFS 4,943,432$ 4,792 78.76$ 31.45$

Detox - FFS 547,091$ 49 846.89$ 3.48$

ACT - FFS -$ 0 -$ -$

PROS - FFS 63,708$ 15 321.76$ 0.41$

CDT - FFS 14,615$ 15 72.00$ 0.09$


CPEP - FFS 192,049$ 30 487.43$ 1.22$

TCM - FFS 43,169$ 7 454.41$ 0.27$


Assessment - FFS 2,638$ 1 164.88$ 0.02$

FFS BH Subtotal 9,200,627$ 6,254 58.54$

Member MonthsTotal


Inpatient Psych 5,203,898$ 71 842.33$ 4.96$

Inpatient D&A 28,736$ 1 243.53$ 0.03$

IPRT 50,034$ 5 112.69$ 0.05$

Emergency Room 1,112,202$ 71 178.67$ 1.06$


Outpatient D&A 24,354,149$ 3,430 81.21$ 23.21$

Detox 1,696,066$ 35 552.28$ 1.62$

ACT 689$ 0 114.83$ 0.00$

PROS 672,189$ 23 339.49$ 0.64$

CDT 109,283$ 20 62.73$ 0.10$


CPEP 221,168$ 5 488.23$ 0.21$

TCM 309,383$ 8 433.92$ 0.29$


Assessment 16,614$ 2 103.19$ 0.02$


CY 2011

CY 2011

CY 2011

892,075

1,049,244

157,169


State of New York Behavioral Health Carve-In/HARP Data BookWestern SSI


Region: WESTERNPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 581,209$ 67 596.72$ 3.33$

IP Psych - ENC 127,106$ 26 334.49$ 0.73$

IP D&A - FFS 36,368$ 8 319.02$ 0.21$

IPRT - FFS 17,051$ 11 110.72$ 0.10$

ER-BH - FFS 12,777$ 7 119.41$ 0.07$

ER-BH - ENC 127,200$ 44 198.75$ 0.73$

OP Psych - FFS 1,728,869$ 819 145.34$ 9.92$

OP Psych - ENC 630,278$ 1,369 31.69$ 3.62$

OP D&A - FFS 1,838,875$ 1,228 103.06$ 10.55$

OP D&A - ENC 46,319$ 15 218.48$ 0.27$

Detox - FFS 56,279$ 6 662.10$ 0.32$

Detox - ENC 30,558$ 3 664.30$ 0.18$

ACT - FFS 38,764$ 16 165.66$ 0.22$

PROS - FFS 282,690$ 51 380.98$ 1.62$

CDT - FFS 162,702$ 193 58.13$ 0.93$


CPEP - FFS 9,362$ 1 492.74$ 0.05$

TCM - FFS 217,648$ 34 444.18$ 1.25$


Assessment - FFS 653$ 0 217.63$ 0.00$

Assessment - ENC 1,486$ 2 67.53$ 0.01$




IP Psych - FFS 224,623$ 191 512.84$ 8.15$

IP D&A - FFS 17,093$ 25 299.89$ 0.62$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 11,775$ 40 127.99$ 0.43$

OP Psych - FFS 191,470$ 606 137.45$ 6.94$

OP D&A - FFS 308,553$ 1,199 111.96$ 11.19$

Detox - FFS 89,350$ 30 1,276.43$ 3.24$

ACT - FFS 18,668$ 54 151.77$ 0.68$

PROS - FFS 41,264$ 42 429.84$ 1.50$

CDT - FFS 10,050$ 66 66.56$ 0.36$


CPEP - FFS 9,992$ 9 475.79$ 0.36$

TCM - FFS 30,255$ 31 426.13$ 1.10$


Assessment - FFS 124$ 0 123.61$ 0.00$

FFS BH Subtotal 953,217$ 2,293 34.57$

Member MonthsTotal


Inpatient Psych 932,938$ 107 520.61$ 4.62$

Inpatient D&A 53,462$ 10 312.64$ 0.26$

IPRT 17,051$ 9 110.72$ 0.08$

Emergency Room 151,752$ 50 180.87$ 0.75$


Outpatient D&A 2,193,746$ 1,237 105.42$ 10.87$

Detox 176,187$ 12 876.55$ 0.87$

ACT 57,432$ 21 160.87$ 0.28$

PROS 323,955$ 50 386.58$ 1.60$

CDT 172,752$ 175 58.56$ 0.86$


CPEP 19,354$ 2 483.84$ 0.10$

TCM 247,903$ 33 441.89$ 1.23$


Assessment 2,262$ 2 87.01$ 0.01$


CY 2011

CY 2011

CY 2011174,315

201,892

27,577


State of New York Behavioral Health Carve-In/HARP Data BookAll Regions FHPlus


Region: All RegionsPremium Group: FHPlusAge Group: Age 21+




IP Psych - ENC 4,380,977$ 9 1,336.07$ 0.98$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS -$ 0 -$ -$

ER-BH - ENC 854,529$ 16 147.33$ 0.19$

OP Psych - FFS 23,632$ 1 106.45$ 0.01$

OP Psych - ENC 15,327,240$ 589 69.78$ 3.42$

OP D&A - FFS 59,672$ 2 105.24$ 0.01$

OP D&A - ENC 2,528,042$ 69 97.94$ 0.56$

Detox - FFS -$ 0 -$ -$

Detox - ENC 497,052$ 3 425.56$ 0.11$

ACT - FFS -$ 0 -$ -$

PROS - FFS -$ 0 -$ -$

CDT - FFS 2,817$ 0 148.24$ 0.00$


CPEP - FFS -$ 0 -$ -$

TCM - FFS -$ 0 -$ -$



Assessment - ENC 17,620$ 1 49.77$ 0.00$




IP Psych - FFS 21,613$ 22 527.14$ 0.97$

IP D&A - FFS -$ 0 -$ -$

IPRT - FFS -$ 0 -$ -$

ER-BH - FFS 1,589$ 7 122.23$ 0.07$

OP Psych - FFS 23,107$ 132 93.55$ 1.03$

OP D&A - FFS 13,102$ 102 68.96$ 0.59$

Detox - FFS 9,044$ 1 4,522.06$ 0.40$

ACT - FFS -$ 0 -$ -$

PROS - FFS 2,069$ 4 258.63$ 0.09$

CDT - FFS -$ 0 -$ -$


CPEP - FFS 502$ 1 251.24$ 0.02$

TCM - FFS 503$ 1 503.00$ 0.02$



FFS BH Subtotal 71,529$ 270 3.20$

Member MonthsTotal


Inpatient Psych 4,402,589$ 9 1,326.08$ 0.98$


IPRT -$ 0 -$ -$

Emergency Room 856,118$ 16 147.28$ 0.19$


Outpatient D&A 2,600,816$ 71 97.89$ 0.58$

Detox 506,096$ 3 432.56$ 0.11$

ACT -$ 0 -$ -$

PROS 2,069$ 0 258.63$ 0.00$

CDT 2,817$ 0 148.24$ 0.00$


CPEP 502$ 0 251.24$ 0.00$

TCM 503$ 0 503.00$ 0.00$


Assessment 17,620$ 1 49.77$ 0.00$


CY 2011

CY 2011

CY 2011

4,477,496

4,499,883

22,387


State of New York Behavioral Health Carve-In/HARP Data BookAll Regions TANF_SN Adult


Region: All RegionsPremium Group: TANF/SN ADULTAge Group: Age 21+



IP Psych - FFS 416,671$ 1 656.17$ 0.03$

IP Psych - ENC 34,336,277$ 20 1,532.05$ 2.55$

IP D&A - FFS 84,040$ 0 225.31$ 0.01$

IPRT - FFS 202,957$ 2 106.93$ 0.02$

ER-BH - FFS 42,760$ 0 113.12$ 0.00$

ER-BH - ENC 5,424,446$ 32 148.93$ 0.40$

OP Psych - FFS 31,074,111$ 334 82.83$ 2.31$

OP Psych - ENC 66,929,791$ 891 66.86$ 4.97$

OP D&A - FFS 151,823,575$ 1,444 93.64$ 11.27$

OP D&A - ENC 8,272,783$ 59 124.27$ 0.61$

Detox - FFS 198,655$ 0 741.25$ 0.01$

Detox - ENC 6,277,426$ 14 404.03$ 0.47$

ACT - FFS 154,579$ 1 226.99$ 0.01$

PROS - FFS 1,640,147$ 4 366.27$ 0.12$

CDT - FFS 1,558,524$ 18 76.45$ 0.12$


CPEP - FFS 29,616$ 0 493.60$ 0.00$

TCM - FFS 1,568,357$ 3 474.40$ 0.12$


Assessment - FFS 1,546$ 0 257.68$ 0.00$

Assessment - ENC 96,728$ 2 48.53$ 0.01$




IP Psych - FFS 27,226,073$ 186 742.04$ 11.48$

IP D&A - FFS 104,350$ 2 342.13$ 0.04$

IPRT - FFS 16,944$ 1 102.07$ 0.01$

ER-BH - FFS 1,785,826$ 65 138.60$ 0.75$

OP Psych - FFS 25,185,459$ 841 151.62$ 10.62$

OP D&A - FFS 71,796,383$ 3,828 94.93$ 30.28$

Detox - FFS 12,257,862$ 69 898.67$ 5.17$

ACT - FFS 45,599$ 1 218.18$ 0.02$

PROS - FFS 263,771$ 4 350.29$ 0.11$

CDT - FFS 660,611$ 50 67.08$ 0.28$


CPEP - FFS 1,171,719$ 13 444.00$ 0.49$

TCM - FFS 317,642$ 3 501.01$ 0.13$


Assessment - FFS 38,819$ 1 171.77$ 0.02$

FFS BH Subtotal 141,271,971$ 5,076 59.58$

Member MonthsTotal


Inpatient Psych 61,979,020$ 45 1,037.51$ 3.91$

Inpatient D&A 188,390$ 1 277.86$ 0.01$

IPRT 219,901$ 2 106.54$ 0.01$

Emergency Room 7,253,032$ 38 145.98$ 0.46$


Outpatient D&A 231,892,741$ 1,851 94.88$ 14.64$

Detox 18,733,943$ 22 636.24$ 1.18$

ACT 200,178$ 1 224.92$ 0.01$

PROS 1,903,918$ 4 363.97$ 0.12$

CDT 2,219,135$ 23 73.40$ 0.14$


CPEP 1,201,335$ 2 445.10$ 0.08$

TCM 1,885,999$ 3 478.68$ 0.12$


Assessment 137,093$ 2 61.61$ 0.01$


CY 2011

CY 2011

CY 2011

13,473,797

15,844,766

2,370,969


State of New York Behavioral Health Carve-In/HARP Data BookAll Regions SSI


Region: All RegionsPremium Group: SSIAge Group: Age 21+



IP Psych - FFS 10,810,257$ 85 749.62$ 5.33$

IP Psych - ENC 2,080,431$ 23 540.51$ 1.03$

IP D&A - FFS 194,153$ 2 460.08$ 0.10$

IPRT - FFS 123,202$ 6 118.81$ 0.06$

ER-BH - FFS 19,643$ 1 85.03$ 0.01$

ER-BH - ENC 807,046$ 32 147.27$ 0.40$

OP Psych - FFS 33,701,406$ 1,031 193.51$ 16.62$

OP Psych - ENC 4,409,646$ 415 62.96$ 2.18$

OP D&A - FFS 37,660,848$ 1,905 117.04$ 18.58$

OP D&A - ENC 1,368,953$ 21 379.53$ 0.68$

Detox - FFS 131,660$ 1 707.85$ 0.06$

Detox - ENC 564,271$ 7 470.23$ 0.28$

ACT - FFS 1,211,670$ 32 221.51$ 0.60$

PROS - FFS 1,489,126$ 20 435.04$ 0.73$

CDT - FFS 1,517,504$ 119 75.71$ 0.75$


CPEP - FFS 105,482$ 1 473.01$ 0.05$

TCM - FFS 2,332,663$ 28 488.52$ 1.15$


Assessment - FFS 715$ 0 178.73$ 0.00$

Assessment - ENC 21,196$ 3 47.63$ 0.01$




IP Psych - FFS 3,338,200$ 135 737.56$ 8.28$

IP D&A - FFS 74,603$ 5 457.69$ 0.19$

IPRT - FFS 1,091$ 0 77.96$ 0.00$

ER-BH - FFS 201,438$ 42 142.36$ 0.50$

OP Psych - FFS 6,414,801$ 961 198.59$ 15.91$

OP D&A - FFS 11,226,821$ 2,878 116.09$ 27.84$

Detox - FFS 1,189,556$ 33 1,074.58$ 2.95$

ACT - FFS 130,701$ 24 162.56$ 0.32$

PROS - FFS 198,622$ 15 407.01$ 0.49$

CDT - FFS 257,008$ 116 65.71$ 0.64$


CPEP - FFS 75,671$ 5 447.76$ 0.19$

TCM - FFS 304,082$ 18 492.84$ 0.75$


Assessment - FFS 31,830$ 3 274.40$ 0.08$

FFS BH Subtotal 23,467,235$ 4,239 58.20$

Member MonthsTotal


Inpatient Psych 16,228,888$ 113 711.92$ 6.68$

Inpatient D&A 268,756$ 3 459.41$ 0.11$

IPRT 124,293$ 5 118.26$ 0.05$

Emergency Room 1,028,126$ 35 144.28$ 0.42$


Outpatient D&A 50,256,622$ 2,084 119.06$ 20.68$

Detox 1,885,487$ 12 756.31$ 0.78$

ACT 1,342,371$ 31 213.96$ 0.55$

PROS 1,687,747$ 19 431.54$ 0.69$

CDT 1,774,512$ 118 74.08$ 0.73$


CPEP 181,153$ 2 462.12$ 0.07$

TCM 2,636,745$ 27 489.01$ 1.08$


Assessment 53,741$ 3 95.12$ 0.02$


CY 2011

CY 2011

CY 20112,027,286

2,430,530

403,244



STATE OF NEW YORK

MERCER 68

APPENDIX A

Risk FactorsMedicaid beneficiaries who are eligible for MMC MCOs are eligible for enrollment in the HARP ifthey meet either:

• Target criteria and risk factors as defined below (individuals meeting these criteria will beidentified through quarterly Medicaid data reviews by the plans and/or the State); or

• Service system or service provider identification of individuals presenting with seriousfunctional deficits as determined by:

A case review of individual’s usage history to determine if target criteria and risk factorsare met; or

Completion of HARP eligibility screen.

Risk Factors: For individuals meeting the targeting criteria, HARP enrollment will occur whenany of the following risk factors exist:

• Meets the HARP eligibility screen criteria that at least includes the needs-based criteria for1915(i)-like eligibility.

• Supplemental Security Income (SSI) individuals who received an "organized" MH service, inthe year prior to enrollment.

• Non-SSI individuals with three or more months of ACT or TCM, PROS or Prepaid MentalHealth Plan services in the year prior to enrollment.

• SSI and non-SSI individuals with more than 30 days of Psychiatric Inpatient services in thethree years prior to enrollment.

• SSI and non-SSI individuals with three or more Psychiatric Inpatient admissions in the threeyears prior to enrollment.

• SSI and non-SSI individuals discharged from OMH Psychiatric Center after an Inpatient staygreater than 60 days in the year prior to enrollment.

• SSI and non-SSI individuals with a current or expired Assisted Outpatient Treatment order inthe five years prior to enrollment.

• SSI and non-SSI individuals discharged from correctional facilities with a history of Inpatientor Outpatient BH treatment in the four years prior to enrollment.

• Residents in OMH-funded housing for persons with SMI in any of the three years prior toenrollment.

• Members with two or more services in an Inpatient/Outpatient Chemical DependenceDetoxification program within the year prior to enrollment.

• Members with one Inpatient stay with a SUD primary diagnosis within the year prior toenrollment.


STATE OF NEW YORK

MERCER 69

• Members with two or more Inpatient Hospital admissions with SUD primary diagnosis ormembers with an Inpatient Hospital admission for an SUD related medical diagnosis-relatedgroup and a secondary diagnosis of SUD within the year prior to enrollment.

• Members with two or more emergency department visits with primary substance usediagnosis or primary medical non-substance use that is related to a secondary substanceuse diagnosis within the year prior to enrollment.

• Individuals transitioning with a history of involvement in children’s services (e.g., ResidentialTreatment Facility, Home and Community-based services (HCBS), B2H waiver, ResidentialRehabilitation Services for Youth).

Needs-based Criteria: All individuals in the HARP will be evaluated for eligibility for 1915(i)-likeservices. Individuals for whom it is believed that they will be eligible for the 1915(i)-like serviceswill receive a conflict-free evaluation/assessment from an appropriately qualified individual,using a standardized clinical and functional assessment tool consistent with the State’sapproved Balancing Incentive Payment Program. Individuals meeting one of the needs-basedcriteria identified below, which are less stringent than HCBS institutional levels of care, will beeligible for 1915(i)-like services:

• An individual with at least “moderate” levels of need as indicated by a State designatedscore on a tool derived from the interRAI Assessment Suite.

• An individual with need for HCBS services as indicated by a face to face assessment withthe interRAI Assessment Suite and a risk factor of a newly-emerged psychotic disordersuggestive of Schizophrenia herein called individuals with First Episode Psychosis (FEP).Individuals with FEP may have minimal service history.

• A HARP-enrolled individual who either previously met the needs-based criteria above or hasone of the needs-based historical risk factors identified above; AND who is assessed andfound that, but for the provision of HCBS for stabilization and maintenance purposes, woulddecline to prior levels of need (i.e., subsequent medically necessary services andcoordination of care for stabilization and maintenance is needed to prevent decline toprevious needs-based functioning).

Mercer (US) Inc.333 South 7th Street, Suite 1400Minneapolis, MN 55402+1 612 642 8600

Documents

DATA BOOK FOR BEHAVIORAL HEALTH: MAINSTREAM PLANS AND