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(1)

SUMMARY STATISTICS

AS OF JULY 1, 2011

MEDICAID

MANAGED

(2)

2011 M

EDICAID

M

ANAGED

C

ARE

E

NROLLMENT

R

EPORT

S

UMMARY

S

TATISTICS AS OF

J

ULY

1,

2011

This report is composed annually by the Data and Systems Group (DSG) of the Centers

for Medicare & Medicaid Services (CMS). The Enrollment Report profiles Medicaid

managed care programs on a plan-specific basis as of July 1, 2011. County level data

are not collected. The information was collected from State Medicaid agencies and

CMS Regional Offices. Data are presented for all States, the District of Columbia,

Puerto Rico, and the Virgin Islands. Data are not presented for the following territories:

Guam, Northern Mariana Islands, and American Somoa. Special Thanks to Loan

Swisher, Carolyn Lawson, and Joseph Del Pilar of DSG for developing this publication.

Please contact Loan Swisher at 410-786-4650; E-mail:

loan.swisher@cms.hhs.gov

,

Carolyn Lawson at 410-786-0704; Email:

carolyn.lawson@cms.hhs.gov

or Joe Del Pilar

at 410-786-0081; E-mail

joseph.delpilar@cms.hhs.gov

if you have any questions

(3)

Medicaid Managed Care Enrollment Report as of July 1, 2011

Table of Contents

Managed Care Trends (2002-2011) and National Breakout of

Managed Care Entities and Enrollment charts ... Page 1

Total Medicaid Population (in percentages) Distribution

by Year: Managed Care versus “Other” from 2006-2011 ... Page 2

Total Medicaid Population (in millions) Distribution

by Year: Managed Care versus “Other” from 2006-2011 ... Page 3

Medicaid Managed Care Penetration Rates by State... Page 4

Managed Care Entity Type Enrollment by State ... Page 5

Number of Managed Care Entities by State ... Page 6

Top 20 Medicaid Managed Care States ... Page 7

Regional Breakout of Medicaid Managed Care Enrollment &

States with Comprehensive Health Care Reform Demonstrations ... Page 8

Prepaid Ambulatory Health Plans (PAHPs) and Enrollment by State ... Page 9

Prepaid Inpatient Health Plans (PIHPs) and Enrollment by State ... Page 10

Medicaid Dual Eligible Enrollment by State ... Page 11

Dual Eligible Enrollment by Managed Care Entity Type ... Page 12

Dual Eligible Enrollment by Plan ... Page 13

Medicaid Managed Care Enrollment Plan level data by State ... Page 23

Facts Sheet (Major changes from 7/1/2010-7/1/2011)…..…………..…Page 80

New Medicaid Managed Care Plans………Page 83

Terminated Medicaid Managed Care Plans……….Page 85

Glossary………Page 86

(4)

NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

AS OF July 1, 2011

1

TOTAL MEDICAID

MANAGED CARE

OTHER

% MANAGED CARE

YEAR

POPULATION

POPULATION

POPULATION

ENROLLMENT

2011

57,106,941

42,384,539

14,722,402

74.22%

2010

54,612,393

39,020,325

15,592,068

71.45%

2009

50,471,859

36,202,281

14,269,578

71.73%

2008

47,142,791

33,427,582

13,715,209

70.91%

2007

45,962,271

29,463,098

16,499,173

64.10%

2006

45,652,642

29,830,406

15,822,236

65.34%

2005

45,392,325

28,575,585

16,816,740

62.95%

2004

44,355,955

26,913,570

17,442,385

60.68%

2003

42,740,719

25,262,873

17,477,846

59.11%

2002

40,147,539

23,117,668

17,029,871

57.58%

These figures represent point-in-time enrollment as of June 30th from 2002 -2009 and as of July 1st for 2010-2011. The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. This table also provides unduplicated national figures for the Total Medicaid population and Other population. The statistics also include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.

NATIONAL BREAKOUT OF MANAGED CARE ENTITIES AND ENROLLMENT AS OF JULY 1, 2011

MANAGED CARE ENTITY TYPE # OF PLANS # OF ENROLLEES

Health Insuring Organization 5 959,590

Commercial Managed Care

Organization 157 11,937,912

Medicaid-only Managed Care

Organization 175 16,223,580

Primary Care Case Management 40 8,904,584

Prepaid Inpatient Health Plan 163 9,710,324

Prepaid Ambulatory Health Plan 63 12,264,859

Program of ALL-inclusive Care for the

Elderly 79 22,714

Other 11 1,483,143

TOTAL 693 61,506,706

This table provides duplicated figures by plan type. The total number of enrollees include individuals who were 19,122,167 individuals who were enrolled in more than one managed care plan. It also includes individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.

(5)

NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

2

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

2005

2006

2007

2008

2009

2010

2011

62.95% 65.34% 64.10% 70.91% 71.73% 71.45% 74.22% 37.05% 34.66% 35.90% 29.09% 28.27% 28.55% 25.78%

Pe

rc

ent

of

Tot

al

M

edi

ca

id Popul

at

ion

Year

Total Annual Medicaid Population Distribution by Year: Managed Care v. Other

as of July 1, 2011

Other

(6)

NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

* Note: Numbers may not add up to totals due to rounding.

3

0.00

10.00

20.00

30.00

40.00

50.00

60.00

2005

2006

2007

2008

2009

2010

2011

28.58 29.83 29.46 33.43 36.20 39.02 42.38 16.82 15.82 16.50 13.72 14.72 15.59 14.72

Tot

al

M

edi

ca

id Popul

at

ion

(in m

ill

ions

)

Year

Total Annual Medicaid Population Distribution by Year: Managed Care v. Other

as of July 1, 2011

Other

(7)

4

ROW

STATE

MEDICAID

MANAGED CARE

PERCENT IN

NUMBER

ENROLLMENT

ENROLLMENT

MANAGED CARE

1

ALABAMA

930,736

568,332

61.06%

2

ALASKA

120,611

0

0.00%

3

ARIZONA

1,351,988

1,198,818

88.67%

4

ARKANSAS

608,332

477,060

78.42%

5

CALIFORNIA

7,580,978

4,553,090

60.06%

6

COLORADO

583,618

551,972

94.58%

7

CONNECTICUT

578,620

396,960

68.60%

8

DELAWARE

200,810

161,655

80.50%

9

DISTRICT OF COLUMBIA

201,777

136,003

67.40%

10

FLORIDA

3,069,456

1,958,679

63.81%

11

GEORGIA

1,548,090

1,413,643

91.32%

12

HAWAII

272,218

268,645

98.69%

13

IDAHO

230,725

230,725

100.00%

14

ILLINOIS

2,787,200

1,888,500

67.76%

15

INDIANA

1,055,779

741,744

70.26%

16

IOWA

440,993

401,785

91.11%

17

KANSAS

354,664

310,036

87.42%

18

KENTUCKY

823,133

735,978

89.41%

19

LOUISIANA

1,208,859

789,871

65.34%

20

MAINE

357,706

176,335

49.30%

21

MARYLAND

986,304

735,859

74.61%

22

MASSACHUSETTS

1,566,222

832,064

53.13%

23

MICHIGAN

1,818,312

1,606,688

88.36%

24

MINNESOTA

847,638

556,665

65.67%

25

MISSISSIPPI

621,607

541,854

87.17%

26

MISSOURI

895,998

875,227

97.68%

27

MONTANA

106,493

81,085

76.14%

28

NEBRASKA

237,484

202,189

85.14%

29

NEVADA

297,640

248,819

83.60%

30

NEW HAMPSHIRE

135,092

0

0.00%

31

NEW JERSEY

1,098,608

853,645

77.70%

32

NEW MEXICO

551,017

401,318

72.83%

33

NEW YORK

4,925,236

3,777,868

76.70%

34

NORTH CAROLINA

1,488,263

1,238,563

83.22%

35

NORTH DAKOTA

66,698

42,423

63.60%

36

OHIO

2,129,706

1,605,821

75.40%

37

OKLAHOMA

684,387

591,850

86.48%

38

OREGON

652,846

640,912

98.17%

39

PENNSYLVANIA

2,134,956

1,740,659

81.53%

40

PUERTO RICO

1,089,058

896,562

82.32%

41

RHODE ISLAND

197,248

135,253

68.57%

42

SOUTH CAROLINA

862,145

862,145

100.00%

43

SOUTH DAKOTA

120,474

91,268

75.76%

44

TENNESSEE

1,218,676

1,218,676

100.00%

45

TEXAS

3,943,189

2,786,985

70.68%

46

UTAH

269,643

268,984

99.76%

47

VERMONT

177,108

103,529

58.46%

48

VIRGIN ISLANDS

10,924

0

0.00%

49

VIRGINIA

915,038

532,292

58.17%

50

WASHINGTON

1,182,587

1,041,904

88.10%

51

WEST VIRGINIA

326,749

166,555

50.97%

52

WISCONSIN

1,173,355

747,046

63.67%

53

WYOMING

69,947

0

0.00%

TOTALS

57,106,941

42,384,539

74.22%

The unduplicated Medicaid enrollment figures include individuals in State health care reform programs that expand

eligibility beyond traditional Medicaid eligibility standards. The unduplicated managed care enrollment figures

includes enrollees receiving comprehensive and limited benefits.

(8)

5 Commercial Medicaid-only

STATE HIO MCO MCO PCCM PIHP PAHP PACE OTHER

Alabama 0 0 0 546,500 0 21,832 0 0 Alaska 0 0 0 0 0 0 0 0 Arizona 0 0 1,198,818 0 124,491 0 0 0 Arkansas 0 0 0 375,809 0 470,209 70 0 California 959,590 3,494,439 69,809 0 176,109 515,046 2,757 0 Colorado 0 0 46,962 48,601 572,491 0 1,711 0 Connecticut 0 94,423 302,002 535 0 0 0 1,157,240 Delaware 0 0 154,904 0 0 0 0 6,751 Dist of Columbia 0 0 137,424 0 4,626 51,617 0 0 Florida 0 823,342 425,922 607,852 835,222 288,876 528 15,941 Georgia 0 0 951,408 162,161 0 1,413,643 0 0 Hawaii 0 190,517 76,302 0 0 0 0 0 Idaho 0 0 0 210,172 0 441,460 0 0 Illinois 0 141,116 72,301 1,675,100 0 0 0 0 Indiana 0 705,708 0 34,815 0 0 0 1,221 Iowa 0 0 0 196,450 401,785 383,735 97 0 Kansas 0 0 181,540 26,722 296,449 419,958 297 0 Kentucky 0 0 171,142 361,764 0 735,978 0 0 Louisiana 0 0 0 765,935 0 0 262 23,759 Maine 0 0 0 176,335 0 0 0 0 Maryland 0 0 735,856 0 0 51,584 113 708 Massachusetts 0 168,967 341,388 323,828 323,828 0 2,723 0 Michigan 0 0 1,211,393 0 1,606,688 312,918 686 0 Minnesota 0 503,142 53,523 0 0 0 0 0 Mississippi 0 0 51,626 0 0 541,854 0 0 Missouri 0 0 406,796 0 0 447,317 176 0 Montana 0 0 0 153,588 0 0 0 74,653 Nebraska 0 100,972 0 7,282 0 0 0 202,189 Nevada 0 90,328 78,523 0 0 248,819 0 0 New Hampshire 0 0 0 0 0 0 0 0 New Jersey 0 853,645 0 0 853,645 379 0 New Mexico 0 401,318 0 374,013 0 372 0 New York 0 1,028,627 2,697,017 14,091 34,357 0 3,776 North Carolina 0 0 0 1,148,879 89,501 0 183 0 North Dakota 0 0 0 42,423 0 3,196 56 0 Ohio 0 0 1,605,042 0 0 0 779 0 Oklahoma 0 0 0 439,228 0 591,850 79 0 Oregon 0 69,836 427,151 3,090 552,553 571,046 867 0 Pennsylvania 0 1,152,069 0 302,300 1,711,897 514,939 2,676 0 Puerto Rico 0 1,040,493 0 0 859,271 0 0 0 Rhode Island 0 45,545 89,504 1,920 0 54,675 204 0 South Carolina 0 0 428,765 142,296 0 862,145 387 0 South Dakota 0 0 0 91,268 0 0 0 0 Tennessee 0 0 1,174,007 0 44,669 1,828,753 317 0 Texas 0 259,451 1,612,932 914,602 437,122 6,668 984 0 Utah 0 850 50,636 71,658 225,761 314,394 0 0 Vermont 0 0 103,529 0 0 0 108 0 Virgin Islands 0 0 0 0 0 0 0 0 Virginia 0 363,181 169,111 54,019 0 318,184 700 0 Washington 0 730,592 0 0 1,004,647 518 399 550 West Virginia 0 166,555 0 5,361 0 0 0 0 Wisconsin 0 366,441 344,602 0 34,975 0 1,028 0 Wyoming 0 0 0 0 0 0 0 0 TOTALS 959,590 11,937,912 16,223,580 8,904,584 9,710,455 12,264,859 22,714 1,483,012 This table provides duplicated figures that include enrollees receiving comprehensive and limited benefits. Total number of enrollees includes those who were enrolled in more than one managed care plan. Figures also include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.

(9)

6

Commercial

Medicaid-

only

STATE

HIO

MCO

MCO

PCCM

PIHP

PAHP

PACE

OTHER

Alabama 0 0 0 1 0 1 0 0 Alaska 0 0 0 0 0 0 0 0 Arizona 0 0 29 0 1 0 0 0 Arkansas 0 0 0 1 0 1 1 0 California 5 21 3 0 10 13 5 0 Colorado 0 0 1 3 6 0 3 0 Connecticut 0 1 2 1 0 0 0 2 Delaware 0 0 2 0 0 0 0 1 Dist of Columbia 0 0 2 0 1 1 0 0 Florida 0 22 6 1 27 6 3 2 Georgia 0 0 3 1 0 1 0 0 Hawaii 0 4 1 0 0 0 0 0 Idaho 0 0 0 1 0 3 0 0 Illinois 0 2 3 1 0 0 0 0 Indiana 0 6 0 2 0 0 0 1 Iowa 0 0 0 1 1 1 1 0 Kansas 0 0 2 1 1 2 2 0 Kentucky 0 0 1 1 0 1 0 0 Louisiana 0 0 0 1 0 0 2 1 Maine 0 0 0 1 0 0 0 0 Maryland 0 0 7 0 0 5 1 1 Massachusetts 0 3 6 1 1 0 6 0 Michigan 0 0 14 0 18 1 4 0 Minnesota 0 5 3 0 0 0 0 0 Mississippi 0 0 2 0 0 1 0 0 Missouri 0 0 12 0 0 1 1 0 Montana 0 0 0 2 0 0 0 1 Nebraska 0 2 0 1 0 0 0 1 Nevada 0 1 1 0 0 1 0 0 New Hampshire 0 0 0 0 0 0 0 0 New Jersey 0 0 4 0 0 1 3 0 New Mexico 0 6 0 0 1 0 1 0 New York 0 20 13 3 22 0 7 0 North Carolina 0 0 0 2 1 0 4 0 North Dakota 0 0 0 1 0 1 1 0 Ohio 0 0 7 0 0 0 2 0 Oklahoma 0 0 0 2 0 1 1 0 Oregon 0 2 13 1 10 8 1 0 Pennsylvania 0 12 0 1 37 2 15 0 Puerto Rico 0 9 0 0 1 0 0 0 Rhode Island 0 1 1 1 0 1 1 0 South Carolina 0 0 4 3 0 2 2 0 South Dakota 0 0 0 1 0 0 0 0 Tennessee 0 0 6 0 1 2 1 0 Texas 0 6 14 1 1 1 3 0 Utah 0 1 1 1 10 2 0 0 Vermont 0 0 1 0 0 0 1 0 Virgin Islands 0 0 0 0 0 0 0 0 Virginia 0 3 2 1 0 1 5 0 Washington 0 8 0 0 2 2 1 1 West Virginia 0 3 0 1 0 0 0 0 Wisconsin 0 19 9 0 11 0 1 0 Wyoming 0 0 0 0 0 0 0 0

TOTALS

5 157 175 40 163 63 79 11

(10)

7

MEDICAID MANAGED CARE ENROLLMENT AS OF 7/1/2011

STATES 1-10

Rank

States

Waiver Type

Managed Care Enrollment

1 California

1115, 1915(a), PACE

4,553,090

2 New York

1115, 1915(a), PACE

3,777,868

3 Texas

1915(b), 1932(a), 1915(a), 1915(b)/(c), PACE

2,786,985

4 Florida

1915(b), 1115(a), 1915(b)/(c), 1915(a)/(c), PACE

1,958,679

5 Illinois

1932(a), 1915(a)

1,888,500

6 Pennsylvania

1915(b), 1915(a), 1902(a)(70), PACE

1,740,659

7 Michigan

1915(b), 1915(b)/1915(c), PACE

1,576,588

8 Ohio

1932(a), PACE

1,605,821

9 Georgia

1932(a), 1902(a)(70)

1,413,643

7 North Carolina

1915(b)/(c), 1932(a), PACE

1,238,563

Subtotal

22,540,396

National Managed Care Grand Total

42,384,539

Percentage

53.18%

STATES 11-20

11 Tennessee

1115

1,218,676

12 Arizona

1115

1,198,818

13 Washington

1115, 1915(b), 1932(a), 1937, PACE

1,041,904

14 Puerto Rico

1915(a)

896,562

15 Missouri

1915(b), 1902(a)(70), PACE

875,227

16 South Carolina

1932(a), 1902(a)(70), PACE

862,145

17 New Jersey

1915(b), 1932(a), 1902(a)(70), PACE

853,645

18 Massachusetts

1115(a), 1915(a)/(c), PACE

832,064

19 Louisiana

1115, 1932(a), PACE

789,871

20 Wisconsin

1915(b), 1915(a), 1932(a), 1915(b)/(c),

1932(a)/19159(c), PACE

747,046

Subtotal

9,315,958

National Managed Care Grand Total

42,384,539

Percentage

21.98%

(11)

REGIONAL BREAK-OUT OF MEDICAID MANAGED CARE ENROLLMENT AS OF JULY 1, 2011

REGION MEDICAID MANAGED CARE % REGION BENEFICIARIES % NATIONAL MANAGED

ENROLLMENT ENROLLMENT ENROLLED IN MANAGED CARE CARE ENROLLMENT

I - Boston 3,011,996 1,644,141 54.59% 3.88% II - New York 7,123,826 5,528,075 77.60% 13.04% III - Philadelphia 4,765,634 3,473,023 72.88% 8.19% IV - Atlanta 10,562,106 8,537,870 80.83% 20.14% V - Chicago 9,811,990 7,146,464 72.83% 16.86% VI - Dallas 6,995,784 5,047,084 72.14% 11.91%

VII - Kansas City 1,929,139 1,789,237 92.75% 4.22%

VIII - Denver 1,216,873 1,035,732 85.11% 2.44%

IX - San Francisco 9,502,824 6,269,372 65.97% 14.79%

X - Seattle 2,186,769 1,913,541 87.51% 4.51%

TOTALS 57,106,941 42,384,539 74.22% 100.00%

The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. This table also provides unduplicated Medicaid enrollment figures by region. The enrollment figures include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.

STATES WITH COMPREHENSIVE HEALTH CARE REFORM DEMONSTRATIONS AS OF JULY 1, 2011

STATE MEDICAID EXPANSION MANAGED CARE % ENROLLED

ENROLLMENT ENROLLMENT ENROLLMENT IN MANAGED CARE

Arizona 1,351,988 220,020 1,198,818 88.67% Arkansas 608,332 5,978 477,060 78.42% California 7,580,978 175,978 4,553,090 60.06% Delaware 200,810 35,092 161,655 80.50% Florida 3,069,456 283,841 1,958,679 63.81% Hawaii 272,218 31,279 268,645 98.69% Indiana 1,055,779 41,291 741,744 70.26% Iowa 440,993 50,280 401,785 91.11% Kentucky 823,133 0 735,978 89.41% Maryland 986,304 51,586 735,859 74.61% Massachusetts 1,566,222 88,893 832,064 53.13% Minnesota 847,638 87,770 556,665 65.67% New Mexico 551,017 26,665 401,318 72.83% New York 4,925,236 407,782 3,777,868 76.70% Oregon 652,846 70,347 640,912 98.17% Rhode Island 197,248 24,191 135,253 68.57% Tennessee 1,218,676 28,203 1,218,676 100.00% Utah 269,643 44,557 268,984 99.76% Vermont 177,108 36,375 103,529 58.46% Washington 1,182,587 37,257 1,041,904 88.10% TOTALS 27,978,212 1,747,385 20,210,486 72.24%

The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. This table also provides unduplicated Medicaid and Expansion enrollment figures. The enrollment figures include

individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.

(12)

9

State

Medical

Only

Medical Only

Enrollees

Mental

Health

Mental

Health

Enrollees

Dental

Dental

Enrollees Transportation

Transportation

Enrollees

Disease

Management

Disease

Management

Enrollees

*Other

*Other

Enrollees

ALABAMA

1

21,832

ARKANSAS

1

470,209

CALIFORNIA

13

515,046

DISTRICT OF COLUMBIA

1

51,617

FLORIDA

2

258,547

1

24,406

3

5,923

GEORGIA

1

1,413,643

IDAHO

1

563

1

210,172

1

230,725

IOWA

1

383,735

KANSAS

1

296,449

1

123,509

KENTUCKY

1

735,978

MARYLAND

5

51,584

MICHIGAN

1

312,918

MISSISSIPPI

1

541,854

MISSOURI

1

447,317

NEVADA

1

248,819

NEW JERSEY

1

853,645

NORTH DAKOTA

1

3,196

OKLAHOMA

1

591,850

OREGON

8

571,046

PENNSYLVANIA

1

454,519

1

60,420

RHODE ISLAND

1

54,675

SOUTH CAROLINA

2

862,145

TENNESSEE

1

747,958

1

1,080,795

TEXAS

1

6,668

UTAH

1

45,410

1

268,984

VIRGINIA

1

318,184

WASHINGTON

2

518

Total

9

589,598

1

296,449

27 2,670,362

17

7,550,930

8

76,725

1

1,080,795

*Other Tennessee - Pharmacy Benefit Manager PAHP

Number of Substance Use Disorder PAHP - 0

(13)

10

State

Medical

Only

Medical

Only

Enrollees

Mental

Health

Mental

Health

Enrollees MH & SUD

MH & SUD

Enrollees

SUD

SUD

Enrollees

Long Term

Care

Long Term

care

Enrollees

ARIZONA

1

124,491

CALIFORNIA

9

175,978

1

131

COLORADO

1

20,519

5

551,972

DISTRICT OF COLUMBIA

1

4,626

FLORIDA

4

132,230

6

685,639

17

17,353

IOWA

1

401,785

KANSAS

1

296,449

MASSACHUSETTS

1

323,828

MICHIGAN

18 1,606,688

NEW MEXICO

1

374,013

NEW YORK

22

34,357

NORTH CAROLINA

1

89,501

OREGON

10

552,553

PENNSYLVANIA

3

211

34

1,711,686

PUERTO RICO

1

859,271

TENNESSEE

1

44,669

TEXAS

1

437,122

UTAH

10

225,761

WASHINGTON

1

881,740

1

122,907

WISCONSIN

2

985

9

33,990

Total

19

378,233

42 4,652,736

53

4,297,337

1

296,449

48

85,700

(14)

11

State

Medicaid Dual Eligibles

Alabama

196,313

Alaska

13,879

Arizona

153,637

Arkansas

116,855

California

1,188,551

Colorado

82,104

Connecticut

121,149

Delaware

24,403

District of Columbia

14,458

Florida

637,738

Georgia

233,374

Hawaii

30,839

Idaho

19,054

Illinois

327,851

Indiana

145,859

Iowa

77,874

Kansas

72,505

Kentucky

174,351

Louisiana

181,277

Maine

93,914

Maryland

110,648

Massachusetts

254,449

Michigan

263,576

Minnesota

127,651

Mississippi

144,764

Missouri

168,335

Montana

21,314

Nebraska

33,994

Nevada

43,522

New Hampshire

28,153

New Jersey

195,802

New Mexico

65,637

New York

706,454

North Carolina

301,493

North Dakota

14,226

Ohio

301,063

Oklahoma

105,532

Oregon

96,210

Pennsylvania

322,835

Puerto Rico

245,208

Rhode Island

37,280

South Carolina

143,325

South Dakota

17,846

Tennessee

236,408

Texas

615,435

Utah

33,767

Vermont

33,453

Virginia

168,354

Washington

158,096

West Virginia

74,765

Wisconsin

182,499

Wyoming

9,923

National Total

9,168,002

DUAL ELIGIBLE ENROLLMENT AS OF July 1, 2011

This table provides an unduplicated number of Medicaid dual eligibles receiving full or partial Medicaid benefits.

(15)

DUAL ELIGIBLE ENROLLMENT BY MANAGED CARE ENTITY TYPE AS OF July 1, 2011

12

STATE

HIO

MCO

PCCM

PIHP

PAHP

PACE

OTHER

Arizona

107,344

Arkansas

46,792

61

California

171,618

102,546

1

19,295

2,501

Colorado

2,789

4,656

60,856

1,708

Connecticut

136,068

Dist. of Columbia

82

9

13,434

Florida

29,821

7,203

3,315

99

319

Hawaii

27,083

Idaho

18,491

19,054

Iowa

61,020

59,918

Kansas

34,942

69,884

253

Kentucky

13,772

97,903

Louisiana

244

Maryland

113

426

Massachusetts

15,835

2,562

Michigan

198,655

653

Minnesota

52,296

Missouri

143

Mississippi

80,527

Nebraska

638

20,274

Nevada

18,154

New Jersey

27,196

27,196

322

New Mexico

32,793

32,373

363

New York

5,807

951

29,570

3,155

North Carolina

102,456

14,286

175

North Dakota

53

Ohio

656

Oklahoma

105,532

77

Oregon

35,280

903

57,456

58,308

838

Pennsylvania

2,774

677

228,038

58,476

2,522

Puerto Rico

244,491

52,387

Rhode Island

21

188

South Carolina

7,063

14,238

351

Tennessee

136,574

1,307

491

308

Texas

134,319

28,923

908

Utah

197

2,524

30,719

24,961

Vermont

257

103

Virginia

653

Washington

1,596

149,182

8

380

Wisconsin

12,327

27,180

864

TOTALS

171,618

985,179

131,317 1,021,170

717,486

20,253 157,087

MANAGED CARE ENTITY TYPES

This table provides duplicated figures that include enrollees receiving comprehensive and limited benefits. Total number of enrollees includes those who were enrolled in more than one managed care plan. Figures also include invididuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.

(16)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

13

State

Plan

Managed Care Entity

Enrollment

AR

Non-Emergency Transportation

Medical-only PAHP 46,792

AR

Total Life Healthcare

PACE

61

AZ

AZ Physicians IPA (HP)

Medicaid-only MCO

18,565

AZ

Bridgeway Health Solution (HP)

Medicaid-only MCO

1,972

AZ

Bridgeway Health Solution (PC)

Medicaid-only MCO

2,817

AZ

Care 1st Health Plan

Medicaid-only MCO

2,932

AZ

Cochise Co. Dept. of Health Services (PC)

Medicaid-only MCO

733

AZ

Department of Economic Security/Division of Developmental Disabilities (PC)

Medicaid-only MCO

5,280

AZ

Evercare Select (PC)

Medicaid-only MCO

2,433

AZ

Health Choice Arizona (HP)

Medicaid-only MCO

13,680

AZ

Maricopa County Health Plan (HP)

Medicaid-only MCO

4,387

AZ

Mercy Care Plan (HP)

Medicaid-only MCO

21,617

AZ

Mercy Care Plan (PC)

Medicaid-only MCO

6,772

AZ

Phoenix Health Plan (HP)

Medicaid-only MCO

11,888

AZ

Pima Health System (HP)

Medicaid-only MCO

110

AZ

Pima Health System (PC)

Medicaid-only MCO

3,649

AZ

Pinal County Long Term Care (PC)

Medicaid-only MCO

1,281

AZ

SCAN

Medicaid-only MCO

2,569

AZ

University Family Care (HP)

Medicaid-only MCO

5,815

AZ

Yavapai County Long Term Care (PC)

Medicaid-only MCO

844

CA

Access Dental Plan-LA

Dental PAHP

2,383

CA

Access Dental Plan-Sacramento

Dental PAHP

2,331

CA

Alameda Alliance for Health

Commercial MCO

6,542

CA

AltaMed Health Services Corporation

PACE

673

CA

American Health Guard-Dental Plan-LA

Dental PAHP

443

CA

Anthem Blue Cross Partnership Plan - Sacramento

Commercial MCO

2,482

CA

Anthem Blue Cross Partnership Plan-TPMP

Commercial MCO

8,953

CA

Caloptima-Orange

HIO

73,993

CA

CalViva Health

Commercial MCO

2,242

CA

Care 1st Health Plan/San Diego

Commercial MCO

368

CA

Care 1st Health Plan-Dental-LA

Dental PAHP

826

CA

Central California Alliance For Health

HIO

25,389

CA

Coalition of Elders Independence dba Center for Elders Independence

PACE

440

CA

Community Dental Services/Sacramento

Dental PAHP

399

CA

Community Dental Services-LA

Dental PAHP

230

CA

Community Eldercare of San Diego dba St. Paul's PACE

PACE

137

CA

Community Health Group Partnership Plan-San Diego

Commercial MCO

2,649

CA

Contra Costa Health Plan

Commercial MCO

2,767

CA

Gold Coast Health Plan

HIO

18,188

CA

Health Net Community Solutions, Inc. - Sacramento

Commercial MCO

1,490

CA

Health Net Community Solutions, Inc.-San Diego

Commercial MCO

515

CA

Health Net Community Solutions, Inc.-TPMP

Commercial MCO

8,435

CA

Health Net of CA-Dental-LA

Dental PAHP

2,005

CA

Health Net of CA-Dental-Sacramento

Dental PAHP

870

CA

Health Plan of San Joaquin

Commercial MCO

2,199

CA

Health Plan of San Mateo

Medicaid-only MCO

15,985

CA

Inland Empire Health Plan

Commercial MCO

8,363

(17)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

14

State

Plan

Managed Care Entity

Enrollment

CA

KP Cal, LLC - Sacramento

Commercial MCO

2,083

CA

KP Cal, LLC-San Diego

Commercial MCO

1,232

CA

LA Care Health Plan

Commercial MCO

15,067

CA

Liberty Dental Plan of CA/Sacramento

Dental PAHP

1,153

CA

Liberty Dental Plan of CA-LA

Dental PAHP

581

CA

Molina Healthcare of California Partner Plan, Inc. - Sacramento

Commercial MCO

1,184

CA

Molina Healthcare of California Partner Plan, Inc. - San Diego

Commercial MCO

1,134

CA

Molina Healthcare of California Partner Plan, Inc.-TPMP

Commercial MCO

1,274

CA

On Lok Senior Health Services dba On Lok Lifeways

PACE

1,041

CA

Partnership Health Plan

HIO

38,163

CA

Positive Healthcare/AHF Healthcare Centers

Medicaid-only MCO

368

CA

Safeguard Dental-LA

Dental PAHP

1,746

CA

San Francisco City & CO/Family Mosaic

*Emotional MH Support PIHP

1

CA

San Francisco Health Plan

Commercial MCO

1,926

CA

Santa Barbara San luis Obispo Regional Health Authority

HIO

15,885

CA

Santa Clara Family Health Plan

Commercial MCO

5,785

CA

Senior Care Action Network (SCAN)

Medicaid-only MCO

7,333

CA

Sutter Health sacramento Sierra dba Sutter Senior Care

PACE

210

CA

Western Dental Services-LA

Dental PAHP

2,850

CA

Western Dental Services-Sacramento

Dental PAHP

3,478

CO

Access Behavioral Care

Mental Health (MH) PIHP

10,613

CO

Behavioral Healthcare, Inc.

Mental Health (MH) PIHP

10,956

CO

Colorado Health Partnerships

Mental Health (MH) PIHP

21,894

CO

Denver Health and Hospital Authority

Medicaid-only MCO

2,789

CO

ePCCM

*Enhanced PCCM

294

CO

Foothills Behavioral Health Partners

Mental Health (MH) PIHP

8,015

CO

Northeast Behavioral Health Partnership

Mental Health (MH) PIHP

7,288

CO

Primary Care Physician Program

PCCM Provider

4,362

CO

Rocky Mountain Health Plan Authority

Medical-only PIHP

2,090

CO

Rocky Mountain PACE

PACE

99

CO

Total Long Term Care

PACE

1,422

CO

VOANS PACE, Inc

PACE

187

CT

Benecare

*Dental ASO

68,034

CT

Value Options

*Mental Health ASO

68,034

DC

DC Chartered Health Plan, Incorporated

Medicaid-only MCO

59

DC

Health Services For Children with Special Needs

Medical-only PIHP

9

DC

Medical Transportation Management

Transportation PAHP

13,434

DC

United Healthcare Community Plan

Medicaid-only MCO

23

FL

AHF MCO of Florida, Inc.(Reform) d/b/a Positive Healthcare Florida (Reform)

Commercial MCO

3

FL

AIDS Healthcare Foundation, Inc.

Disease Management PAHP

3,211

FL

American Eldercare

Long Term Care PIHP

704

FL

Amerigroup (NHD)

Long Term Care PIHP

617

FL

Amerigroup of Florida, Inc.

Commercial MCO

5,189

FL

Better Health, LLC (Reform)

Medical-only PIHP

676

FL

Children's Medical Services (Reform)

Medical-only PIHP

21

FL

Coventry Health Care of Florida, Inc. d/b/a Buena Vista

Commercial MCO

574

FL

Coventry Health Care of Florida, Inc. d/b/a Vista

Commercial MCO

510

FL

DentaQuest of FL, Inc d/b/a Dentaquest

Dental PAHP

82

(18)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

15

State

Plan

Managed Care Entity

Enrollment

FL

Florida PACE Centers

PACE

75

FL

Freedom Health Plan, Inc.

Commercial MCO

315

FL

Freedom Health Plan, Inc. (Reform)

Commercial MCO

86

FL

HealthEase of Florida, Inc.

Medicaid-only MCO

3,726

FL

Hope PACE

PACE

12

FL

Humana Medical Plan

Long Term Care PIHP

516

FL

Humana Medical Plan, Inc.

Commercial MCO

1,541

FL

Humana Medical Plan, Inc. (Reform)

Commercial MCO

214

FL

Humana Senior's Choice

Long Term Care PIHP

56

FL

Integral Health Plan

Medicaid-only MCO

150

FL

JMH Health Plan d/b/a Public Health Trust of Miami-Dade County

Commercial MCO

7

FL

Little Havana Activities and Nutrition Centers

Long Term Care PIHP

560

FL

Managed Care of North America d/b/a MCNA Dental Plans

Dental PAHP

22

FL

Medica Health Plans of Florida, Inc.

Commercial MCO

78

FL

Medica Health Plans of Florida, Inc. (Reform)

Commercial MCO

95

FL

Molina Healthcare of Florida, Inc.

Commercial MCO

862

FL

Molina Healthcare of Florida, Inc. (Reform)

Commercial MCO

563

FL

Neighborly Care Network

Long Term Care PIHP

198

FL

Neighborly PACE

PACE

12

FL

Personal Health Plan d/b/a Healthy Palm Beaches, Inc

Medicaid-only MCO

2

FL

Preferred Care Partners Inc. d/b/a Care Florida

Commercial MCO

9

FL

Preferred Care Partners, Inc. d/b/a Care Florida (Reform)

Commercial MCO

20

FL

Preferred Medical Plan, Inc.

Commercial MCO

1,071

FL

Prestige Health Choice

Medicaid-only MCO

917

FL

Project Independence at Home

Long Term Care PIHP

259

FL

Simply Healthcare Plans, Inc.

Commercial MCO

227

FL

South Florida Community Care Network

*Shared Savings Model

319

FL

South Florida Community Care Network (Reform)

Medical-only PIHP

633

FL

Sunshine State Health Plan, Inc.

Medicaid-only MCO

1,786

FL

Sunshine State Health Plan, Inc. (Reform)

Medicaid-only MCO

925

FL

United Health Care (NHD)

Long Term Care PIHP

596

FL

United Healthcare of Florida, Inc.

Commercial MCO

5,176

FL

United Healthcare of Florida, Inc. (Reform)

Commercial MCO

80

FL

United Home Care Services

Long Term Care PIHP

582

FL

Universal Health Care (NHD)

Long Term Care PIHP

232

FL

Universal Health Care, Inc.

Commercial MCO

829

FL

Universal Health Care, Inc. (Reform)

Commercial MCO

372

FL

Urban Jacksonville

Long Term Care PIHP

44

FL

Vista Independence Plan

Long Term Care PIHP

385

FL

WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida

Commercial MCO

4,494

FL

World Net, Inc.

Long Term Care PIHP

3

FL

YourCare Brevard

Long Term Care PIHP

20

HI

Aloha Care

Medicaid-only MCO

94

HI

Evercare

Commercial MCO

13,350

HI

HMSA-Medical

Commercial MCO

131

HI

Kaiser Permanente

Commercial MCO

26

HI

Ohana

Commercial MCO

13,482

IA

Iowa Plan For Behavioral Health

MH/SUD PIHP

61,020

IA

TMS Management Group, Inc.

Transportation PAHP

59,918

(19)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

16

State

Plan

Managed Care Entity

Enrollment

ID

Blue Cross of Idaho

Dental PAHP

18,491

ID

Healthy Connections

PCCM Provider

18,491

ID

Medicare-Medicaid Coordinated Plan

Medical-only PAHP 563

KS

Kansas Health Solutions

Mental Health (MH) PAHP

34,942

KS

Medical Transportation Management Inc. (MTM)

Transportation PAHP

34,942

KS

Midland Care Services

PACE

81

KS

ValueOptions-Kansas

Substance Use Disorders PIHP

34,942

KS

Via Christi Healthcare Outreach Programs for Elders

PACE

172

KY

Human Service Transportation

Transportation PAHP

97,903

KY

Passport Health Plan

Medicaid-only MCO 13,772

LA

Francican PACE Baton Rouge

PACE

115

LA

Greater New Orleans

PACE

129

MA

Commonwealth Care Alliance

Medicaid-only MCO

2,875

MA

Elder Service Plan of Cambridge Health Alliance

PACE

209

MA

Elder Service Plan of East Boston Neighborhood Health Center

PACE

277

MA

Elder Service Plan of Harbor Health Services

PACE

362

MA

Elder Service Plan of the North Shore

PACE

733

MA

Evercare SCO

Medicaid-only MCO

5,410

MA

NaviCare

Medicaid-only MCO

653

MA

Neighborhood Health Plan

Commercial MCO

148

MA

Network Health

Medicaid-only MCO

4

MA

Senior Whole Health (Upham's)

Medicaid-only MCO

6,745

MA

Summit Elder Care

PACE

811

MA

Uphams Elder Service Plan

PACE

170

MD

Hopkins Elder Plus

PACE

113

MD

The Coordinating Center

*Selective Contract

426

MI

Access Alliance of Michigan

Mental Health (MH) PIHP

9,578

MI

Care Resources

PACE

186

MI

CMH Affiliation of Mid-Michigan

Mental Health (MH) PIHP

4,473

MI

CMH for Central Michigan

Mental Health (MH) PIHP

11,441

MI

CMH Partnership of Southeast Michigan

Mental Health (MH) PIHP

9,253

MI

Comprehensive Senior Care Corporation

PACE

105

MI

Detroit-Wayne County CMH Agency

Mental Health (MH) PIHP

50,235

MI

Genesee County CMH Services

Mental Health (MH) PIHP

8,972

MI

Henry Ford Health System-Center for Senior Independence

PACE

220

MI

Lakeshore Behavioral Health Alliance

Mental Health (MH) PIHP

7,527

MI

Life Circles

PACE

142

MI

LifeWays

Mental Health (MH) PIHP

4,179

MI

Macomb County CMH Services

Mental Health (MH) PIHP

12,270

MI

Network 180

Mental Health (MH) PIHP

11,347

MI

North Care

Mental Health (MH) PIHP

9,279

MI

Northern Affiliation

Mental Health (MH) PIHP

7,004

MI

Northwest CMH Affiliation

Mental Health (MH) PIHP

6,354

MI

Oakland County CMH Authority

Mental Health (MH) PIHP

16,553

MI

Saginaw County CMH Authority

Mental Health (MH) PIHP

6,825

MI

Southwest Affiliation

Mental Health (MH) PIHP

6,899

MI

Thumb Alliance PIHP

Mental Health (MH) PIHP

5,152

MI

Venture Behavioral Health

Mental Health (MH) PIHP

11,314

(20)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

17

State

Plan

Managed Care Entity

Enrollment

MN

Health Partners

Commercial MCO

4,131

MN

Itasca Medical Care

Medicaid-only MCO

604

MN

Medica

Commercial MCO

14,135

MN

Metropolitan Health Plan

Commercial MCO

1,569

MN

PrimeWest Health System

Medicaid-only MCO

3,246

MN

South Country Health Alliance

Medicaid-only MCO

3,298

MN

UCARE

Commercial MCO

12,232

MO

Alexian Brothers Community Services

PACE

143

MS

LogistiCare Solutions, LLC

Transportation PAHP

80,527

NC

Carolina Access

PCCM Provider

13,155

NC

Community Care of North Carolina (Access II/III)

PCCM Provider

89,301

NC

Elderhaus

PACE

66

NC

LIFE of St. Joseph of the Pines

PACE

17

NC

PACE of Guilford and Rockingham Counties, Inc. (PACE of the Triad)

PACE

3

NC

Piedmont Behavioral Healthcare

MH/SUD PIHP

14,286

NC

Piedmont Health SeniorCare

PACE

89

ND

Northland PACE

PACE

53

NE

Magellan Behavioral Health

Other

20,274

NE

Nebraska Medicaid Medical Home Pilot

PCCM Provider

638

NJ

AMERIGROUP New Jersey, Inc.

Medicaid-only MCO

3,881

NJ

Healthfirst Health Plan of New Jersey, Inc.

Medicaid-only MCO

514

NJ

Horizon NJ Health

Medicaid-only MCO

13,373

NJ

Life at Lourdes

PACE

131

NJ

Life St. Francis

PACE

144

NJ

LogistiCare

Transportation PAHP

27,196

NJ

Lutheran Senior Life

PACE

47

NJ

UnitedHealthCare Community Plan

Medicaid-only MCO

9,428

NM

AMERIGROUP Community Care of New Mexico, Inc.

Commercial MCO

16,920

NM

Evercare of New Mexico

Commercial MCO

15,873

NM

OptumHealth New Mexico

Mental Health (MH) PIHP

32,373

NM

Total Community Care (PACE)

PACE

363

NV

Logisticare

Transportation PAHP

18,154

NY

Affinity/Medicaid Advantage

Commercial MCO

258

NY

AmeriGroup Advantage Plus/Medicaid Advantage Plus

Long Term Care PIHP

11

NY

Amerigroup Community Connections

Long Term Care PIHP

861

NY

ArchCare Senior Life

PACE

144

NY

Catholic Health - LIFE

PACE

52

NY

CCM Select

Long Term Care PIHP

2,068

NY

Comprehensive Care Management (CCM)

PACE

2,136

NY

Eddy Senior Care

PACE

107

NY

Elder Plan/Medicaid Advantage Plus

Long Term Care PIHP

488

NY

ElderPlan/Managed Long Term Care

Long Term Care PIHP

3,804

NY

ElderPlan/Medicaid Advantage

Commercial MCO

2

NY

Elderserve

Long Term Care PIHP

646

NY

Fidelis Care at Home

Long Term Care PIHP

348

NY

GHI/Medicaid Advantage

Commercial MCO

740

NY

Guildnet

Long Term Care PIHP

5,354

NY

GuildNet/Medicaid Advantage Plus

Long Term Care PIHP

352

(21)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

18

State

Plan

Managed Care Entity

Enrollment

NY

HHH Choices

Long Term Care PIHP

793

NY

HIP Health Plan/Medicaid Advantage

Commercial MCO

1,544

NY

HIP Health Plan/Medicaid Advantage Plus

Long Term Care PIHP

184

NY

Independent Care Systems

Long Term Care PIHP

971

NY

Independent Living For Seniors

PACE

271

NY

Liberty Health Advantage/Medicaid Advantage

Commercial MCO

344

NY

Managed Health Inc/Medicaid Advantage

Commercial MCO

111

NY

MetroPlus/Medicaid Advantage

Commercial MCO

134

NY

NYS Catholic Health Plan/Fidelis/Medicaid Advantage

Commercial MCO

1,002

NY

NYS Catholic Health Plan/Fidelis/Medicaid Advantage Plus

Long Term Care PIHP

58

NY

PACE CNY

PACE

379

NY

Physician Case Management Program

PCCM Provider

947

NY

Senior Health Partners

Long Term Care PIHP

2,552

NY

Senior Network Health

Long Term Care PIHP

359

NY

Senior Whole Health/ Medicaid Advantage

Commercial MCO

529

NY

Senior Whole Health/Medicaid Advantage Plus

Long Term Care PIHP

252

NY

Southern Tier Priority

PCCM Provider

4

NY

Total Aging in Place

Long Term Care PIHP

123

NY

Total Senior Care

PACE

66

NY

Touchstone/Prestige/Medicaid Advantage

Commercial MCO

1,142

NY

United HealthCare/Medicaid Advantage

Commercial MCO

1

NY

VNS Choice

Long Term Care PIHP

8,879

NY

VNS Choice Plus/Medicaid Advantage Plus

Long Term Care PIHP

69

NY

WellCare Advantage Plus/Medicaid Advantage Plus

Long Term Care PIHP

53

NY

WellCare Advocate

Long Term Care PIHP

1,191

OH

McGregor PACE

PACE

162

OH

TriHealth Senior Link

PACE

494

OK

Cherokee Elder Care

PACE

77

OK

SoonerRide

Transportation PAHP

105,532

OR

Access Dental Plan

Dental PAHP

682

OR

Accountable Behavioral Health

Mental Health (MH) PIHP

1,613

OR

Advantage Dental Services

Dental PAHP

16,279

OR

Capitol Dental Care, Inc.

Dental PAHP

17,545

OR

CareOregon

Medicaid-only MCO

11,872

OR

Cascade Comprehensive Care

Medicaid-only MCO

696

OR

Clackamas County Mental Health

Mental Health (MH) PIHP

4,635

OR

Doctors of the Oregon Coast South

Medicaid-only MCO

1,076

OR

Douglas County IPA

Commercial MCO

1,410

OR

Family Dental Care

Dental PAHP

603

OR

FamilyCare (Mental Health)

Mental Health (MH) PIHP

1,267

OR

FamilyCare Health Plans

Commercial MCO

2,121

OR

Greater Oregon Behavioral Health, Inc.

Mental Health (MH) PIHP

6,565

OR

InterCommunity Health Network

Medicaid-only MCO

2,234

OR

Jefferson Behavioral Health

Mental Health (MH) PIHP

8,098

OR

Kaiser Permanente Oregon Plus

Medicaid-only MCO

859

OR

Lane Care MHO

Mental Health (MH) PIHP

5,977

OR

Lane Individual Practice Association

Medicaid-only MCO

3,211

OR

Managed Dental Care of Oregon

Dental PAHP

1,649

(22)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

19

State

Plan

Managed Care Entity

Enrollment

OR

Mid Rogue Independent Physician Association

Medicaid-only MCO

1,700

OR

Mid Valley Behavioral Care Network

Mental Health (MH) PIHP

9,701

OR

MultiCare Dental

Dental PAHP

2,869

OR

ODS Community Health (Dental)

Dental PAHP

10,478

OR

ODS Community Health Inc.

Medicaid-only MCO

362

OR

Oregon Health Management Services

Medicaid-only MCO

417

OR

PacificSource Community Solutions

Medicaid-only MCO

2,079

OR

PacificSource Community Solutions (Mental Health)

Mental Health (MH) PIHP

2,228

OR

PCCM

PCCM Provider

903

OR

Providence Elder Place

PACE

838

OR

Providence Health Assurance

Medicaid-only MCO

2,196

OR

Tuality Health Alliance

Medicaid-only MCO

816

OR

Verity MHO

Mental Health (MH) PIHP

12,283

OR

Washington County Health (Mental Health)

Mental Health (MH) PIHP

5,089

OR

Willamette Dental

Dental PAHP

8,203

PA

Access Plus Program

PCCM Provider

677

PA

Aetna Better Health

Commercial MCO

315

PA

Albright LIFE

Medical-only PIHP

101

PA

AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan

Commercial MCO

178

PA

AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan - VOL

Commercial MCO

6

PA

APS Healthcare

Disease Management PAHP

442

PA

Community Care Behavioral Health - North Central

MH/SUD PIHP

22,330

PA

Community Care Behavioral Health - Northeast

MH/SUD PIHP

13,745

PA

Community LIFE

PACE

334

PA

Counties of Armstrong/Indiana - Value Behavioral Health of PA

MH/SUD PIHP

3,413

PA

Counties of Bedford/Somerset - Community Behavioral Healthcare Network of

Pennsylvania

MH/SUD PIHP

2,784

PA

Counties of Carbon/Monroe/Pike - Community Care Behavioral Health

MH/SUD PIHP

3,927

PA

Counties of Crawford/Mercer/Venango - Value Behavioral Health

MH/SUD PIHP

6,373

PA

Counties of Franklin/Fulton - Community Behavorial Healthcare Network of

Pennsylvania

MH/SUD PIHP

2,230

PA

Counties of Lycoming/Clinton - Community Behavioral Healthcare Network of

Pennsylvania

MH/SUD PIHP

3,085

PA

County of Adams - Community Care Behavioral Health

MH/SUD PIHP

955

PA

County of Allegheny - Community Care Behavioral Health

MH/SUD PIHP

23,137

PA

County of Beaver - Value Behavioral Health of PA

MH/SUD PIHP

3,317

PA

County of Berks - Community Care Behavioral Health

MH/SUD PIHP

6,210

PA

County of Blair County - Community Behavioral Healthcare Network of PA

MH/SUD PIHP

3,127

PA

County of Bucks - Magellan Behavioral Health

MH/SUD PIHP

6,187

PA

County of Butler - Value Behavioral Health of PA

MH/SUD PIHP

2,349

PA

County of Cambria - Value Behavioral Health

MH/SUD PIHP

3,358

PA

County of Chester - Community Care Behavioral Health

MH/SUD PIHP

3,498

PA

County of Cumberland - Community Behavioral Healthcare Network of PA, Inc.

MH/SUD PIHP

2,041

PA

County of Dauphin - Community Behavioral Healthcare Network of PA, Inc.

MH/SUD PIHP

4,340

PA

County of Delaware - Magellan Behavioral Health

MH/SUD PIHP

7,615

PA

County of Erie - Value Behavioral Health

MH/SUD PIHP

5,829

PA

County of Fayette - Value Behavioral Health of PA

MH/SUD PIHP

4,535

(23)

DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 7/1/2011

20

State

Plan

Managed Care Entity

Enrollment

PA

County of Lancaster - Community Behavioral Healthcare Network of PA, Inc.

MH/SUD PIHP

6,628

PA

County of Lawrence - Value Behavioral Health of PA

MH/SUD PIHP

2,198

PA

County of Lebanon - Community Behavioral Healthcare Network of PA, Inc.

MH/SUD PIHP

1,798

PA

County of Lehigh - Magellan Behavioral Health

MH/SUD PIHP

6,245

PA

County of Montgomery - Magellan Behavioral Health

MH/SUD PIHP

6,545

PA

County of Northampton - Magellan Behavioral Health

MH/SUD PIHP

4,103

PA

County of Perry - Community Behavioral Healthcare Network of PA, Inc.

MH/SUD PIHP

549

PA

County of Philadelphia - Community Behavioral Health

MH/SUD PIHP

49,066

PA

County of Washington - Value Behavioral Health of PA

MH/SUD PIHP

3,612

PA

County of Westmoreland - Value Behavioral Health of PA

MH/SUD PIHP

6,464

PA

County of York - Community Care Behavioral Health

MH/SUD PIHP

5,183

PA

Coventry Care

Commercial MCO

117

PA

Everyday LIFE

PACE

44

PA

Gateway Health Plan, Inc.

Commercial MCO

463

PA

Gateway Health Plan, Inc. -VOL

Commercial MCO

17

PA

Health Partners of Philadelphia

Commercial MCO

279

PA

Keystone Mercy Health Plan

Commercial MCO

528

PA

LIFE at Home

PACE

105

PA

LIFE Beaver/Lawrence

PACE

173

PA

LIFE Geisinger

PACE

153

PA

LIFE Lutheran Services

PACE

56

PA

LIFE Northwestern PA

Medical-only PIHP

55

PA

LIFE Pittsburgh

PACE

315

PA

LIFE St Mary

PACE

76

PA

LIFE University of Pennsylvania

PACE

364

PA

Logisticare Solutions, LLC

Transportation PAHP

58,034

PA

Mercy LIFE

PACE

337

PA

New Courtland LIFE

PACE

199

PA

Senior LIFE York

PACE

28

PA

Senior LIFE Johnstown

PACE

139

PA

Senior LIFE Washington

PACE

169

PA

SeniorLIFE Ebensburg

PACE

30

PA

United Healthcare of PA

Commercial MCO

371

PA

United Healthcare of PA, Inc. - VOL

Commercial MCO

69

PA

UPMC Health Plan, Inc./UPMC for You

Commercial MCO

418

PA

UPMC Health Plan, Inc./UPMC for You - VOL

Commercial MCO

13

PA

Value Behavioral Health of PA (Greene County)

MH/SUD PIHP

1,058

PA

Viecare Butler

Medical-only PIHP

48

PR

American Health Medicare

Commercial MCO

25,469

PR

APS Healthcare

MH/SUD PIHP

52,387

PR

First Medical/First Plus

Commercial MCO

314

PR

Humana Health Plans of Puerto Rico, Inc.

Commercial MCO

19,844

PR

Humana Puerto Rico

Commercial MCO

12,120

PR

MCS Advantage

Commercial MCO

54,932

PR

MCS Health Management Options, Inc.

Commercial MCO

31,837

PR

MMM Healthcare Inc.

Commercial MCO

64,407

References

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