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NOTE: This report contains the number of consumers that are MA eligible and managed care eligible any time during the month. The data is based on capitation payments and therefore each consumer we paid for in the month is counted.
BMCO
Monthly Physical Health Managed Care Program Enrollment Report
Released: March 28, 2018
Table of Contents
HEALTHCHOICES
Map 4 Enrollment by Plan and by County 5-7 Market Share by Plan – Statewide 8 Market Share by Zone and by Plan 9 Enrollment by Plan, by Race and by County 10-19 Enrollment by Ethnicity, by Plan and by County 20-29 Plan Make Up by Age Group and Gender 30-32 Plan Make Up by Age Group 33-34 Aid Category Distribution 35 PCP Selection During Enrollment 36
MEDICAL ASSISTANCE TRANSPORTATION PROGRAM
All Zones 38-42
LINK TO MCO DIRECTORY 43
2
3
HealthChoices
Managed Care
Erie
Crawford
Mercer
Warren McKean Potter Tioga Bradford Susquehanna
Wayne
Pike
Lacka-wanna
Monroe
Luzerne
Wyoming
Carbon
Schuylkill
Columbia
Sullivan
Lycoming
Montour
North-umberland Snyder
Union
Juniata Mifflin
Centre
Clinton
Cameron Elk
Clearfield
Jefferson Clarion
Forest
Venango
Blair
Bedford
Huntingdon
Fulton Franklin
Somerset
Cambria
Lawrence
Beaver
Washington
Greene
Butler
Allegheny
Fayette
Westmoreland
Armstrong
Indiana
Perry
Cumberland
Adams York
Lancaster
Dauphin Lebanon
Berks
Lehigh
Northampton
Bucks
Montgomery
Chester
Delaware
Philadelphia
HC SE – 1997
HC SW – 1999
HC L/C – 2001
HC NW – 2012
HC NE – 2013 4
Mandatory February 2018 ENROLLMENT BY PLAN AND BY COUNTY
SOUTHEAST
County 42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL
09 Bucks 5,804 7,175 12,186 40,358 65,523
15 Chester 13,012 7,266 2,856 22,419 45,553
23 Delaware 9,136 10,685 8,704 69,637 98,162
46 Montgomery 9,697 11,314 12,166 55,196 88,373
51 Philadelphia 55,202 36,519 217,156 247,818 556,695
TOTAL 92,851 72,959 253,068 435,428 854,306
PERCENTAGE 11% 8% 30% 51%
SOUTHWEST
County 31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
02 Allegheny 58,869 20,574 102,003 7,904 189,350
03 Armstrong 1,012 495 10,055 432 11,994
04 Beaver 11,213 2,212 13,182 1,347 27,954
05 Bedford 700 1,107 5,909 696 8,412
07 Blair 6,104 3,670 13,636 2,068 25,478
10 Butler 5,398 1,156 14,612 936 22,102
11 Cambria 3,653 5,115 15,120 2,717 26,605
26 Fayette 4,000 9,135 19,582 829 33,546
30 Greene 833 3,364 3,368 382 7,947
32 Indiana 2,462 1,747 8,856 562 13,627
37 Lawrence 6,934 1,481 8,728 775 17,918
56 Somerset 1,798 2,793 6,569 1,050 12,210
63 Washington 5,681 5,099 18,622 1,411 30,813
65 Westmoreland 11,276 7,790 31,725 2,056 52,847
TOTAL 119,933 65,738 271,967 23,165 480,803
PERCENTAGE 25% 14% 56% 5%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
5
Mandatory February 2018 ENROLLMENT BY PLAN AND BY COUNTY
cont.
LEHIGH/CAPITAL
County 51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL
01 Adams 4,143 4,642 1,244 1,290 1,465 12,784
06 Berks 15,335 8,141 6,572 8,453 41,539 80,040
21 Cumberland 12,195 3,777 3,985 1,777 5,073 26,807
22 Dauphin 28,103 10,315 7,663 4,357 6,110 56,548
28 Franklin 984 673 8,169 443 12,559 22,828
29 Fulton 165 294 766 548 702 2,475
31 Huntingdon 463 635 991 3,598 1,603 7,290
36 Lancaster 23,184 10,642 3,290 9,508 29,816 76,440
38 Lebanon 14,217 1,868 1,915 1,989 3,350 23,339
39 Lehigh 22,187 5,561 2,683 5,441 36,876 72,748
48 Northampton 12,907 2,775 2,317 2,699 23,869 44,567
50 Perry 3,602 636 724 314 990 6,266
67 York 21,667 21,698 7,613 6,953 14,653 72,584
TOTAL 159,152 71,657 47,932 47,370 178,605 504,716
PERCENTAGE 32% 14% 9% 9% 35%
NORTHWEST
County 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL
12 Cameron 862 40 103 44 1,049
16 Clarion 4,219 773 562 600 6,154
17 Clearfield 10,434 1,348 1,989 1,783 15,554
20 Crawford 12,333 1,016 1,043 1,212 15,604
24 Elk 3,513 437 288 277 4,515
25 Erie 32,780 14,301 5,996 9,881 62,958
27 Forest 537 99 78 55 769
33 Jefferson 6,667 908 343 405 8,323
42 McKean 6,310 294 1,258 694 8,556
43 Mercer 14,044 3,826 2,272 2,162 22,304
53 Potter 1,835 22 1,355 64 3,276
61 Venango 7,252 874 1,095 1,037 10,258
62 Warren 4,766 681 756 511 6,714
TOTAL 105,552 24,619 17,138 18,725 166,034
PERCENTAGE 64% 15% 10% 11%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
6
Mandatory February 2018 ENROLLMENT BY PLAN AND BY COUNTY
cont.
NORTHEAST
County 41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL
08 Bradford 2,923 4,713 3,544 11,180
13 Carbon 7,300 2,773 1,020 11,093
14 Centre 2,587 6,278 2,474 11,339
18 Clinton 1,179 5,125 773 7,077
19 Columbia 1,508 7,103 1,095 9,706
34 Juniata 816 1,731 694 3,241
35 Lackawanna 7,270 31,257 5,579 44,106
40 Luzerne 18,067 44,865 8,948 71,880
41 Lycoming 5,201 15,144 1,572 21,917
44 Mifflin 2,128 4,583 1,658 8,369
45 Monroe 14,502 12,778 5,104 32,384
47 Montour 324 1,572 303 2,199
49 Northumberland 3,097 10,436 3,507 17,040
52 Pike 2,727 5,189 1,353 9,269
54 Schuylkill 8,905 14,738 3,229 26,872
55 Snyder 1,163 3,009 902 5,074
57 Sullivan 142 500 145 787
58 Susquehanna 1,134 4,587 961 6,682
59 Tioga 5,973 1,024 589 7,586
60 Union 917 2,759 766 4,442
64 Wayne 1,676 5,720 1,192 8,588
66 Wyoming 771 3,401 623 4,795
TOTAL 90,310 189,285 46,031 325,626
PERCENTAGE 28% 59% 14%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
7
Mandatory February 2018 MARKET SHARE BY PLAN – STATEWIDE
Total Enrollment = 2,331,485
AmeriHealth NE 90,310
4% Aetna
208,812 9%
AmeriHealth 195,743
8%
Gateway 303,704
13%
Health Partners 253,068
11%
Keystone 435,428
19%
United 230,246
10%
UPMC 424,889
18%
Geisinger 189,285
8%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18 8
Mandatory February 2018 MARKET SHARE BY ZONE AND BY PLAN
Southeast
Aetna 72,959
8%
Health Partners 253,068
30%
Keystone 435,428
51%
United 92,851
11%
Southwest Aetna 23,165
5%
Gateway 119,933
25%
United 65,738
14%
UPMC 271,967
56%
Lehigh/Capital
Aetna 47,932
10%
Ameri-Health
178,605 35%Gateway
159,152 32%
United 71,657
14%
UPMC 47,370
9%
Northwest
Aetna 18,725
11%
Gateway 24,619
15%
UPMC 105,552
64%
Ameri-Health 17,138
10%
Northeast
Aetna 46,031
14%
Ameri-Health NE
90,310 28%
Geisinger 189,285
58%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
9
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Southeast 09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast
Black or African American
42 United 663 2,507 4,704 2,227 34,671 44,772
43 Aetna 684 1,261 4,816 2,409 22,296 31,466
45 Health Partners 1,393 450 4,551 3,548 105,043 114,985
47 Keystone 4,130 3,930 33,450 12,665 151,480 205,655
Southeast MCOs 6,870 8,148 47,521 20,849 313,490 396,878
American Indian or Alaskan
Native
42 United 10 33 17 22 73 155
43 Aetna 31 38 7 54 64 194
45 Health Partners 28 10 11 50 259 358
47 Keystone 78 94 114 174 313 773
Southeast MCOs 147 175 149 300 709 1,480
Asian
42 United 248 268 573 556 3,853 5,498
43 Aetna 279 178 485 785 1,545 3,272
45 Health Partners 651 90 453 690 8,002 9,886
47 Keystone 1,365 638 4,342 3,685 19,003 29,033
Southeast MCOs 2,543 1,174 5,853 5,716 32,403 47,689
White
42 United 3,927 7,224 2,880 4,897 8,075 27,003
43 Aetna 5,174 4,510 4,350 6,227 6,941 27,202
45 Health Partners 7,983 1,756 2,521 5,733 34,791 52,784
47 Keystone 29,020 13,676 25,560 29,051 41,169 138,476
Southeast MCOs 46,104 27,166 35,311 45,908 90,976 245,465
Other or system default
42 United 639 2,144 596 1,370 6,705 11,454
43 Aetna 564 854 622 1,118 4,340 7,498
45 Health Partners 1,532 336 832 1,488 63,788 67,976
47 Keystone 4,187 3,026 4,416 7,156 29,753 48,538
Southeast MCOs 6,922 6,360 6,466 11,132 104,586 135,466
Native Hawaiian or Other
Pacific Islander
42 United 6 12 8 9 76 111
43 Aetna 9 8 17 18 52 104
45 Health Partners 18 3 9 14 205 249
47 Keystone 50 29 62 67 143 351
Southeast MCOs 83 52 96 108 476 815
Unknown
42 United 311 824 358 616 1,749 3,858
43 Aetna 434 417 388 703 1,281 3,223
45 Health Partners 581 211 327 643 5,068 6,830
47 Keystone 1,528 1,026 1,693 2,398 5,957 12,602
Southeast MCOs 2,854 2,478 2,766 4,360 14,055 26,513
MCO TOTAL
42 United 5,804 13,012 9,136 9,697 55,202 92,851
43 Aetna 7,175 7,266 10,685 11,314 36,519 72,959
45 Health Partners 12,186 2,856 8,704 12,166 217,156 253,068
47 Keystone 40,358 22,419 69,637 55,196 247,818 435,428
TOTAL 65,523 45,553 98,162 88,373 556,695 854,306
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
10
Racia thnic information is self orted b consumers.
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Southwest 02 Allegheny 03 Armstrong 04 Beaver 05 Bedford 07 Blair 10 Butler 11 Cambria 26 Fayette
Black or African
American
31 Gateway 28,212 24 2,608 16 446 228 508 396
32 United 8,408 14 442 11 253 41 898 831
34 UPMC 33,464 143 2,114 69 618 364 1,365 1,533
59 Aetna 2,802 7 267 9 130 25 756 86
Southwest MCOs 72,886 188 5,431 105 1,447 658 3,527 2,846
American Indian or
Alaskan Native
31 Gateway 130 4 13 1 7 5 6 6
32 United 45 2 3 1 7 1 4 9
34 UPMC 305 16 34 13 27 27 28 37
59 Aetna 26 1 5 0 4 0 2 5
Southwest MCOs 506 23 55 15 45 33 40 57
Asian
31 Gateway 786 2 30 0 10 27 6 14
32 United 458 2 28 3 24 22 12 17
34 UPMC 4,981 28 120 25 72 149 38 66
59 Aetna 187 0 14 3 10 10 11 4
Southwest MCOs 6,412 32 192 31 116 208 67 101
White
31 Gateway 26,645 967 8,291 667 5,535 4,993 3,034 3,508
32 United 10,208 464 1,632 1,071 3,314 1,015 4,049 8,109
34 UPMC 55,386 9,749 10,386 5,669 12,634 13,462 13,301 17,516
59 Aetna 4,068 417 988 669 1,880 847 1,872 693
Southwest MCOs 96,307 11,597 21,297 8,076 23,363 20,317 22,256 29,826
Other or system
default
31 Gateway 1,775 6 197 9 61 79 62 41
32 United 781 5 70 13 36 32 103 96
34 UPMC 4,229 57 296 102 139 301 213 176
59 Aetna 354 1 49 10 23 25 50 17
Southwest MCOs 7,139 69 612 134 259 437 428 330
Native Hawaiian or
Other Pacific Islander
31 Gateway 28 0 5 0 2 5 1 2
32 United 17 0 0 0 0 0 2 1
34 UPMC 80 2 9 4 5 4 4 13
59 Aetna 11 0 0 0 0 0 1 1
Southwest MCOs 136 2 14 4 7 9 8 17
Unknown
31 Gateway 1,293 9 69 7 43 61 36 33
32 United 657 8 37 8 36 45 47 72
34 UPMC 3,558 60 223 27 141 305 171 241
59 Aetna 456 6 24 5 21 29 25 23
Southwest MCOs 5,964 83 353 47 241 440 279 369
MCO TOTAL
31 Gateway 58,869 1,012 8,605 700 6,104 5,398 3,653 4,000
32 United 20,574 495 2,212 1,107 3,670 1,156 5,115 9,135
34 UPMC 102,003 10,055 13,182 5,909 13,636 14,612 15,120 19,582
59 Aetna 7,904 432 1,347 696 2,068 936 2,717 829
TOTAL l/E 189,350 11,994 -re27,954 p y8,412 25,478 22,102 26,605 33,546
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
11
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Southwest cont.
30 Greene 32 Indiana 37 Lawrence 56 Somerset 63 Washington 65 Westmoreland Southwest
Black or African
American
31 Gateway 15 86 944 17 707 1,453 35,660
32 United 29 84 207 25 584 796 12,623
34 UPMC 38 233 888 56 1,645 2,142 44,672
59 Aetna 7 31 125 17 163 165 4,590
Southwest MCOs 89 434 2,164 115 3,099 4,556 97,545
American Indian or
Alaskan Native
31 Gateway 0 0 7 1 7 28 215
32 United 4 6 1 4 6 13 106
34 UPMC 7 17 13 7 28 46 605
59 Aetna 0 3 1 2 2 5 56
Southwest MCOs 11 26 22 14 43 92 982
Asian
31 Gateway 2 24 12 5 20 41 979
32 United 3 5 4 2 20 30 630
34 UPMC 9 63 43 22 130 257 6,003
59 Aetna 4 2 3 3 9 20 280
Southwest MCOs 18 94 62 32 179 348 7,892
White
31 Gateway 802 2,286 5,877 1,742 4,756 9,401 78,504
32 United 3,306 1,604 1,225 2,720 4,318 6,648 49,683
34 UPMC 3,266 8,318 7,580 6,359 16,090 27,979 207,695
59 Aetna 361 490 619 998 1,162 1,721 16,785
Southwest MCOs 7,735 12,698 15,301 11,819 26,326 45,749 352,667
Other or system
default
31 Gateway 13 30 47 26 93 180 2,619
32 United 16 19 31 24 85 146 1,457
34 UPMC 20 92 108 54 322 548 6,657
59 Aetna 5 19 14 10 31 60 668
Southwest MCOs 54 160 200 114 531 934 11,401
Native Hawaiian or
Other Pacific Islander
31 Gateway 0 2 1 1 0 3 50
32 United 0 0 1 0 4 1 26
34 UPMC 3 1 2 1 10 17 155
59 Aetna 0 0 0 0 1 2 16
Southwest MCOs 3 3 4 2 15 23 247
Unknown
31 Gateway 1 34 46 6 98 170 1,906
32 United 6 29 12 18 82 156 1,213
34 UPMC 25 132 94 70 397 736 6,180
59 Aetna 5 17 13 20 43 83 770
Southwest MCOs 37 212 165 114 620 1,145 10,069
MCO TOTAL
31 Gateway 833 2,462 6,934 1,798 5,681 11,276 119,933
32 United 3,364 1,747 1,481 2,793 5,099 7,790 65,738
34 UPMC 3,368 8,856 8,728 6,569 18,622 31,725 271,967
59 Aetna 382 562 775 1,050 1,411 2,056 23,165
TOTAL 7,947 13,627 17,918 12,210 30,813 52,847 480,803
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
12
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Lehigh/Capital 01 Adams 06 Berks 21 Cumberland 22 Dauphin 28 Franklin 29 Fulton 31 Huntingdon
Black or African American
51 Gateway 158 1,433 1,483 10,869 94 3 21
52 United 247 751 492 3,702 61 4 27
53 Aetna 57 748 380 2,454 674 19 38
54 UPMC 47 666 164 1,243 35 9 114
57 AmeriHealth 57 3,411 528 1,820 1,047 14 54
Lehigh/Capital MCOs 566 7,009 3,047 20,088 1,911 49 254
American Indian or
Alaskan Native
51 Gateway 17 22 41 59 7 1 0
52 United 11 22 12 32 3 0 1
53 Aetna 5 13 17 32 16 1 0
54 UPMC 3 26 9 13 4 2 0
57 AmeriHealth 1 54 9 27 36 3 2
Lehigh/Capital MCOs 37 137 88 163 66 7 3
Asian
51 Gateway 33 183 319 1,511 12 0 1
52 United 41 122 141 574 2 0 1
53 Aetna 9 127 120 298 51 1 6
54 UPMC 15 112 47 231 0 2 13
57 AmeriHealth 8 305 103 217 109 0 4
Lehigh/Capital MCOs 106 849 730 2,831 174 3 25
White
51 Gateway 3,626 7,184 8,543 8,669 750 161 430
52 United 3,660 4,391 2,463 3,641 528 285 593
53 Aetna 1,028 3,816 2,898 3,424 6,497 729 930
54 UPMC 1,086 5,196 1,266 1,948 348 535 3,397
57 AmeriHealth 1,234 14,142 3,727 2,485 9,276 666 1,517
Lehigh/Capital MCOs 10,634 34,729 18,897 20,167 17,399 2,376 6,867
Other or system default
51 Gateway 203 6,087 1,302 5,830 75 0 9
52 United 531 2,550 471 1,807 47 5 10
53 Aetna 87 1,567 318 1,040 573 12 15
54 UPMC 87 2,093 204 623 34 0 44
57 AmeriHealth 104 22,390 471 1,178 1,386 16 12
Lehigh/Capital MCOs 1,012 34,687 2,766 10,478 2,115 33 90
Native Hawaiian or Other
Pacific Islander
51 Gateway 4 4 16 29 0 0 0
52 United 1 13 5 14 1 0 0
53 Aetna 1 13 8 8 9 0 0
54 UPMC 4 17 4 5 1 0 2
57 AmeriHealth 2 32 6 8 11 0 3
Lehigh/Capital MCOs 12 79 39 64 22 0 5
Unknown
51 Gateway 102 422 491 1,136 46 0 2
52 United 151 292 193 545 31 0 3
53 Aetna 57 288 244 407 349 4 2
54 UPMC 48 343 83 294 21 0 28
57 AmeriHealth 59 1,205 229 375 694 3 11
Lehigh/Capital MCOs 417 2,550 1,240 2,757 1,141 7 46
MCO TOTAL
51 Gateway 4,143 15,335 12,195 28,103 984 165 463
52 United 4,642 8,141 3,777 10,315 673 294 635
53 Aetna 1,244 6,572 3,985 7,663 8,169 766 991
54 UPMC 1,290 8,453 1,777 4,357 443 548 3,598
57 AmeriHealth 1,465 41,539 5,073 6,110 12,559 702 1,603
TOTAL 12,784 80,040 26,807 56,548 22,828 2,475 7,290
Racial/Ethnic
information is self-
reported by consumers
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18 .
13
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Lehigh/Capital cont.
Racial/Ethnic
information is self-
reported by consumers.
36 Lancaster 38 Lebanon 39 Lehigh 48 Northampton 50 Perry 67 York Lehigh/Capital
Black or African
American
51 Gateway 1,913 612 3,003 1,844 41 2,422 23,896
52 United 1,276 112 801 343 8 3,860 11,684
53 Aetna 345 85 487 338 32 1,213 6,870
54 UPMC 941 143 798 305 9 947 5,421
57 AmeriHealth 3,314 166 4,256 2,529 15 2,271 19,482
Lehigh/Capital MCOs 7,789 1,118 9,345 5,359 105 10,713 67,353
American Indian or
Alaskan Native
51 Gateway 41 10 32 29 3 63 325
52 United 28 0 9 6 0 48 172
53 Aetna 13 3 3 11 4 36 154
54 UPMC 30 1 13 9 0 31 141
57 AmeriHealth 56 6 50 67 1 65 377
Lehigh/Capital MCOs 168 20 107 122 8 243 1,169
Asian
51 Gateway 928 118 337 192 8 212 3,854
52 United 315 24 125 52 2 253 1,652
53 Aetna 77 16 68 57 5 111 946
54 UPMC 367 17 149 59 2 70 1,084
57 AmeriHealth 725 63 632 484 1 193 2,844
Lehigh/Capital MCOs 2,412 238 1,311 844 18 839 10,380
White
51 Gateway 14,613 9,520 15,470 7,491 3,431 15,632 95,520
52 United 5,889 1,240 3,748 1,854 591 12,196 41,079
53 Aetna 2,102 1,306 1,722 1,532 646 4,956 31,586
54 UPMC 5,904 1,322 3,631 1,804 288 4,592 31,317
57 AmeriHealth 15,270 1,747 26,540 15,283 931 8,636 101,454
Lehigh/Capital MCOs 43,778 15,135 51,111 27,964 5,887 46,012 300,956
Other or system default
51 Gateway 4,455 3,531 2,823 2,979 75 2,734 30,103
52 United 2,518 415 615 383 21 4,593 13,966
53 Aetna 534 424 292 277 18 932 6,089
54 UPMC 1,530 414 597 371 12 932 6,941
57 AmeriHealth 8,694 1,204 4,464 4,792 21 2,857 47,589
Lehigh/Capital MCOs 17,731 5,988 8,791 8,802 147 12,048 104,688
Native Hawaiian or
Other Pacific Islander
51 Gateway 14 14 29 10 0 17 137
52 United 18 5 24 5 0 39 125
53 Aetna 4 3 4 4 0 12 66
54 UPMC 3 0 18 8 0 9 71
57 AmeriHealth 37 4 45 30 0 22 200
Lehigh/Capital MCOs 76 26 120 57 0 99 599
Unknown
51 Gateway 1,220 412 493 362 44 587 5,317
52 United 598 72 239 132 14 709 2,979
53 Aetna 215 78 107 98 19 353 2,221
54 UPMC 733 92 235 143 3 372 2,395
57 AmeriHealth 1,720 160 889 684 21 609 6,659
Lehigh/Capital MCOs 4,486 814 1,963 1,419 101 2,630 19,571
MCO TOTAL
51 Gateway 23,184 14,217 22,187 12,907 3,602 21,667 159,152
52 United 10,642 1,868 5,561 2,775 636 21,698 71,657
53 Aetna 3,290 1,915 2,683 2,317 724 7,613 47,932
54 UPMC 9,508 1,989 5,441 2,699 314 6,953 47,370
57 AmeriHealth 29,816 3,350 36,876 23,869 990 14,653 178,605
TOTAL 76,440 23,339 72,748 44,567 6,266 72,584 504,716
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
14
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northwest 12 Cameron 16 Clarion 17 Clearfield 20 Crawford 24 Elk 25 Erie 27 Forest
Black or African American
35 UPMC 20 107 102 435 42 5,046 2
36 Gateway 0 17 30 43 6 3,630 1
37 AmeriHealth 6 23 35 33 8 1,274 0
56 Aetna 1 22 20 42 2 2,451 0
New West MCOs 27 169 187 553 58 12,401 3
American Indian or Alaskan
Native
35 UPMC 2 3 10 28 12 108 2
36 Gateway 0 1 0 2 0 26 5
37 AmeriHealth 1 2 6 1 1 11 0
56 Aetna 0 1 0 0 0 43 1
New West MCOs 3 7 16 31 13 188 8
Asian
35 UPMC 8 14 56 46 6 1,439 1
36 Gateway 0 5 3 0 0 223 1
37 AmeriHealth 0 2 7 1 0 169 0
56 Aetna 0 6 5 1 1 116 0
New West MCOs 8 27 71 48 7 1,947 2
White
35 UPMC 825 4,007 10,140 11,626 3,420 24,110 529
36 Gateway 40 737 1,294 953 425 9,361 91
37 AmeriHealth 95 524 1,910 992 276 4,151 78
56 Aetna 43 566 1,726 1,146 270 6,590 52
New West MCOs 1,003 5,834 15,070 14,717 4,391 44,212 750
Other or system default
35 UPMC 5 43 59 86 14 1,681 3
36 Gateway 0 9 13 8 4 914 1
37 AmeriHealth 1 6 14 8 1 318 0
56 Aetna 0 3 14 8 2 561 2
New West MCOs 6 61 100 110 21 3,474 6
Native Hawaiian or Other
Pacific Islander
35 UPMC 0 2 2 1 0 21 0
36 Gateway 0 0 0 0 0 8 0
37 AmeriHealth 0 0 0 0 0 4 0
56 Aetna 0 1 0 3 0 6 0
New West MCOs 0 3 2 4 0 39 0
Unknown
35 UPMC 2 43 65 111 19 375 0
36 Gateway 0 4 8 10 2 139 0
37 AmeriHealth 0 5 17 8 2 69 0
56 Aetna 0 1 18 12 2 114 0
New West MCOs 2 53 108 141 25 697 0
MCO TOTAL
35 UPMC 1,059 6,080 15,372 15,461 4,510 62,544 782
36 Gateway 40 773 1,348 1,016 437 14,301 99
37 AmeriHealth 103 562 1,989 1,043 288 5,996 78
56 Aetna 44 600 1,783 1,212 277 9,881 55
TOTAL 1,049 6,154 15,554 15,604 4,515 62,958 769
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
15
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northwest cont.
33 Jefferson 42 McKean 43 Mercer 53 Potter 61 Venango 62 Warren New West
Black or African American
35 UPMC 66 75 1,789 11 193 45 7,933
36 Gateway 7 5 702 0 29 11 4,481
37 AmeriHealth 6 9 474 17 27 6 1,918
56 Aetna 3 11 459 0 30 9 3,050
New West MCOs 82 100 3,424 28 279 71 17,382
American Indian or Alaskan
Native
35 UPMC 10 17 15 4 15 15 241
36 Gateway 2 1 4 0 4 1 46
37 AmeriHealth 2 0 7 4 4 3 42
56 Aetna 0 4 3 0 2 4 58
New West MCOs 14 22 29 8 25 23 387
Asian
35 UPMC 18 19 90 2 26 7 1,732
36 Gateway 2 1 20 0 3 0 258
37 AmeriHealth 2 9 15 0 5 5 215
56 Aetna 0 1 13 1 1 1 146
New West MCOs 22 30 138 3 35 13 2,351
White
35 UPMC 6,509 6,133 11,780 1,781 6,898 4,646 92,404
36 Gateway 893 283 3,017 21 820 658 18,593
37 AmeriHealth 328 1,228 1,702 1,311 1,042 737 14,374
56 Aetna 396 675 1,624 61 987 489 14,625
New West MCOs 8,126 8,319 18,123 3,174 9,747 6,530 139,996
Other or system default
35 UPMC 35 37 200 11 60 33 2,267
36 Gateway 2 4 39 1 10 4 1,009
37 AmeriHealth 1 9 40 9 9 2 418
56 Aetna 4 3 29 1 11 5 643
New West MCOs 42 53 308 22 90 44 4,337
Native Hawaiian or Other
Pacific Islander
35 UPMC 0 3 9 1 2 2 43
36 Gateway 0 0 1 0 0 0 9
37 AmeriHealth 0 0 0 1 1 1 7
56 Aetna 0 0 0 0 1 0 11
New West MCOs 0 3 10 2 4 3 70
Unknown
35 UPMC 29 26 161 25 58 18 932
36 Gateway 2 0 43 0 8 7 223
37 AmeriHealth 4 3 34 13 7 2 164
56 Aetna 2 0 34 1 5 3 192
New West MCOs 37 29 272 39 78 30 1,511
MCO TOTAL
35 UPMC 6,667 6,310 14,044 1,835 7,252 4,766 105,552
36 Gateway 908 294 3,826 22 874 681 24,619
37 AmeriHealth 343 1,258 2,272 1,355 1,095 756 17,138
56 Aetna 405 694 2,162 64 1,037 511 18,725
TOTAL 8,323 8,556 22,304 3,276 10,258 6,714 166,034
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
16
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northeast
08 Bradford 13 Carbon 14 Centre 18 Clinton 19 Columbia 34 Juniata 35 Lackawanna 40 Luzerne
Black or African American
41 AmeriHealth NE 43 224 111 28 74 12 846 1,975
44 Geisinger 64 104 242 92 218 19 2,554 4,543
50 Aetna 56 47 156 23 70 11 684 1,387
New East MCOs 163 375 509 143 362 42 4,084 7,905
American Indian or
Alaskan Native
41 AmeriHealth NE 6 18 3 3 5 2 21 29
44 Geisinger 11 6 16 4 11 2 67 45
50 Aetna 6 2 9 0 5 2 19 10
New East MCOs 23 26 28 7 21 6 107 84
Asian
41 AmeriHealth NE 22 18 69 8 15 1 210 116
44 Geisinger 22 16 148 17 44 8 986 413
50 Aetna 5 3 100 1 10 6 188 89
New East MCOs 49 37 317 26 69 15 1,384 618
White
41 AmeriHealth NE 2,791 6,669 2,280 1,108 1,338 701 4,959 10,207
44 Geisinger 4,552 2,488 5,645 4,884 6,606 1,546 22,927 31,055
50 Aetna 3,416 881 2,096 720 952 608 3,837 5,943
New East MCOs 10,759 10,038 10,021 6,712 8,896 2,855 31,723 47,205
Other or system default
41 AmeriHealth NE 32 256 62 17 54 80 1,015 5,415
44 Geisinger 26 111 112 68 146 140 3,925 8,043
50 Aetna 23 60 59 14 37 56 671 1,334
New East MCOs 81 427 233 99 237 276 5,611 14,792
Native Hawaiian or Other
Pacific Islander
41 AmeriHealth NE 0 0 4 2 1 0 3 8
44 Geisinger 1 0 2 0 3 0 16 36
50 Aetna 3 1 5 0 2 0 12 7
New East MCOs 4 1 11 2 6 0 31 51
Unknown
41 AmeriHealth NE 29 115 58 13 21 20 216 317
44 Geisinger 37 48 113 60 75 16 782 730
50 Aetna 35 26 49 15 19 11 168 178
New East MCOs 101 189 220 88 115 47 1,166 1,225
MCO TOTAL
41 AmeriHealth NE 2,923 7,300 2,587 1,179 1,508 816 7,270 18,067
44 Geisinger 4,713 2,773 6,278 5,125 7,103 1,731 31,257 44,865
50 Aetna 3,544 1,020 2,474 773 1,095 694 5,579 8,948
TOTAL 11,180 11,093 11,339 7,077 9,706 3,241 44,106 71,880
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
17
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northeast cont.
41 Lycoming 44 Mifflin 45 Monroe 47 Montour 49 Northumberland 52 Pike 54 Schuylkill 55 Snyder
Black or African American
41 AmeriHealth NE 908 46 2,481 14 162 350 392 43
44 Geisinger 2,129 88 2,333 36 416 333 538 88
50 Aetna 218 44 1,146 7 208 122 181 21
New East MCOs 3,255 178 5,960 57 786 805 1,111 152
American Indian or
Alaskan Native
41 AmeriHealth NE 10 3 38 1 8 16 15 1
44 Geisinger 23 4 43 5 10 20 20 4
50 Aetna 3 1 19 1 6 4 9 1
New East MCOs 36 8 100 7 24 40 44 6
Asian
41 AmeriHealth NE 20 5 177 5 14 16 50 19
44 Geisinger 72 17 200 19 53 51 73 7
50 Aetna 11 10 64 7 12 11 14 9
New East MCOs 103 32 441 31 79 78 137 35
White
41 AmeriHealth NE 4,126 2,028 8,830 294 2,690 1,948 7,741 1,065
44 Geisinger 12,624 4,390 7,543 1,460 9,409 4,306 13,252 2,791
50 Aetna 1,289 1,573 2,675 275 3,100 1,008 2,842 838
New East MCOs 18,039 7,991 19,048 2,029 15,199 7,262 23,835 4,694
Other or system default
41 AmeriHealth NE 88 35 2,414 8 179 305 573 23
44 Geisinger 187 63 2,178 34 410 333 653 81
50 Aetna 30 26 924 5 142 149 147 12
New East MCOs 305 124 5,516 47 731 787 1,373 116
Native Hawaiian or Other
Pacific Islander
41 AmeriHealth NE 7 1 34 0 1 6 7 0
44 Geisinger 4 3 12 2 8 5 7 2
50 Aetna 1 1 9 1 3 0 2 1
New East MCOs 12 5 55 3 12 11 16 3
Unknown
41 AmeriHealth NE 42 10 528 2 43 86 127 12
44 Geisinger 105 18 469 16 130 141 195 36
50 Aetna 20 3 267 7 36 59 34 20
New East MCOs 167 31 1,264 25 209 286 356 68
MCO TOTAL
41 AmeriHealth NE 5,201 2,128 14,502 324 3,097 2,727 8,905 1,163
44 Geisinger 15,144 4,583 12,778 1,572 10,436 5,189 14,738 3,009
50 Aetna 1,572 1,658 5,104 303 3,507 1,353 3,229 902
TOTAL 21,917 8,369 32,384 2,199 17,040 9,269 26,872 5,074
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
18
Mandatory February 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northeast cont.
57 Sullivan 58 Susquehanna 59 Tioga 60 Union 64 Wayne 66 Wyoming New East
Black or African American
41 AmeriHealth NE 2 12 82 52 46 10 7,913
44 Geisinger 5 36 21 182 125 34 14,200
50 Aetna 8 12 17 49 36 6 4,509
New East MCOs 15 60 120 283 207 50 26,622
American Indian or
Alaskan Native
41 AmeriHealth NE 0 2 15 0 3 0 199
44 Geisinger 1 8 1 4 15 4 324
50 Aetna 0 1 1 1 4 4 108
New East MCOs 1 11 17 5 22 8 631
Asian
41 AmeriHealth NE 1 2 14 4 14 2 802
44 Geisinger 0 15 6 20 31 14 2,232
50 Aetna 0 0 0 1 5 1 547
New East MCOs 1 17 20 25 50 17 3,581
White
41 AmeriHealth NE 135 1,095 5,792 831 1,551 737 68,916
44 Geisinger 491 4,465 963 2,428 5,366 3,296 152,487
50 Aetna 136 936 552 693 1,102 606 36,078
New East MCOs 762 6,496 7,307 3,952 8,019 4,639 257,481
Other or system default
41 AmeriHealth NE 0 16 44 25 41 12 10,694
44 Geisinger 2 32 17 95 112 24 16,792
50 Aetna 0 8 13 17 27 4 3,758
New East MCOs 2 56 74 137 180 40 31,244
Native Hawaiian or Other
Pacific Islander
41 AmeriHealth NE 0 0 1 0 1 0 76
44 Geisinger 0 0 0 0 6 0 107
50 Aetna 0 0 0 0 2 0 50
New East MCOs 0 0 1 0 9 0 233
Unknown
41 AmeriHealth NE 4 7 25 5 20 10 1,710
44 Geisinger 1 31 16 30 65 29 3,143
50 Aetna 1 4 6 5 16 2 981
New East MCOs 6 42 47 40 101 41 5,834
MCO TOTAL
41 AmeriHealth NE 142 1,134 5,973 917 1,676 771 90,310 44 Geisinger 500 4,587 1,024 2,759 5,720 3,401 189,285 50 Aetna 145 961 589 766 1,192 623 46,031
TOTAL 787 6,682 7,586 4,442 8,588 4,795 325,626
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
19
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Southeast
09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast
Other/Unknown
42 United 23 31 23 31 96 204
43 Aetna 23 13 17 35 73 161
45 Health Partners 15 22 19 34 144 234
47 Keystone 61 24 57 106 207 455
Southeast MCOs 122 90 116 206 520 1,054
Non-Hispanic
42 United 5,149 9,676 8,639 8,368 48,574 80,406
43 Aetna 6,582 6,083 10,122 10,410 32,188 65,385
45 Health Partners 10,540 2,492 7,932 10,819 148,552 180,335
47 Keystone 35,866 18,127 65,792 48,806 219,479 388,070
Southeast MCOs 58,137 36,378 92,485 78,403 448,793 714,196
Hispanic
42 United 632 3,305 474 1,298 6,532 12,241
43 Aetna 570 1,170 546 869 4,258 7,413
45 Health Partners 1,631 342 753 1,313 68,460 72,499
47 Keystone 4,431 4,268 3,788 6,284 28,132 46,903
Southeast MCOs 7,264 9,085 5,561 9,764 107,382 139,056
TOTAL 65,523 45,553 98,162 88,373 556,695 854,306
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
20
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Southwest
02 Allegheny 03 Armstrong 04 Beaver 05 Bedford 07 Blair 10 Butler 11 Cambria 26 Fayette
Other/Unknown
31 Gateway 53 0 3 0 3 8 1 1
32 United 35 1 2 0 2 2 5 5
34 UPMC 181 5 9 4 12 23 9 18
59 Aetna 24 0 2 1 0 4 1 1
Southwest MCOs 293 6 16 5 17 37 16 25
Non-Hispanic
31 Gateway 57,966 1,000 11,075 694 6,024 5,292 3,579 3,963
32 United 20,114 492 2,157 1,099 3,615 1,122 5,002 9,064
34 UPMC 99,454 9,970 13,008 5,830 13,439 14,300 14,953 19,381
59 Aetna 7,673 429 1,306 688 2,033 911 2,680 807
Southwest MCOs 185,207 11,891 27,546 8,311 25,111 21,625 26,214 33,215
Hispanic
31 Gateway 850 12 135 6 77 98 73 36
32 United 425 2 53 8 53 32 108 66
34 UPMC 2,368 80 165 75 185 289 158 183
59 Aetna 207 3 39 7 35 21 36 21
Southwest MCOs 3,850 97 392 96 350 440 375 306
TOTAL 189,350 11,994 27,954 8,412 25,478 22,102 26,605 33,546
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
21
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Southwest cont.
30 Greene 32 Indiana 37 Lawrence 56 Somerset 63 Washington 65 Westmoreland Southwest
Other/Unknown
31 Gateway 1 0 0 1 10 5 86
32 United 2 2 1 0 4 23 84
34 UPMC 2 6 4 4 15 33 325
59 Aetna 0 3 0 0 4 5 45
Southwest MCOs 5 11 5 5 33 66 540
Non-Hispanic
31 Gateway 827 2,436 6,875 1,778 5,578 11,162 118,249
32 United 3,343 1,719 1,449 2,767 5,005 7,657 64,605
34 UPMC 3,342 8,765 8,546 6,503 18,320 31,324 267,135
59 Aetna 381 544 764 1,038 1,367 2,017 22,638
Southwest MCOs 7,893 13,464 17,634 12,086 30,270 52,160 472,627
Hispanic
31 Gateway 5 26 59 19 93 109 1,598
32 United 19 26 31 26 90 110 1,049
34 UPMC 24 85 178 62 287 368 4,507
59 Aetna 1 15 11 12 40 34 482
Southwest MCOs 49 152 279 119 510 621 7,636
TOTAL 7,947 13,627 17,918 12,210 30,813 52,847 480,803
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
22
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Lehigh/Capital
01 Adams 06 Berks 21 Cumberland 22 Dauphin 28 Franklin 29 Fulton 31 Huntingdon
Other/Unknown
51 Gateway 2 15 13 16 4 0 0
52 United 4 11 11 20 0 0 0
53 Aetna 5 13 7 15 9 0 0
54 UPMC 0 14 4 6 5 1 1
57 AmeriHealth 3 26 8 7 25 0 0
Lehigh/Capital MCOs 14 79 43 64 43 1 1
Non-Hispanic
51 Gateway 3,859 8,245 11,311 21,878 901 164 455
52 United 3,769 5,266 3,395 8,492 635 292 624
53 Aetna 1,097 4,752 3,759 6,699 7,530 752 980
54 UPMC 1,148 5,992 1,623 3,757 414 545 3,553
57 AmeriHealth 1,309 15,906 4,671 4,790 10,642 685 1,594
Lehigh/Capital MCOs 11,182 40,161 24,759 45,616 20,122 2,438 7,206
Hispanic
51 Gateway 282 7,075 871 6,209 79 1 8
52 United 869 2,864 371 1,803 38 2 11
53 Aetna 142 1,807 219 949 630 14 11
54 UPMC 142 2,447 150 594 24 2 44
57 AmeriHealth 153 25,607 394 1,313 1,892 17 9
Lehigh/Capital MCOs 1,588 39,800 2,005 10,868 2,663 36 83
TOTAL 12,784 80,040 26,807 56,548 22,828 2,475 7,290
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
23
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Lehigh/Capital cont.
36 Lancaster 38 Lebanon 39 Lehigh 48 Northampton 50 Perry 67 York Lehigh/Capital
Other/Unknown
51 Gateway 27 5 11 11 1 15 120
52 United 7 5 9 6 2 18 93
53 Aetna 4 2 7 10 1 9 82
54 UPMC 34 3 16 14 0 4 102
57 AmeriHealth 37 3 49 33 1 21 213
Lehigh/Capital
MCOs 109 18 92 74 5 67 610
Non-Hispanic
51 Gateway 18,042 9,196 10,197 8,447 3,520 18,698 114,913
52 United 7,632 1,292 3,142 2,225 620 16,346 53,730
53 Aetna 2,669 1,365 1,684 1,922 705 6,513 40,427
54 UPMC 7,620 1,388 3,526 2,083 304 5,833 37,786
57 AmeriHealth 19,019 1,730 18,330 16,746 972 11,111 107,505
Lehigh/Capital
MCOs 54,982 14,971 36,879 31,423 6,121 58,501 354,361
Hispanic
51 Gateway 5,115 5,016 11,979 4,449 81 2,954 44,119
52 United 3,003 571 2,410 544 14 5,334 17,834
53 Aetna 617 548 992 385 18 1,091 7,423
54 UPMC 1,854 598 1,899 602 10 1,116 9,482
57 AmeriHealth 10,760 1,617 18,497 7,090 17 3,521 70,887
Lehigh/Capital
MCOs 21,349 8,350 35,777 13,070 140 14,016 149,745
TOTAL 76,440 23,339 72,748 44,567 6,266 72,584 504,716
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
24
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northwest
12 Cameron 16 Clarion 17 Clearfield 20 Crawford 24 Elk 25 Erie 27 Forest
Other/Unknown
35 UPMC 0 3 3 6 0 24 0
36 Gateway 0 1 0 0 0 3 0
37 AmeriHealth 0 1 0 1 0 2 0
56 Aetna 0 0 0 3 0 3 0
New West MCOs 0 5 3 10 0 32 0
Non-Hispanic
35 UPMC 837 4,180 10,361 12,206 3,477 30,687 536
36 Gateway 39 769 1,341 1,006 435 12,983 94
37 AmeriHealth 100 556 1,964 1,033 281 5,567 78
56 Aetna 43 589 1,756 1,197 272 9,087 54
New West MCOs 1,019 6,094 15,422 15,442 4,465 58,324 762
Hispanic
35 UPMC 25 36 70 121 36 2,069 1
36 Gateway 1 3 7 10 2 1,315 5
37 AmeriHealth 3 5 25 9 7 427 0
56 Aetna 1 11 27 12 5 791 1
New West MCOs 30 55 129 152 50 4,602 7
TOTAL 1,049 6,154 15,554 15,604 4,515 62,958 769
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
25
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northwest cont.
33 Jefferson 42 McKean 43 Mercer 53 Potter 61 Venango 62 Warren New West
Other/Unknown
35 UPMC 5 1 23 3 5 6 79
36 Gateway 0 0 2 0 1 0 7
37 AmeriHealth 0 0 9 1 1 1 16
56 Aetna 2 0 2 0 1 0 11
New West MCOs 7 1 36 4 8 7 113
Non-Hispanic
35 UPMC 6,591 6,234 13,843 1,809 7,163 4,737 102,661
36 Gateway 905 291 3,786 21 863 667 23,200
37 AmeriHealth 342 1,251 2,236 1,346 1,076 751 16,581
56 Aetna 402 692 2,139 63 1,024 507 17,825
New West MCOs 8,240 8,468 22,004 3,239 10,126 6,662 160,267
Hispanic
35 UPMC 71 75 178 23 84 23 2,812
36 Gateway 3 3 38 1 10 14 1,412
37 AmeriHealth 1 7 27 8 18 4 541
56 Aetna 1 2 21 1 12 4 889
New West MCOs 76 87 264 33 124 45 5,654
TOTAL 8,323 8,556 22,304 3,276 10,258 6,714 166,034
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
26
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northeast
08 Bradford 13 Carbon 14 Centre 18 Clinton 19 Columbia 34 Juniata 35 Lackawanna 40 Luzerne
Other/Unknown
41 AmeriHealth NE 6 4 6 2 1 1 14 10
44 Geisinger 4 3 13 5 3 2 47 33
50 Aetna 6 3 8 1 0 0 10 10
New East MCOs 16 10 27 8 4 3 71 53
Non-Hispanic
41 AmeriHealth NE 2,881 6,734 2,519 1,148 1,431 724 5,905 11,688
44 Geisinger 4,646 2,581 6,139 5,033 6,859 1,575 26,094 35,082
50 Aetna 3,511 937 2,393 758 1,028 626 4,646 7,224
New East MCOs 11,038 10,252 11,051 6,939 9,318 2,925 36,645 53,994
Hispanic
41 AmeriHealth NE 36 562 62 29 76 91 1,351 6,369
44 Geisinger 63 189 126 87 241 154 5,116 9,750
50 Aetna 27 80 73 14 67 68 923 1,714
New East MCOs 126 831 261 130 384 313 7,390 17,833
TOTAL 11,180 11,093 11,339 7,077 9,706 3,241 44,106 71,880
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18 27
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northeast cont.
41 Lycoming 44 Mifflin 45 Monroe 47 Montour 49 Northumberland 52 Pike 54 Schuylkill 55 Snyder
Other/Unknown
41 AmeriHealth NE 4 1 14 0 2 2 2 1
44 Geisinger 10 0 20 0 3 20 5 5
50 Aetna 2 0 11 0 2 4 1 3
New East MCOs 16 1 45 0 7 26 8 9
Non-Hispanic
41 AmeriHealth NE 5,083 2,052 11,727 306 2,786 2,254 7,872 1,119
44 Geisinger 14,882 4,443 10,251 1,526 9,672 4,596 13,578 2,890
50 Aetna 1,534 1,586 3,977 299 3,269 1,134 2,974 868
New East MCOs 21,499 8,081 25,955 2,131 15,727 7,984 24,424 4,877
Hispanic
41 AmeriHealth NE 114 75 2,761 18 309 471 1,031 43
44 Geisinger 252 140 2,507 46 761 573 1,155 114
50 Aetna 36 72 1,116 4 236 215 254 31
New East MCOs 402 287 6,384 68 1,306 1,259 2,440 188
TOTAL 21,917 8,369 32,384 2,199 17,040 9,269 26,872 5,074
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
28
Mandatory February 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northeast cont.
57 Sullivan 58 Susquehanna 59 Tioga 60 Union 64 Wayne 66 Wyoming New East
Other/Unknown
41 AmeriHealth NE 0 0 1 1 3 0 75
44 Geisinger 0 1 0 4 2 4 184
50 Aetna 0 2 0 0 1 0 64
New East MCOs 0 3 1 5 6 4 323
Non-Hispanic
41 AmeriHealth NE 139 1,124 5,914 847 1,575 756 76,584
44 Geisinger 485 4,502 1,015 2,561 5,492 3,325 167,227
50 Aetna 142 945 580 724 1,125 616 40,896
New East MCOs 766 6,571 7,509 4,132 8,192 4,697 284,707
Hispanic
41 AmeriHealth NE 3 10 58 69 98 15 13,651
44 Geisinger 15 84 9 194 226 72 21,874
50 Aetna 3 14 9 42 66 7 5,071
New East MCOs 21 108 76 305 390 94 40,596
TOTAL 787 6,682 7,586 4,442 8,588 4,795 325,626
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
29
Mandatory February 2018 PLAN MAKE UP BY AGE GROUP AND GENDER
SOUTHEAST
42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL
< 21 Yrs
Female 22,068 17,336 60,595 115,636 215,635 Male 22,924 18,631 61,472 124,171 227,198 Total 44,992 35,967 122,067 239,807 442,833
22-45 Yrs
Female 17,693 13,571 53,140 81,039 165,443 Male 14,857 13,155 31,201 47,143 106,356 Total 32,550 26,726 84,341 128,182 271,799
46-64 Yrs
Female 7,017 4,330 24,741 35,188 71,276 Male 7,655 5,508 20,305 29,686 63,154 Total 14,672 9,838 45,046 64,874 134,430
Over 64
Yrs
Female 376 277 1,041 1,631 3,325 Male 261 151 573 934 1,919 Total 637 428 1,614 2,565 5,244
TOTAL 92,851 72,959 253,068 435,428 854,306
SOUTHWEST
31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
< 21 Yrs
Female 30,858 16,488 64,297 4,774 116,417 Male 32,919 17,696 68,548 4,900 124,063 Total 63,777 34,184 132,845 9,674 240,480
22-45 Yrs
Female 23,982 12,506 55,561 4,878 96,927 Male 13,573 9,129 34,715 4,651 62,068 Total 37,555 21,635 90,276 9,529 158,995
46-64 Yrs
Female 10,393 5,111 26,756 1,794 44,054 Male 7,979 4,700 21,392 2,111 36,182 Total 18,372 9,811 48,148 3,905 80,236
Over 64
Yrs
Female 148 67 423 33 671 Male 81 41 275 24 421 Total 229 108 698 57 1,092
TOTAL 119,933 65,738 271,967 23,165 480,803
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18 30
Mandatory February 2018 PLAN MAKE UP BY AGE GROUP AND GENDER
LEHIGH/CAPITAL
51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL
< 21 Yrs
Female 45,319 19,894 11,656 11,679 49,080 137,628
Male 47,855 20,705 12,390 12,681 51,725 145,356
Total 93,174 40,599 24,046 24,360 100,805 282,984
22-45 Yrs
Female 30,879 13,523 9,995 9,653 35,792 99,842
Male 15,030 8,210 7,157 6,495 17,416 54,308
Total 45,909 21,733 17,152 16,148 53,208 154,150
46-64 Yrs
Female 11,372 4,958 3,377 3,594 14,229 37,530
Male 8,043 4,104 3,185 3,078 9,505 27,915
Total 19,415 9,062 6,562 6,672 23,734 65,445
Over 64
Yrs
Female 444 157 106 105 585 1,397
Male 210 106 66 85 273 740
Total 654 263 172 190 858 2,137
TOTAL 159,152 71,657 47,932 47,370 178,605 504,716
NORTHWEST
35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL
< 21 Yrs
Female 26,652 6,221 3,841 4,652 41,366
Male 28,443 6,500 4,071 4,795 43,809
Total 55,095 12,721 7,912 9,447 85,175
22-45 Yrs
Female 21,080 4,915 3,505 3,677 33,177
Male 12,701 3,349 2,753 2,832 21,635
Total 33,781 8,264 6,258 6,509 54,812
46-64 Yrs
Female 9,540 1,927 1,476 1,480 14,423
Male 6,996 1,682 1,472 1,257 11,407
Total 16,536 3,609 2,948 2,737 25,830
Over 64
Yrs
Female 80 12 14 16 122
Male 60 13 6 16 95
Total 140 25 20 32 217
TOTAL 105,552 24,619 17,138 18,725 166,034
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
31
Mandatory February 2018 PLAN MAKE UP BY AGE GROUP AND GENDER
NORTHEAST
41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL
< 21 Yrs Female 22,711 48,135 11,317 82,163
Male 23,915 50,636 11,963 86,514
Total 46,626 98,771 23,280 168,677
22-45 Yrs Female 18,768 38,356 9,224 66,348
Male 10,986 22,024 6,781 39,791
Total 29,754 60,380 16,005 106,139
46-64 Yrs Female 7,752 16,965 3,594 28,311
Male 5,911 12,683 3,048 21,642
Total 13,663 29,648 6,642 49,953
Over 64 Yrs Female 183 302 61 546
Male 84 184 43 311
Total 267 486 104 857
TOTAL 90,310 189,285 46,031 325,626
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18 32
Mandatory February 2018 PLAN MAKE UP BY AGE GROUP
SOUTHEAST
42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL
< 21 Yrs 44,992 35,967 122,067 239,807 442,833
22-45 Yrs 32,550 26,726 84,341 128,182 271,799
46-64 Yrs 14,672 9,838 45,046 64,874 134,430
Over 64 Yrs 637 428 1,614 2,565 5,244
TOTAL 92,851 72,959 253,068 435,428 854,306
SOUTHWEST
31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
< 21 Yrs 63,777 34,184 132,845 9,674 240,480
22-45 Yrs 37,555 21,635 90,276 9,529 158,995
46-64 Yrs 18,372 9,811 48,148 3,905 80,236
Over 64 Yrs 229 108 698 57 1,092
TOTAL 119,933 65,738 271,967 23,165 480,803
LEHIGH/CAPITAL
51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL
< 21 Yrs 93,174 40,599 24,046 24,360 100,805 282,984
22-45 Yrs 45,909 21,733 17,152 16,148 53,208 154,150
46-64 Yrs 19,415 9,062 6,562 6,672 23,734 65,445
Over 64 Yrs 654 263 172 190 858 2,137
TOTAL 159,152 71,657 47,932 47,370 178,605 504,716
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
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Mandatory February 2018 PLAN MAKE UP BY AGE GROUP
NORTHWEST
35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL
< 21 Yrs 55,095 12,721 7,912 9,447 85,175
22-45 Yrs 33,781 8,264 6,258 6,509 54,812
46-64 Yrs 16,536 3,609 2,948 2,737 25,830
Over 64 Yrs 140 25 20 32 217
TOTAL 105,552 24,619 17,138 18,725 166,034
NORTHEAST
41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL
< 21 Yrs 46,626 98,771 23,280 168,677
22-45 Yrs 29,754 60,380 16,005 106,139
46-64 Yrs 13,663 29,648 6,642 49,953
Over 64 Yrs 267 486 104 857
TOTAL 90,310 189,285 46,031 325,626
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 03/08/18
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HealthChoices Enrollment 2nd Quarter 2017 AID CATEGORY DISTRIBUTION
Southeast
Newly Eligible (45+) 10%
Newly Eligible (19-44)
22%
SSI & HH 16%
TANF/HB/MAGI (Ages 0-20)
42%
B&CC <1% TANF/HB/MAGI
(Ages 21+) 10%
Northwest
Newly Eligible (45+) 9%
Newly Eligible (19-44)
22%
SSI & HH 18%
TANF/HB/MAGI (Ages 0-20)
41%
B&CC <1%
TANF/HB/MAGI (Ages 21+)
10%
Southwest B&CC <1%
TANF/HB/MAGI (Ages 21+)
11%
Newly Eligible (19-44)
21%
Newly Eligible (45+) 11%SSI & HH
18%
TANF/HB/MAGI (Ages 0-20)
40% Lehigh/Capital
Newly Eligible (45+) 9%
B&CC <1%
Newly Eligible(19-44)
21%
SSI & HH 15%
TANF/HB/MAGI (Ages 0-20)
45%
TANF/HB/MAGI (Ages 21+)
10%
Northeast B&CC <1% TANF/HB/MAGI
(Ages 21+) 10%
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Newly Eligible (19-44)
22%
Newly Eligible(45+) 10%
SSI & HH 15%
TANF/HB/MAGI (Ages 0-20)
42%
Source: Division of Financial Analysis
New Categories of Aid: TANF/HB/MAGI is Temporary Assistance for Needy Families, Healthy Beginnings, and Modified Adjusted Gross Income.
HealthChoices Enrollment February 2018 PCP SELECTION
The table displays the total number of new members that voluntarily enrolled in HealthChoices and selected a PCP as a percentage of total new members that voluntarily enrolled in HealthChoices.
February 2018
Zone Percentage
Southeast 91.0%
Southwest 92.9%
Lehigh/Capital 92.3%
Northwest 94.8%
Northeast 92.2%
Total 92.2%
Source: Maximus
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Medical Assistance Transportation Program
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Based on Data Submitted by Each County
MATP 1Q FY 16/17
Southeast
COUNTY Total Expenditure Para Transit Trips Mass Transit Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Bucks $ 535,852 20,103 - 16,035 36,138 1.5%
Chester $ 578,443 13,305 2,080 2,888 18,273 1.8%
Delaware $ 1,170,077 23,928 - 12,990 36,918 1.2%
Montgomery $ 785,331 20,509 - 7,785 28,294 1.3%
Philadelphia $ 12,327,788 278,800 822,868 13,830 1,115,498 3.5%
HC-SE Zone $ 15,397,491 356,645 824,948 53,528 1,235,121 9%
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MATP 1Q FY 16/17
Southwest
COUNTY Total Expenditure Para Transit Trips Mass Transit Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Allegheny $ 2,198,681 39,010 142,915 34,365 216,290 4.1%
Armstrong $ 420,871 9,801 - 4,876 14,677 5.2%
Beaver $ 539,568 13,109 230 20,636 33,975 3.0%
Bedford $ 134,029 4,374 - 3,659 8,033 4.1%
Blair $ 313,204 14,110 2,052 3,519 19,681 3.3%
Butler $ 548,029 13,132 - 5,005 18,137 3.7%
Cambria $ 1,003,543 32,361 4,736 4,584 41,681 5.5%
Fayette $ 354,051 17,164 39 17,206 34,409 2.4%
Greene $ 141,094 3,909 - 2,276 6,185 3.9%
Indiana $ 287,379 7,364 478 5,508 13,350 3.8%
Lawrence $ 252,123 6,541 3,365 14,722 24,628 3.4%
Somerset $ 275,334 5,423 - 6,942 12,365 3.6%
Washington $ 592,114 17,321 1,107 14,102 32,530 4.2%
Westmoreland $ 709,300 21,053 218 15,685 36,956 2.4%
HC-SW Zone $ 7,769,320 204,672 155,140 153,085 512,897 53%
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MATP 1Q FY 16/17
Lehigh/Capital
COUNTY Total Expenditure Para Transit Trips Mass Transit Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Berks $ 647,047 17,047 12,721 6,603 36,371 2.4%
Cumberland $ 104,192 3,770 48 1,206 5,024 1.2%
Dauphin $ 753,945 25,260 6,538 2,309 34,107 2.1%
Franklin $ 81,894 2,694 - 1,251 3,945 1.1%
Fulton $ 109,557 1,537 - 1,184 2,721 7.2%
Huntingdon $ 139,486 2,192 - 5,297 7,489 5.4%
Lancaster $ 677,839 21,899 684 5,455 28,038 1.5%
Lebanon $ 349,742 18,555 306 1,503 20,364 2.4%
Lehigh $ 844,268 25,436 1,762 6,038 33,236 0.3%
Northampton $ 408,681 12,721 1,320 7,932 21,973 0.5%
Perry $ 149,242 3,114 - 1,290 4,404 5.3%
York/Adams $ 289,984 9,005 975 3,854 13,834 0.8%
HC-L/C Zone $ 4,555,877 143,230 24,354 43,922 211,506 30%
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MATP 1Q FY 16/17
Northwest
COUNTY Total
Expenditure
Para Transit
Trips
Mass Transit
Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Cameron $ 41,302 529 - 239 768 2.4%
Clarion $ 148,973 2,709 - 2,212 4,921 3.5%
Clearfield $ 247,278 6,681 - 7,196 13,877 3.7%
Crawford $ 273,966 3,272 431 10,963 14,666 4.5%
Elk $ 156,203 2,987 2 891 3,880 3.0%
Erie $ 498,198 20,000 1,271 3,505 24,776 1.0%
Forest $ 35,150 738 - 180 918 3.8%
Jefferson $ 355,917 9,268 - 4,189 13,457 6.4%
McKean $ 175,975 2,045 44 623 2,712 1.7%
Mercer $ 198,820 8,116 - 2,703 10,819 2.4%
Potter $ 153,422 1,788 - 878 2,666 5.5%
Venango $ 299,180 5,564 129 2,165 7,858 3.2%
Warren $ 61,787 1,297 122 2,560 3,979 4.0%
HC-Northwest Zone $ 2,646,171 64,994 1,999 38,304 105,297 45%
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MATP 1Q FY 16/17
Northeast
COUNTY Total
Expenditure
Para Transit
Trips
Mass Transit
Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Bradford/Tioga $ 350,235 6,349 172 1,494 8,015 2.6%
Carbon $ 339,989 6,719 - 1,466 8,185 2.1%
Centre $ 141,051 5,075 188 1,712 6,975 3.1%
Clinton $ 221,447 4,172 - 507 4,679 3.5%
Columbia $ 108,532 3,076 - 2,134 5,210 1.8%
Juniata $ 23,474 745 - 294 1,039 1.5%
Lackawanna $ 243,080 7,014 1,569 3,641 12,224 0.8%
Luzerne $ 351,391 19,253 1,366 8,456 29,075 1.5%
Lycoming $ 459,253 10,293 2,373 3,452 16,118 3.2%
Mifflin $ 124,389 3,977 - 854 4,831 2.5%
Monroe $ 192,392 5,124 905 4,798 10,827 1.7%
Montour $ 34,727 473 - 1,192 1,665 2.6%
Northumberland $ 198,569 6,658 - 2,884 9,542 2.8%
Pike $ 75,429 1,214 - 2,532 3,746 0.9%
Schuylkill $ 280,381 4,576 1,008 2,709 8,293 1.8%
Snyder $ 49,843 1,597 - 794 2,391 2.1%
Sullivan $ 26,926 363 40 68 471 3.6%
Susquehanna $ 145,357 2,415 - 1,603 4,018 3.4%
Union $ 29,890 846 - 580 1,426 2.0%
Wayne $ 183,470 4,071 - 1,724 5,795 3.5%
Wyoming $ 58,236 1,351 - 710 2,061 2.0%
HC-Northeast Zone $ 3,638,061 95,361 7,621 43,604 146,586 49%
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Useful Information
To view a complete Pennsylvania Medicaid Managed Care Organization (MCO) Directory go to http://dhs.pa.gov/provider/healthcaremedicalassistance/managedcar einformation/ and choose the Pennsylvania Medicaid MCO Directory.
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