Post on 12-May-2023
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: October 29, 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
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 September 2018 ENROLLMENT BY PLAN AND BY COUNTY
SOUTHEAST
County 42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL
09 Bucks 5,624 6,885 12,119 40,105 64,733
15 Chester 12,844 7,161 2,639 22,278 44,922
23 Delaware 8,743 9,935 8,597 69,169 96,444
46 Montgomery 9,444 11,002 11,009 55,927 87,382
51 Philadelphia 54,610 35,499 213,906 248,850 552,865
TOTAL 91,265 70,482 248,270 436,329 846,346
PERCENTAGE 11% 8% 29% 52%
SOUTHWEST
County 31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
02 Allegheny 56,790 19,992 99,901 7,704 184,387
03 Armstrong 1,021 530 9,732 423 11,706
04 Beaver 10,749 2,244 13,256 1,261 27,510
05 Bedford 680 1,059 5,882 649 8,270
07 Blair 5,803 3,581 14,003 2,011 25,398
10 Butler 5,122 1,092 14,515 821 21,550
11 Cambria 3,588 5,001 15,141 2,668 26,398
26 Fayette 3,745 8,684 19,259 769 32,457
30 Greene 768 3,180 3,286 370 7,604
32 Indiana 2,310 1,637 8,703 562 13,212
37 Lawrence 6,644 1,454 8,780 741 17,619
56 Somerset 1,660 2,662 6,443 1,022 11,787
63 Washington 5,343 4,958 18,521 1,417 30,239
65 Westmoreland 10,828 7,498 31,530 1,964 51,820
TOTAL 115,051 63,572 268,952 22,382 469,957
PERCENTAGE 24% 14% 57% 5%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
5
Mandatory September 2018 ENROLLMENT BY PLAN AND BY COUNTY
cont. LEHIGH/CAPITAL
County 51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL
01 Adams 4,001 4,559 1,241 1,243 1,475 12,519
06 Berks 14,737 7,874 6,608 8,405 41,310 78,934
21 Cumberland 11,769 3,657 4,071 1,935 5,015 26,447
22 Dauphin 27,188 10,419 7,837 5,030 6,394 56,868
28 Franklin 981 826 8,053 419 12,397 22,676
29 Fulton 151 280 793 526 688 2,438
31 Huntingdon 423 580 1,032 3,448 1,572 7,055
36 Lancaster 22,025 10,324 3,133 9,437 29,529 74,448
38 Lebanon 13,832 1,760 1,828 1,925 3,365 22,710
39 Lehigh 21,598 5,364 2,322 5,265 38,164 72,713
48 Northampton 12,463 2,771 2,104 2,567 24,180 44,085
50 Perry 3,508 659 660 353 1,033 6,213
67 York 20,946 21,390 7,670 7,101 14,867 71,974
TOTAL 153,622 70,463 47,352 47,654 179,989 499,080
PERCENTAGE 31% 14% 9% 10% 36%
NORTHWEST
County 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL
12 Cameron 826 35 109 38 1,008
16 Clarion 4,169 689 555 588 6,001
17 Clearfield 10,029 1,302 1,936 1,740 15,007
20 Crawford 12,057 901 1,018 1,096 15,072
24 Elk 3,424 390 301 265 4,380
25 Erie 32,543 13,612 5,839 9,706 61,700
27 Forest 522 89 75 53 739
33 Jefferson 6,511 838 327 341 8,017
42 McKean 6,187 263 1,194 657 8,301
43 Mercer 14,066 3,689 2,233 2,117 22,105
53 Potter 1,771 25 1,266 52 3,114
61 Venango 7,075 779 1,023 955 9,832
62 Warren 4,705 657 728 469 6,559
TOTAL 103,885 23,269 16,604 18,077 161,835
PERCENTAGE 64% 14% 10% 11%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
6
Mandatory September 2018 ENROLLMENT BY PLAN AND BY COUNTY
cont.
NORTHEAST
County 41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL
08 Bradford 2,900 4,519 3,411 10,830
13 Carbon 7,529 2,618 937 11,084
14 Centre 2,431 6,068 2,489 10,988
18 Clinton 1,145 4,953 778 6,876
19 Columbia 1,522 6,928 1,094 9,544
34 Juniata 820 1,747 648 3,215
35 Lackawanna 7,337 30,934 5,526 43,797
40 Luzerne 18,341 44,548 8,387 71,276
41 Lycoming 5,161 14,825 1,488 21,474
44 Mifflin 2,116 4,512 1,599 8,227
45 Monroe 14,848 12,126 4,985 31,959
47 Montour 335 1,555 301 2,191
49 Northumberland 3,123 10,612 3,509 17,244
52 Pike 2,751 5,109 1,323 9,183
54 Schuylkill 9,105 14,264 3,072 26,441
55 Snyder 1,164 2,970 848 4,982
57 Sullivan 144 458 140 742
58 Susquehanna 1,139 4,547 917 6,603
59 Tioga 5,841 943 545 7,329
60 Union 877 2,651 724 4,252
64 Wayne 1,631 5,638 1,161 8,430
66 Wyoming 726 3,325 558 4,609
TOTAL 90,986 185,850 44,440 321,276
PERCENTAGE 28% 59% 14%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
7
Mandatory September 2018 MARKET SHARE BY PLAN – STATEWIDE
Total Enrollment = 2,298,494
AmeriHealth NE 90,986
4% Aetna
202,733 9%
AmeriHealth 196,593
8%
Gateway 291,942
13%
Health Partners 248,270
11%
Keystone 436,329
19%
United 225,300
10%
UPMC 420,491
18%
Geisinger 185,850
8%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18 8
Mandatory September 2018 MARKET SHARE BY ZONE AND BY PLAN
Northwest
Aetna 18,077
11%
Gateway 23,269
15%
UPMC 103,885
64%
Ameri-Health 16,604
10%
Southeast
Aetna 70,482
8%
Health Partners 248,270
29%
Keystone 436,329
52%
United 91,265
11%
Southwest Aetna 22,382
5%
Gateway 115,051
24%
United 63,572
14%
UPMC 268,952
57%
Lehigh/Capital
UPMC 47,654
10%
Aetna 47,352
9%
Ameri-Health
179,989 36%Gateway
153,622 31%
United 70,463
14%
Northeast
Aetna 44,440
14%
Ameri-Health NE
90,986 28%
Geisinger 185,850
58%
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
9
Mandatory September 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 644 2,465 4,562 2,224 34,152 44,047
43 Aetna 643 1,194 4,427 2,315 21,664 30,243
45 Health Partners 1,347 481 4,585 3,188 103,301 112,902
47 Keystone 4,151 3,841 33,358 12,876 151,657 205,883
Southeast MCOs 6,785 7,981 46,932 20,603 310,774 393,075
American Indian or Alaskan
Native
42 United 8 30 18 35 69 160
43 Aetna 20 44 14 47 66 191
45 Health Partners 33 8 17 36 257 351
47 Keystone 81 94 100 201 330 806
Southeast MCOs 142 176 149 319 722 1,508
Asian
42 United 265 288 496 493 3,678 5,220
43 Aetna 287 174 479 769 1,457 3,166
45 Health Partners 696 72 445 691 8,084 9,988
47 Keystone 1,369 655 4,388 3,742 19,369 29,523
Southeast MCOs 2,617 1,189 5,808 5,695 32,588 47,897
White
42 United 3,772 7,129 2,699 4,762 7,988 26,350
43 Aetna 4,893 4,469 4,014 6,081 6,656 26,113
45 Health Partners 7,748 1,579 2,415 5,099 34,019 50,860
47 Keystone 28,464 13,576 24,884 29,177 40,811 136,912
Southeast MCOs 44,877 26,753 34,012 45,119 89,474 240,235
Other or system default
42 United 622 2,075 616 1,328 6,769 11,410
43 Aetna 577 830 612 1,096 4,291 7,406
45 Health Partners 1,656 314 798 1,392 62,638 66,798
47 Keystone 4,360 3,036 4,548 7,377 30,122 49,443
Southeast MCOs 7,215 6,255 6,574 11,193 103,820 135,057
Native Hawaiian or Other
Pacific Islander
42 United 12 21 4 17 105 159
43 Aetna 22 11 20 24 54 131
45 Health Partners 19 2 12 19 249 301
47 Keystone 68 31 75 78 172 424
Southeast MCOs 121 65 111 138 580 1,015
Unknown
42 United 301 836 348 585 1,849 3,919
43 Aetna 443 439 369 670 1,311 3,232
45 Health Partners 620 183 325 584 5,358 7,070
47 Keystone 1,612 1,045 1,816 2,476 6,389 13,338
Southeast MCOs 2,976 2,503 2,858 4,315 14,907 27,559
MCO TOTAL
42 United 5,624 12,844 8,743 9,444 54,610 91,265
43 Aetna 6,885 7,161 9,935 11,002 35,499 70,482
45 Health Partners 12,119 2,639 8,597 11,009 213,906 248,270
47 Keystone 40,105 22,278 69,169 55,927 248,850 436,329
TOTAL 64,733 44,922 96,444 87,382 552,865 846,346
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
10
Mandatory September 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 27,601 26 2,541 19 433 223 499 384
32 United 8,163 24 447 13 256 31 908 818
34 UPMC 32,750 153 2,129 53 685 394 1,439 1,491
59 Aetna 2,797 6 255 9 120 23 723 79
Southwest MCOs 71,311 209 5,372 94 1,494 671 3,569 2,772
American Indian or
Alaskan Native
31 Gateway 125 1 17 0 6 5 6 4
32 United 44 1 4 1 10 1 4 14
34 UPMC 309 19 36 11 26 25 28 48
59 Aetna 24 0 7 3 3 0 3 5
Southwest MCOs 502 21 64 15 45 31 41 71
Asian
31 Gateway 734 2 31 0 10 22 6 12
32 United 453 2 27 3 25 15 13 20
34 UPMC 4,859 26 105 27 89 158 34 60
59 Aetna 189 0 9 3 9 9 13 3
Southwest MCOs 6,235 30 172 33 133 204 66 95
White
31 Gateway 25,172 979 7,882 649 5,254 4,725 2,959 3,277
32 United 9,784 488 1,646 1,020 3,214 966 3,907 7,651
34 UPMC 53,713 9,400 10,413 5,649 12,885 13,292 13,206 17,228
59 Aetna 3,816 409 913 621 1,841 731 1,839 643
Southwest MCOs 92,485 11,276 20,854 7,939 23,194 19,714 21,911 28,799
Other or system
default
31 Gateway 1,746 5 195 8 53 81 70 35
32 United 811 7 74 11 38 38 102 99
34 UPMC 4,436 65 324 102 155 310 245 189
59 Aetna 404 3 50 9 22 29 54 19
Southwest MCOs 7,397 80 643 130 268 458 471 342
Native Hawaiian or
Other Pacific Islander
31 Gateway 25 0 5 0 2 3 1 5
32 United 26 0 0 0 0 0 5 1
34 UPMC 110 2 12 3 4 5 6 14
59 Aetna 20 0 0 0 0 1 2 0
Southwest MCOs 181 2 17 3 6 9 14 20
Unknown
31 Gateway 1,387 8 78 4 45 63 47 28
32 United 711 8 46 11 38 41 62 81
34 UPMC 3,724 67 237 37 159 331 183 229
59 Aetna 454 5 27 4 16 28 34 20
Southwest MCOs 6,276 88 388 56 258 463 326 358
MCO TOTAL
31 Gateway 56,790 1,021 8,208 680 5,803 5,122 3,588 3,745
32 United 19,992 530 2,244 1,059 3,581 1,092 5,001 8,684
34 UPMC 99,901 9,732 13,256 5,882 14,003 14,515 15,141 19,259
59 Aetna 7,704 423 1,261 649 2,011 821 2,668 769
TOTAL 184,387 11,706 27,510 8,270 25,398 21,550 26,398 32,457
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
11
Mandatory September 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 20 76 920 14 646 1,417 34,819
32 United 30 76 186 22 567 748 12,289
34 UPMC 41 240 884 63 1,664 2,175 44,161
59 Aetna 14 34 116 21 165 169 4,531
Southwest MCOs 105 426 2,106 120 3,042 4,509 95,800
American Indian or
Alaskan Native
31 Gateway 1 1 7 0 3 27 203
32 United 4 3 1 3 10 23 123
34 UPMC 5 22 17 7 37 48 638
59 Aetna 0 2 1 4 6 6 64
Southwest MCOs 10 28 26 14 56 104 1,028
Asian
31 Gateway 2 21 10 5 18 38 911
32 United 1 6 7 2 21 32 627
34 UPMC 12 54 44 23 128 254 5,873
59 Aetna 3 2 2 2 10 23 277
Southwest MCOs 18 83 63 32 177 347 7,688
White
31 Gateway 730 2,153 5,604 1,611 4,489 8,985 74,469
32 United 3,125 1,503 1,206 2,588 4,190 6,371 47,659
34 UPMC 3,168 8,140 7,607 6,200 15,925 27,645 204,471
59 Aetna 345 485 594 963 1,160 1,618 15,978
Southwest MCOs 7,368 12,281 15,011 11,362 25,764 44,619 342,577
Other or system
default
31 Gateway 13 28 55 23 89 177 2,578
32 United 14 23 41 27 82 144 1,511
34 UPMC 32 101 131 64 339 585 7,078
59 Aetna 5 23 17 10 29 69 743
Southwest MCOs 64 175 244 124 539 975 11,910
Native Hawaiian or
Other Pacific Islander
31 Gateway 0 1 0 1 1 1 45
32 United 0 0 0 1 2 2 37
34 UPMC 2 1 2 0 8 25 194
59 Aetna 0 0 0 0 1 1 25
Southwest MCOs 2 2 2 2 12 29 301
Unknown
31 Gateway 2 30 48 6 97 183 2,026
32 United 6 26 13 19 86 178 1,326
34 UPMC 26 145 95 86 420 798 6,537
59 Aetna 3 16 11 22 46 78 764
Southwest MCOs 37 217 167 133 649 1,237 10,653
MCO TOTAL
31 Gateway 768 2,310 6,644 1,660 5,343 10,828 115,051
32 United 3,180 1,637 1,454 2,662 4,958 7,498 63,572
34 UPMC 3,286 8,703 8,780 6,443 18,521 31,530 268,952
59 Aetna 370 562 741 1,022 1,417 1,964 22,382
TOTAL 7,604 13,212 17,619 11,787 30,239 51,820 469,957
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
12
Mandatory September 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 148 1,362 1,469 10,607 84 3 18
52 United 243 705 487 3,817 92 5 32
53 Aetna 66 796 404 2,451 641 18 48
54 UPMC 50 639 196 1,416 33 11 100
57 AmeriHealth 66 3,418 532 1,866 1,039 16 53
Lehigh/Capital MCOs 573 6,920 3,088 20,157 1,889 53 251
American Indian or
Alaskan Native
51 Gateway 21 20 35 66 7 1 0
52 United 13 19 12 28 3 0 1
53 Aetna 5 17 15 32 10 2 0
54 UPMC 3 17 4 14 2 1 0
57 AmeriHealth 2 54 11 22 37 4 2
Lehigh/Capital MCOs 44 127 77 162 59 8 3
Asian
51 Gateway 32 173 330 1,381 9 0 1
52 United 36 113 153 615 2 0 2
53 Aetna 12 110 121 365 43 1 5
54 UPMC 17 128 51 282 0 1 13
57 AmeriHealth 9 306 113 226 104 0 2
Lehigh/Capital MCOs 106 830 768 2,869 158 2 23
White
51 Gateway 3,451 6,945 8,095 8,361 748 145 391
52 United 3,560 4,241 2,298 3,583 611 270 535
53 Aetna 1,000 3,794 2,857 3,392 6,338 752 961
54 UPMC 1,031 5,174 1,331 2,215 337 512 3,262
57 AmeriHealth 1,210 14,271 3,558 2,542 9,031 649 1,485
Lehigh/Capital MCOs 10,252 34,425 18,139 20,093 17,065 2,328 6,634
Other or system default
51 Gateway 206 5,763 1,317 5,544 76 0 9
52 United 537 2,467 510 1,735 71 4 6
53 Aetna 97 1,575 392 1,104 610 13 13
54 UPMC 87 2,061 238 738 30 0 44
57 AmeriHealth 109 21,817 545 1,215 1,420 15 14
Lehigh/Capital MCOs 1,036 33,683 3,002 10,336 2,207 32 86
Native Hawaiian or Other
Pacific Islander
51 Gateway 2 13 14 29 1 0 0
52 United 9 23 10 13 1 0 0
53 Aetna 4 17 10 12 9 0 0
54 UPMC 2 18 5 11 0 0 1
57 AmeriHealth 6 61 4 16 17 0 3
Lehigh/Capital MCOs 23 132 43 81 28 0 4
Unknown
51 Gateway 141 461 509 1,200 56 2 4
52 United 161 306 187 628 46 1 4
53 Aetna 57 299 272 481 402 7 5
54 UPMC 53 368 110 354 17 1 28
57 AmeriHealth 73 1,383 252 507 749 4 13
Lehigh/Capital MCOs 485 2,817 1,330 3,170 1,270 15 54
MCO TOTAL
51 Gateway 4,001 14,737 11,769 27,188 981 151 423
52 United 4,559 7,874 3,657 10,419 826 280 580
53 Aetna 1,241 6,608 4,071 7,837 8,053 793 1,032
54 UPMC 1,243 8,405 1,935 5,030 419 526 3,448
57 AmeriHealth 1,475 41,310 5,015 6,394 12,397 688 1,572
TOTAL 12,519 78,934 26,447 56,868 22,676 2,438 7,055
Racial/Ethnic
information is self-
reported by consumers
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18 .
13
Mandatory September 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Lehigh/Capital cont.
36 Lancaster 38 Lebanon 39 Lehigh 48 Northampton 50 Perry 67 York Lehigh/Capital
Black or African
American
51 Gateway 1,858 564 2,991 1,786 39 2,400 23,329
52 United 1,261 106 847 393 9 3,881 11,878
53 Aetna 330 76 391 303 29 1,226 6,779
54 UPMC 963 120 756 268 11 1,010 5,573
57 AmeriHealth 3,296 153 4,485 2,641 20 2,266 19,851
Lehigh/Capital MCOs 7,708 1,019 9,470 5,391 108 10,783 67,410
American Indian or
Alaskan Native
51 Gateway 51 10 28 30 3 82 354
52 United 22 1 6 6 1 43 155
53 Aetna 13 6 7 10 4 55 176
54 UPMC 26 3 12 8 0 45 135
57 AmeriHealth 59 3 56 80 1 65 396
Lehigh/Capital MCOs 171 23 109 134 9 290 1,216
Asian
51 Gateway 833 109 321 195 7 213 3,604
52 United 286 22 120 71 2 248 1,670
53 Aetna 77 21 52 43 2 109 961
54 UPMC 397 19 160 55 1 67 1,191
57 AmeriHealth 704 66 641 501 1 171 2,844
Lehigh/Capital MCOs 2,297 237 1,294 865 13 808 10,270
White
51 Gateway 13,861 9,226 14,854 7,306 3,344 14,924 91,651
52 United 5,686 1,172 3,484 1,759 590 11,870 39,659
53 Aetna 2,020 1,239 1,462 1,348 589 4,914 30,666
54 UPMC 5,667 1,323 3,466 1,742 315 4,554 30,929
57 AmeriHealth 15,063 1,771 26,996 15,362 967 8,645 101,550
Lehigh/Capital MCOs 42,297 14,731 50,262 27,517 5,805 44,907 294,455
Other or system default
51 Gateway 4,128 3,488 2,785 2,759 76 2,633 28,784
52 United 2,445 362 610 368 31 4,526 13,672
53 Aetna 466 405 296 296 19 959 6,245
54 UPMC 1,546 363 589 339 16 983 7,034
57 AmeriHealth 8,461 1,178 4,754 4,716 25 2,929 47,198
Lehigh/Capital MCOs 17,046 5,796 9,034 8,478 167 12,030 102,933
Native Hawaiian or
Other Pacific Islander
51 Gateway 22 17 39 14 0 25 176
52 United 18 3 19 13 0 43 152
53 Aetna 5 1 5 7 0 15 85
54 UPMC 7 2 16 9 0 14 85
57 AmeriHealth 43 16 75 54 0 41 336
Lehigh/Capital MCOs 95 39 154 97 0 138 834
Unknown
51 Gateway 1,272 418 580 373 39 669 5,724
52 United 606 94 278 161 26 779 3,277
53 Aetna 222 80 109 97 17 392 2,440
54 UPMC 831 95 266 146 10 428 2,707
57 AmeriHealth 1,903 178 1,157 826 19 750 7,814
Lehigh/Capital MCOs 4,834 865 2,390 1,603 111 3,018 21,962
MCO TOTAL
51 Gateway 22,025 13,832 21,598 12,463 3,508 20,946 153,622
52 United 10,324 1,760 5,364 2,771 659 21,390 70,463
53 Aetna 3,133 1,828 2,322 2,104 660 7,670 47,352
54 UPMC 9,437 1,925 5,265 2,567 353 7,101 47,654
57 AmeriHealth 29,529 3,365 38,164 24,180 1,033 14,867 179,989
TOTAL 74,448 22,710 72,713 44,085 6,213 71,974 499,080
Racial/Ethnic
information is self-
reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18 14
Mandatory September 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 16 118 118 419 40 4,951 4
36 Gateway 0 13 28 38 6 3,491 1
37 AmeriHealth 6 27 27 32 5 1,236 0
56 Aetna 1 24 24 38 0 2,489 0
Northwest MCOs 23 182 197 527 51 12,167 5
American Indian or Alaskan
Native
35 UPMC 2 3 9 33 13 110 3
36 Gateway 0 1 0 0 0 28 4
37 AmeriHealth 1 3 5 0 1 10 0
56 Aetna 0 0 0 1 1 41 1
Northwest MCOs 3 7 14 34 15 189 8
Asian
35 UPMC 7 16 51 47 7 1,387 1
36 Gateway 0 4 1 0 0 197 0
37 AmeriHealth 0 0 8 3 0 159 0
56 Aetna 0 3 5 1 1 112 0
Northwest MCOs 7 23 65 51 8 1,855 1
White
35 UPMC 788 3,932 9,713 11,341 3,325 23,926 513
36 Gateway 34 664 1,248 848 380 8,875 83
37 AmeriHealth 102 515 1,863 965 291 4,057 75
56 Aetna 37 553 1,683 1,029 257 6,378 49
Northwest MCOs 961 5,664 14,507 14,183 4,253 43,236 720
Other or system default
35 UPMC 9 38 60 88 18 1,712 1
36 Gateway 1 6 15 5 4 858 1
37 AmeriHealth 0 5 18 10 3 295 0
56 Aetna 0 2 17 11 3 552 3
Northwest MCOs 10 51 110 114 28 3,417 5
Native Hawaiian or Other
Pacific Islander
35 UPMC 0 4 4 2 1 27 0
36 Gateway 0 0 0 0 0 10 0
37 AmeriHealth 0 0 1 0 0 6 0
56 Aetna 0 1 0 1 1 10 0
Northwest MCOs 0 5 5 3 2 53 0
Unknown
35 UPMC 4 58 74 127 20 430 0
36 Gateway 0 1 10 10 0 153 0
37 AmeriHealth 0 5 14 8 1 76 0
56 Aetna 0 5 11 15 2 124 0
Northwest MCOs 4 69 109 160 23 783 0
MCO TOTAL
35 UPMC 1,059 6,080 15,372 15,461 4,510 62,544 782
36 Gateway 35 689 1,302 901 390 13,612 89
37 AmeriHealth 109 555 1,936 1,018 301 5,839 75
56 Aetna 38 588 1,740 1,096 265 9,706 53
TOTAL 1,008 6,001 15,007 15,072 4,380 61,700 739
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
15
Mandatory September 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northwest cont. 33 Jefferson 42 McKean 43 Mercer 53 Potter 61 Venango 62 Warren Northwest
Black or African American
35 UPMC 51 76 1,768 9 196 45 7,811
36 Gateway 6 5 698 0 28 10 4,324
37 AmeriHealth 3 11 464 20 30 11 1,872
56 Aetna 5 11 432 0 30 1 3,055
Northwest MCOs 65 103 3,362 29 284 67 17,062
American Indian or Alaskan
Native
35 UPMC 5 16 26 2 18 15 255
36 Gateway 2 1 4 0 3 1 44
37 AmeriHealth 1 0 7 3 0 3 34
56 Aetna 0 5 1 0 4 3 57
Northwest MCOs 8 22 38 5 25 22 390
Asian
35 UPMC 16 20 94 1 26 8 1,681
36 Gateway 1 0 19 0 2 0 224
37 AmeriHealth 2 8 13 2 6 5 206
56 Aetna 1 1 14 0 1 1 140
Northwest MCOs 20 29 140 3 35 14 2,251
White
35 UPMC 6,374 5,997 11,766 1,730 6,734 4,588 90,727
36 Gateway 825 253 2,883 24 727 641 17,485
37 AmeriHealth 315 1,164 1,661 1,224 971 700 13,903
56 Aetna 330 635 1,597 51 894 457 13,950
Northwest MCOs 7,844 8,049 17,907 3,029 9,326 6,386 136,065
Other or system default
35 UPMC 31 45 215 10 54 30 2,311
36 Gateway 1 4 36 1 10 2 944
37 AmeriHealth 2 10 39 11 5 7 405
56 Aetna 3 5 33 0 15 4 648
Northwest MCOs 37 64 323 22 84 43 4,308
Native Hawaiian or Other
Pacific Islander
35 UPMC 1 3 9 1 3 2 57
36 Gateway 0 0 1 0 1 0 12
37 AmeriHealth 0 0 2 0 2 1 12
56 Aetna 0 0 1 0 2 0 16
Northwest MCOs 1 3 13 1 8 3 97
Unknown
35 UPMC 33 30 188 18 44 17 1,043
36 Gateway 3 0 48 0 8 3 236
37 AmeriHealth 4 1 47 6 9 1 172
56 Aetna 2 0 39 1 9 3 211
Northwest MCOs 42 31 322 25 70 24 1,662
MCO TOTAL
35 UPMC 6,511 6,187 14,066 1,771 7,075 4,705 103,885
36 Gateway 838 263 3,689 25 779 657 23,269
37 AmeriHealth 327 1,194 2,233 1,266 1,023 728 16,604
56 Aetna 341 657 2,117 52 955 469 18,077
TOTAL 8,017 8,301 22,105 3,114 9,832 6,559 161,835
Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
16
Mandatory September 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 48 263 103 26 78 11 853 2,084
44 Geisinger 66 103 252 97 227 21 2,554 4,547
50 Aetna 48 55 152 25 81 14 721 1,297
Northeast MCOs 162 421 507 148 386 46 4,128 7,928
American Indian or
Alaskan Native
41 AmeriHealth NE 7 18 8 2 2 1 23 25
44 Geisinger 7 7 14 3 10 1 70 58
50 Aetna 6 3 6 0 3 1 20 13
Northeast MCOs 20 28 28 5 15 3 113 96
Asian
41 AmeriHealth NE 17 19 69 8 16 4 209 117
44 Geisinger 16 18 138 16 42 9 959 395
50 Aetna 4 4 100 3 11 5 167 85
Northeast MCOs 37 41 307 27 69 18 1,335 597
White
41 AmeriHealth NE 2,748 6,797 2,099 1,080 1,363 690 4,929 10,118
44 Geisinger 4,343 2,325 5,442 4,714 6,431 1,561 22,453 30,436
50 Aetna 3,271 797 2,107 726 935 570 3,661 5,547
Northeast MCOs 10,362 9,919 9,648 6,520 8,729 2,821 31,043 46,101
Other or system default
41 AmeriHealth NE 36 296 86 15 45 91 1,042 5,594
44 Geisinger 39 113 102 60 129 137 3,864 8,215
50 Aetna 27 53 70 12 40 50 697 1,224
Northeast MCOs 102 462 258 87 214 278 5,603 15,033
Native Hawaiian or Other
Pacific Islander
41 AmeriHealth NE 0 1 3 2 1 0 8 27
44 Geisinger 1 0 8 1 5 0 22 42
50 Aetna 0 1 5 0 2 0 13 12
Northeast MCOs 1 2 16 3 8 0 43 81
Unknown
41 AmeriHealth NE 44 135 63 12 17 23 273 376
44 Geisinger 47 52 112 62 84 18 1,012 855
50 Aetna 55 24 49 12 22 8 247 209
Northeast MCOs 146 211 224 86 123 49 1,532 1,440
MCO TOTAL
41 AmeriHealth NE 2,900 7,529 2,431 1,145 1,522 820 7,337 18,341
44 Geisinger 4,519 2,618 6,068 4,953 6,928 1,747 30,934 44,548
50 Aetna 3,411 937 2,489 778 1,094 648 5,526 8,387
TOTAL 10,830 11,084 10,988 6,876 9,544 3,215 43,797 71,276
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
17
Mandatory September 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 928 50 2,526 12 159 368 392 34
44 Geisinger 2,161 105 2,203 47 415 351 547 100
50 Aetna 203 51 1,174 7 205 120 201 17
Northeast MCOs 3,292 206 5,903 66 779 839 1,140 151
American Indian or
Alaskan Native
41 AmeriHealth NE 10 4 38 1 10 13 19 1
44 Geisinger 32 5 50 2 12 26 20 3
50 Aetna 2 1 19 0 9 4 10 3
Northeast MCOs 44 10 107 3 31 43 49 7
Asian
41 AmeriHealth NE 17 7 180 5 10 24 47 19
44 Geisinger 70 18 197 22 50 47 71 9
50 Aetna 7 7 63 6 10 10 16 10
Northeast MCOs 94 32 440 33 70 81 134 38
White
41 AmeriHealth NE 4,056 1,990 8,863 296 2,672 1,938 7,872 1,064
44 Geisinger 12,380 4,344 7,201 1,441 9,522 4,210 12,873 2,755
50 Aetna 1,207 1,517 2,636 273 3,031 953 2,658 816
Northeast MCOs 17,643 7,851 18,700 2,010 15,225 7,101 23,403 4,635
Other or system default
41 AmeriHealth NE 83 35 2,487 13 193 306 619 27
44 Geisinger 204 64 2,078 35 453 361 675 75
50 Aetna 34 28 924 8 170 160 143 17
Northeast MCOs 321 127 5,489 56 816 827 1,437 119
Native Hawaiian or Other
Pacific Islander
41 AmeriHealth NE 4 0 47 0 2 12 6 1
44 Geisinger 5 3 27 2 7 8 9 2
50 Aetna 2 3 12 1 1 2 1 2
Northeast MCOs 11 6 86 3 10 22 16 5
Unknown
41 AmeriHealth NE 42 13 631 2 56 91 130 18
44 Geisinger 109 19 498 13 165 154 208 34
50 Aetna 20 8 255 4 47 51 45 16
Northeast MCOs 171 40 1,384 19 268 296 383 68
MCO TOTAL
41 AmeriHealth NE 5,140 2,099 14,772 329 3,102 2,752 9,085 1,164
44 Geisinger 14,961 4,558 12,254 1,562 10,624 5,157 14,403 2,978
50 Aetna 1,475 1,615 5,083 299 3,473 1,300 3,074 881
TOTAL 21,576 8,272 32,109 2,190 17,199 9,209 26,562 5,023
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
18
Mandatory September 2018 ENROLLMENT BY PLAN, BY RACE AND BY COUNTY
Northeast cont.
57 Sullivan 58 Susquehanna 59 Tioga 60 Union 64 Wayne 66 Wyoming Northeast
Black or African American
41 AmeriHealth NE 1 10 91 57 41 11 8,158
44 Geisinger 4 38 22 171 131 27 14,162
50 Aetna 7 17 15 50 35 8 4,487
Northeast MCOs 12 65 128 278 207 46 26,807
American Indian or
Alaskan Native
41 AmeriHealth NE 1 2 16 0 3 3 207
44 Geisinger 0 11 0 5 20 5 374
50 Aetna 1 1 1 1 6 3 116
Northeast MCOs 2 14 17 6 29 11 697
Asian
41 AmeriHealth NE 1 3 16 5 17 3 807
44 Geisinger 1 9 6 17 29 16 2,137
50 Aetna 0 1 1 2 5 1 516
Northeast MCOs 2 13 23 24 51 20 3,460
White
41 AmeriHealth NE 135 1,099 5,626 767 1,505 683 68,487
44 Geisinger 449 4,404 891 2,328 5,280 3,206 148,520
50 Aetna 131 876 509 649 1,052 538 34,419
Northeast MCOs 715 6,379 7,026 3,744 7,837 4,427 251,426
Other or system default
41 AmeriHealth NE 1 18 66 40 44 12 11,173
44 Geisinger 3 33 13 101 99 26 16,845
50 Aetna 0 14 13 17 44 5 3,739
Northeast MCOs 4 65 92 158 187 43 31,757
Native Hawaiian or Other
Pacific Islander
41 AmeriHealth NE 0 0 2 0 0 1 119
44 Geisinger 0 1 0 0 4 0 145
50 Aetna 0 0 0 0 1 0 56
Northeast MCOs 0 1 2 0 5 1 320
Unknown
41 AmeriHealth NE 5 7 24 8 21 13 2,035
44 Geisinger 1 51 11 29 75 45 3,667
50 Aetna 1 8 6 5 18 3 1,107
Northeast MCOs 7 66 41 42 114 61 6,809
MCO TOTAL
41 AmeriHealth NE 144 1,139 5,841 877 1,631 726 90,986
44 Geisinger 458 4,547 943 2,651 5,638 3,325 185,850
50 Aetna 140 917 545 724 1,161 558 44,440
TOTAL 742 6,603 7,329 4,252 8,430 4,609 321,276
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
19
Mandatory September 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 14 13 7 24 75 133
43 Aetna 15 8 12 21 48 104
45 Health Partners 11 11 14 24 99 159
47 Keystone 35 14 32 64 145 290
Southeast MCOs 75 46 65 133 367 686
Non-Hispanic
42 United 5,007 9,569 8,234 8,118 47,898 78,826
43 Aetna 6,310 5,993 9,410 10,080 31,226 63,019
45 Health Partners 10,377 2,329 7,855 9,773 146,402 176,736
47 Keystone 35,589 18,013 65,233 49,337 220,121 388,293
Southeast MCOs 57,283 35,904 90,732 77,308 445,647 706,874
Hispanic
42 United 603 3,262 502 1,302 6,637 12,306
43 Aetna 560 1,160 513 901 4,225 7,359
45 Health Partners 1,731 299 728 1,212 67,405 71,375
47 Keystone 4,481 4,251 3,904 6,526 28,584 47,746
Southeast MCOs 7,375 8,972 5,647 9,941 106,851 138,786
TOTAL 64,733 44,922 96,444 87,382 552,865 846,346
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
20
Mandatory September 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 40 0 2 0 2 6 1 0
32 United 23 1 2 0 1 1 2 3
34 UPMC 105 2 7 2 5 12 8 15
59 Aetna 22 0 1 1 0 0 1 0
Southwest MCOs 190 3 12 3 8 19 12 18
Non-Hispanic
31 Gateway 55,933 1,006 10,613 676 5,722 5,029 3,505 3,711
32 United 19,520 519 2,185 1,052 3,532 1,061 4,888 8,611
34 UPMC 97,369 9,656 13,060 5,810 13,818 14,224 14,968 19,050
59 Aetna 7,498 416 1,227 638 1,981 802 2,616 741
Southwest MCOs 180,320 11,597 27,085 8,176 25,053 21,116 25,977 32,113
Hispanic
31 Gateway 817 15 134 4 79 87 82 34
32 United 449 10 57 7 48 30 111 70
34 UPMC 2,427 74 189 70 180 279 165 194
59 Aetna 184 7 33 10 30 19 51 28
Southwest MCOs 3,877 106 413 91 337 415 409 326
TOTAL 184,387 11,706 27,510 8,270 25,398 21,550 26,398 32,457
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
21
Mandatory September 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 6 5 64
32 United 1 1 0 0 2 16 53
34 UPMC 2 3 1 4 9 24 199
59 Aetna 0 1 0 0 2 2 30
Southwest MCOs 4 5 1 5 19 47 346
Non-Hispanic
31 Gateway 763 2,286 6,589 1,647 5,256 10,708 113,444
32 United 3,162 1,607 1,421 2,633 4,890 7,370 62,451
34 UPMC 3,255 8,605 8,574 6,377 18,217 31,108 264,091
59 Aetna 368 536 729 1,008 1,379 1,925 21,864
Southwest MCOs 7,548 13,034 17,313 11,665 29,742 51,111 461,850
Hispanic
31 Gateway 4 24 55 12 81 115 1,543
32 United 17 29 33 29 66 112 1,068
34 UPMC 29 95 205 62 295 398 4,662
59 Aetna 2 25 12 14 36 37 488
Southwest MCOs 52 173 305 117 478 662 7,761
TOTAL 7,604 13,212 17,619 11,787 30,239 51,820 469,957
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
22
Mandatory September 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 9 9 9 1 0 0
52 United 3 7 5 19 0 0 0
53 Aetna 3 8 1 12 7 0 0
54 UPMC 0 6 2 6 2 1 1
57 AmeriHealth 1 13 6 6 9 0 0
Lehigh/Capital MCOs 9 43 23 52 19 1 1
Non-Hispanic
51 Gateway 3,712 7,934 10,884 21,147 898 147 415
52 United 3,681 5,030 3,273 8,564 771 278 572
53 Aetna 1,090 4,797 3,830 6,811 7,389 774 1,020
54 UPMC 1,105 5,970 1,791 4,329 394 523 3,403
57 AmeriHealth 1,313 15,754 4,561 4,960 10,458 671 1,558
Lehigh/Capital MCOs 10,901 39,485 24,339 45,811 19,910 2,393 6,968
Hispanic
51 Gateway 287 6,794 876 6,032 82 4 8
52 United 875 2,837 379 1,836 55 2 8
53 Aetna 148 1,803 240 1,014 657 19 12
54 UPMC 138 2,429 142 695 23 2 44
57 AmeriHealth 161 25,543 448 1,428 1,930 17 14
Lehigh/Capital MCOs 1,609 39,406 2,085 11,005 2,747 44 86
TOTAL 12,519 78,934 26,447 56,868 22,676 2,438 7,055
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
23
Mandatory September 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 15 5 10 5 1 12 78
52 United 2 2 5 6 2 13 64
53 Aetna 3 2 4 5 0 5 50
54 UPMC 22 2 9 8 0 2 61
57 AmeriHealth 30 2 26 24 1 13 131
Lehigh/Capital MCOs 72 13 54 48 4 45 384
Non-Hispanic
51 Gateway 17,190 8,795 10,003 8,122 3,425 18,069 110,741
52 United 7,396 1,223 3,007 2,240 633 16,063 52,731
53 Aetna 2,591 1,304 1,419 1,705 640 6,540 39,910
54 UPMC 7,528 1,369 3,435 2,017 340 5,955 38,159
57 AmeriHealth 18,901 1,739 18,828 16,920 1,010 11,198 107,871
Lehigh/Capital MCOs 53,606 14,430 36,692 31,004 6,048 57,825 349,412
Hispanic
51 Gateway 4,820 5,032 11,585 4,336 82 2,865 42,803
52 United 2,926 535 2,352 525 24 5,314 17,668
53 Aetna 539 522 899 394 20 1,125 7,392
54 UPMC 1,887 554 1,821 542 13 1,144 9,434
57 AmeriHealth 10,598 1,624 19,310 7,236 22 3,656 71,987
Lehigh/Capital MCOs 20,770 8,267 35,967 13,033 161 14,104 149,284
TOTAL 74,448 22,710 72,713 44,085 6,213 71,974 499,080
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
24
Mandatory September 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 4 3 5 0 13 0
36 Gateway 0 0 0 0 0 4 0
37 AmeriHealth 0 1 0 1 0 2 0
56 Aetna 0 0 0 3 0 3 0
Northwest MCOs 0 5 3 9 0 22 0
Non-Hispanic
35 UPMC 800 4,127 9,958 11,920 3,384 30,474 521
36 Gateway 34 689 1,296 893 389 12,337 85
37 AmeriHealth 108 548 1,915 1,005 293 5,458 75
56 Aetna 37 576 1,715 1,078 259 8,923 52
Northwest MCOs 979 5,940 14,884 14,896 4,325 57,192 733
Hispanic
35 UPMC 26 38 68 132 40 2,056 1
36 Gateway 1 0 6 8 1 1,271 4
37 AmeriHealth 1 6 21 12 8 379 0
56 Aetna 1 12 25 15 6 780 1
Northwest MCOs 29 56 120 167 55 4,486 6
TOTAL 1,008 6,001 15,007 15,072 4,380 61,700 739
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
25
Mandatory September 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northwest cont.
33 Jefferson 42 McKean 43 Mercer 53 Potter 61 Venango 62 Warren Northwest
Other/Unknown
35 UPMC 4 0 16 3 3 2 53
36 Gateway 0 0 1 0 1 0 6
37 AmeriHealth 0 0 8 0 1 1 14
56 Aetna 0 0 0 0 1 0 7
Northwest MCOs 4 0 25 3 6 3 80
Non-Hispanic
35 UPMC 6,431 6,115 13,874 1,754 7,000 4,673 101,031
36 Gateway 837 262 3,652 24 770 651 21,919
37 AmeriHealth 326 1,186 2,190 1,255 1,006 723 16,088
56 Aetna 337 655 2,099 51 943 465 17,190
Northwest MCOs 7,931 8,218 21,815 3,084 9,719 6,512 156,228
Hispanic
35 UPMC 76 72 176 14 72 30 2,801
36 Gateway 1 1 36 1 8 6 1,344
37 AmeriHealth 1 8 35 11 16 4 502
56 Aetna 4 2 18 1 11 4 880
Northwest MCOs 82 83 265 27 107 44 5,527
TOTAL 8,017 8,301 22,105 3,114 9,832 6,559 161,835
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
26
Mandatory September 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 4 3 4 1 1 1 7 7
44 Geisinger 4 3 13 1 0 1 25 21
50 Aetna 4 1 7 0 0 0 6 4
Northeast MCOs 12 7 24 2 1 2 38 32
Non-Hispanic
41 AmeriHealth NE 2,855 6,898 2,368 1,120 1,443 722 5,924 11,753
44 Geisinger 4,454 2,422 5,930 4,876 6,693 1,596 25,660 34,455
50 Aetna 3,377 870 2,417 758 1,018 582 4,557 6,809
Northeast MCOs 10,686 10,190 10,715 6,754 9,154 2,900 36,141 53,017
Hispanic
41 AmeriHealth NE 41 628 59 24 78 97 1,406 6,581
44 Geisinger 61 193 125 76 235 150 5,249 10,072
50 Aetna 30 66 65 20 76 66 963 1,574
Northeast MCOs 132 887 249 120 389 313 7,618 18,227
TOTAL 10,830 11,084 10,988 6,876 9,544 3,215 43,797 71,276
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18 27
Mandatory September 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 3 2 8 0 1 0 1 0
44 Geisinger 6 0 13 0 1 13 5 3
50 Aetna 1 0 8 0 2 1 1 2
Northeast MCOs 10 2 29 0 4 14 7 5
Non-Hispanic
41 AmeriHealth NE 5,048 2,028 11,969 314 2,804 2,296 7,975 1,119
44 Geisinger 14,559 4,377 9,751 1,501 9,819 4,516 13,040 2,854
50 Aetna 1,459 1,532 3,874 294 3,235 1,101 2,807 819
Northeast MCOs 21,066 7,937 25,594 2,109 15,858 7,913 23,822 4,792
Hispanic
41 AmeriHealth NE 110 86 2,871 21 318 455 1,129 45
44 Geisinger 260 135 2,362 54 792 580 1,219 113
50 Aetna 28 67 1,103 7 272 221 264 27
Northeast MCOs 398 288 6,336 82 1,382 1,256 2,612 185
TOTAL 21,474 8,227 31,959 2,191 17,244 9,183 26,441 4,982
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
28
Mandatory September 2018 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY
Northeast cont.
57 Sullivan 58 Susquehanna 59 Tioga 60 Union 64 Wayne 66 Wyoming Northeast
Other/Unknown
41 AmeriHealth NE 0 0 1 0 1 0 45
44 Geisinger 0 1 0 4 1 5 120
50 Aetna 0 1 0 0 1 0 39
Northeast MCOs 0 2 1 4 3 5 204
Non-Hispanic
41 AmeriHealth NE 139 1,126 5,774 800 1,515 713 76,703
44 Geisinger 445 4,452 936 2,435 5,415 3,242 163,428
50 Aetna 138 901 539 688 1,098 551 39,424
Northeast MCOs 722 6,479 7,249 3,923 8,028 4,506 279,555
Hispanic
41 AmeriHealth NE 5 13 66 77 115 13 14,238
44 Geisinger 13 94 7 212 222 78 22,302
50 Aetna 2 15 6 36 62 7 4,977
Northeast MCOs 20 122 79 325 399 98 41,517
TOTAL 742 6,603 7,329 4,252 8,430 4,609 321,276
Racial/Ethnic information is self-reported by consumers.
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
29
Mandatory September 2018 PLAN MAKE UP BY AGE GROUP AND GENDER
SOUTHEAST
42 United 43 Aetna 45 Health
Partners 47 Keystone TOTAL
< 21 Yrs
Female 21,628 16,801 59,311 116,630 214,370 Male 22,562 18,255 60,454 125,788 227,059 Total 44,190 35,056 119,765 242,418 441,429
22-45 Yrs
Female 17,227 12,864 51,844 80,815 162,750 Male 14,784 12,565 30,776 46,616 104,741 Total 32,011 25,429 82,620 127,431 267,491
46-64 Yrs
Female 6,826 4,150 24,279 34,613 69,868 Male 7,552 5,380 19,979 29,264 62,175 Total 14,378 9,530 44,258 63,877 132,043
Over 64 Yrs
Female 406 283 1,041 1,617 3,347 Male 280 184 586 986 2,036 Total 686 467 1,627 2,603 5,383
TOTAL 91,265 70,482 248,270 436,329 846,346
SOUTHWEST
31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
< 21 Yrs
Female 29,736 16,049 64,438 4,645 114,868 Male 31,767 17,225 68,976 4,864 122,832 Total 61,503 33,274 133,414 9,509 237,700
22-45 Yrs
Female 22,992 12,126 54,582 4,674 94,374 Male 12,892 8,558 33,421 4,412 59,283 Total 35,884 20,684 88,003 9,086 153,657
46-64 Yrs
Female 9,937 4,943 26,136 1,681 42,697 Male 7,524 4,572 20,759 2,060 34,915 Total 17,461 9,515 46,895 3,741 77,612
Over 64 Yrs
Female 134 55 378 28 595 Male 69 44 262 18 393 Total 203 99 640 46 988
TOTAL 115,051 63,572 268,952 22,382 469,957
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
30
Mandatory September 2018 PLAN MAKE UP BY AGE GROUP AND GENDER
LEHIGH/CAPITAL
57 51 Gateway 52 United 53 Aetna 54 UPMC TOTAL
AmeriHealth
Female 43,863 19,535 11,660 11,990 49,827 136,875
< 21 Yrs Male 46,464 20,616 12,493 13,055 52,260 144,888
Total 90,327 40,151 24,153 25,045 102,087 281,763
Female 29,693 13,202 9,815 9,577 36,076 98,363
22-45 Yrs Male 14,057 7,950 6,801 6,209 17,217 52,234
Total 43,750 21,152 16,616 15,786 53,293 150,597
Female 11,055 4,819 3,310 3,570 14,241 36,995
46-64 Yrs Male 7,838 4,057 3,104 3,045 9,513 27,557
Total 18,893 8,876 6,414 6,615 23,754 64,552
Female 425 178 107 122 575 1,407
Over 64 Yrs Male 227 106 62 86 280 761
Total 652 284 169 208 855 2,168
TOTAL 153,622 70,463 47,352 47,654 179,989 499,080
NORTHWEST
Female
< 21 Yrs Male
Total
Female
22-45 Yrs Male
Total
Female
46-64 Yrs Male
Total
Female
Over 64 Yrs Male
Total
31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
26,597 5,921 3,759 4,496 40,773
28,193 6,148 3,983 4,625 42,949
54,790 12,069 7,742 9,121 83,722
20,605 4,680 3,393 3,556 32,234
12,143 3,076 2,594 2,711 20,524
32,748 7,756 5,987 6,267 52,758
9,423 1,838 1,438 1,439 14,138
6,803 1,582 1,412 1,225 11,022
16,226 3,420 2,850 2,664 25,160
61 15 15 10 101
60 9 10 15 94
121 24 25 25 195
TOTAL 103,885 23,269 16,604 18,077 161,835
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
31
Mandatory September 2018 PLAN MAKE UP BY AGE GROUP AND GENDER
NORTHEAST
41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL
< 21 Yrs
Female 23,180 47,458 10,969 81,607
Male 24,220 50,161 11,694 86,075
Total 47,400 97,619 22,663 167,682
22-45 Yrs
Female 18,649 37,458 8,891 64,998
Male 10,829 21,261 6,464 38,554
Total 29,478 58,719 15,355 103,552
46-64 Yrs
Female 7,894 16,723 3,432 28,049
Male 5,933 12,296 2,895 21,124
Total 13,827 29,019 6,327 49,173
Over 64 Yrs
Female 192 318 59 569
Male 89 175 36 300
Total 281 493 95 869
TOTAL 90,986 185,850 44,440 321,276
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18 32
Mandatory September 2018 PLAN MAKE UP BY AGE GROUP
SOUTHEAST
42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL
< 21 Yrs 44,190 35,056 119,765 242,418 441,429
22-45 Yrs 32,011 25,429 82,620 127,431 267,491
46-64 Yrs 14,378 9,530 44,258 63,877 132,043
Over 64 Yrs 686 467 1,627 2,603 5,383
TOTAL 91,265 70,482 248,270 436,329 846,346
SOUTHWEST
31 Gateway 32 United 34 UPMC 59 Aetna TOTAL
< 21 Yrs 61,503 33,274 133,414 9,509 237,700
22-45 Yrs 35,884 20,684 88,003 9,086 153,657
46-64 Yrs 17,461 9,515 46,895 3,741 77,612
Over 64 Yrs 203 99 640 46 988
TOTAL 115,051 63,572 268,952 22,382 469,957
LEHIGH/CAPITAL
51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL
< 21 Yrs 90,327 40,151 24,153 25,045 102,087 281,763
22-45 Yrs 43,750 21,152 16,616 15,786 53,293 150,597
46-64 Yrs 18,893 8,876 6,414 6,615 23,754 64,552
Over 64 Yrs 652 284 169 208 855 2,168
TOTAL 153,622 70,463 47,352 47,654 179,989 499,080
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
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Mandatory September 2018 PLAN MAKE UP BY AGE GROUP
NORTHWEST
35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL
< 21 Yrs 54,790 12,069 7,742 9,121 83,722
22-45 Yrs 32,748 7,756 5,987 6,267 52,758
46-64 Yrs 16,226 3,420 2,850 2,664 25,160
Over 64 Yrs 121 24 25 25 195
TOTAL 103,885 23,269 16,604 18,077 161,835
NORTHEAST
41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL
< 21 Yrs 47,400 97,619 22,663 167,682
22-45 Yrs 29,478 58,719 15,355 103,552
46-64 Yrs 13,827 29,019 6,327 49,173
Over 64 Yrs 281 493 95 869
TOTAL 90,986 185,850 44,440 321,276
Source: PA Department of Human Services Enterprise Data Warehouse – Updated 10/11/18
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HealthChoices Enrollment 4th Quarter 2017 AID CATEGORY DISTRIBUTION
Southeast
Newly Eligible (45+) 10%
Newly Eligible (19-44)
23%
SSI & HH 16%
TANF/HB/MAGI (Ages 0-20)
42%
B&CC <1% TANF/HB/MAGI
(Ages 21+) 10%
Northwest
Newly Eligible (19-44)
22%
SSI & HH 17%
TANF/HB/MAGI (Ages 0-20)
41%
B&CC <1%
TANF/HB/MAGI (Ages 21+)
10%
Newly Eligible (45+) 9%
Southwest B&CC <1%
TANF/HB/MAGI (Ages 21+)
11%
Newly Eligible (19-44)
22%
Newly Eligible (45+) 10%SSI & HH
18%
TANF/HB/MAGI (Ages 0-20)
39% Lehigh/Capital B&CC
<1%
Newly Eligible (45+) 9%
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+) 11%
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Newly Eligible (19-44)
22%
Newly Eligible(45+) 10%
SSI & HH 14%
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 September 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.
September 2018
Zone Percentage
Southeast 92.9%
Southwest 93.6%
Lehigh/Capital 93.9%
Northwest 94.3%
Northeast 93.7%
Total 93.5%
Source: Maximus
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MATP 4Q FY 16/17
Southeast
COUNTY Total Expenditure Para Transit Trips Mass Transit Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Bucks $ 611,076 19,835 - 16,208 36,043 2.6%
Chester $ 635,252 13,159 4,102 4,788 22,049 4.2%
Delaware $ 1,220,906 25,521 3,749 5,232 34,502 1.7%
Montgomery $ 881,681 20,253 2,930 6,553 29,736 2.1%
Philadelphia $ 10,834,539 271,955 834,697 13,474 1,120,126 3.5%
HC-SE Zone $ 14,183,454 350,723 845,478 46,255 1,242,456 3.1%
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MATP 4Q FY 16/17
Southwest
COUNTY Total Expenditure Para Transit Trips Mass Transit Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Allegheny $ 2,698,984 43,726 179,766 45,010 268,502 6.7%
Armstrong $ 417,075 9,757 - 4,828 14,585 8.0%
Beaver $ 555,070 12,858 301 22,108 35,267 4.8%
Bedford $ 137,494 3,733 - 5,284 9,017 6.9%
Blair $ 306,549 10,005 4,633 2,155 16,793 4.7%
Butler $ 709,154 14,537 - 5,535 20,072 6.1%
Cambria $ 1,014,211 28,909 6,373 7,270 42,552 8.8%
Fayette $ 426,920 13,351 25 20,285 33,661 4.6%
Greene $ 178,031 4,902 - 1,824 6,726 5.5%
Indiana $ 267,342 6,411 720 5,648 12,779 5.9%
Lawrence $ 274,278 7,240 2,748 13,260 23,248 6.1%
Somerset $ 311,150 6,194 - 7,353 13,547 6.1%
Washington $ 664,887 18,428 1,957 13,087 33,472 6.4%
Westmoreland $ 727,440 21,875 123 16,725 38,723 4.3%
HC-SW Zone $ 8,688,585 201,926 196,646 170,372 568,944 6.1%
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MATP 4Q FY 16/17
Lehigh/Capital
COUNTY Total Expenditure Para Transit Trips Mass Transit Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Berks $ 576,458 17,060 11,012 4,908 32,980 4.9%
Cumberland $ 133,664 4,320 48 2,197 6,565 2.0%
Dauphin $ 775,320 25,567 6,231 2,090 33,888 5.4%
Franklin $ 98,120 2,974 - 1,812 4,786 1.9%
Fulton $ 102,682 1,527 - 1,412 2,939 11.5%
Huntingdon $ 179,182 3,274 - 7,063 10,337 8.4%
Lancaster $ 645,910 20,645 729 5,799 27,173 2.7%
Lebanon $ 363,331 16,754 426 998 18,178 4.2%
Lehigh $ 450,924 15,417 3,744 2,448 21,609 1.7%
Northampton $ 181,808 3,264 5,944 2,220 11,428 1.7%
Perry $ 63,232 2,337 - 746 3,083 3.4%
York/Adams $ 307,937 8,921 514 5,579 15,014 1.3%
HC-L/C Zone $ 3,878,568 122,060 28,648 37,272 187,980 3.1%
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MATP 4Q FY 16/17
Northwest
COUNTY Total
Expenditure
Para Transit
Trips
Mass Transit
Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Cameron $ 77,633 1,050 125 189 1,364 4.8%
Clarion $ 157,145 2,443 - 2,118 4,561 5.7%
Clearfield $ 314,922 9,228 - 6,828 16,056 6.3%
Crawford $ 294,094 1,663 834 18,247 20,744 7.7%
Elk $ 220,445 3,088 - 789 3,877 5.6%
Erie $ 446,425 17,718 724 3,341 21,783 2.3%
Forest $ 40,237 750 - 174 924 5.0%
Jefferson $ 455,067 9,539 8 4,444 13,991 11.0%
McKean $ 183,832 2,402 36 792 3,230 3.6%
Mercer $ 241,852 9,357 - 2,161 11,518 4.1%
Potter $ 203,464 2,283 - 1,108 3,391 10.4%
Venango $ 245,607 4,269 65 2,173 6,507 5.2%
Warren $ 68,823 1,339 56 2,270 3,665 6.6%
HC-Northwest Zone $ 2,949,546 65,129 1,848 44,634 111,611 4.8%
41
MATP 4Q FY 16/17
Northeast
COUNTY Total
Expenditure
Para Transit
Trips
Mass Transit
Trips
Mileage
Reimbursement
Trips
Total Trips Client Utilization
Bradford/Tioga $ 406,750 6,463 274 1,768 8,505 4.6%
Carbon $ 119,323 2,517 - 1,026 3,543 4.7%
Centre $ 132,339 4,134 145 1,563 5,842 4.4%
Clinton $ 228,222 3,726 - 764 4,490 6.8%
Columbia $ 108,231 2,252 - 3,025 5,277 2.9%
Juniata $ 22,099 626 - 170 796 2.2%
Lackawanna $ 168,637 6,876 2,862 1,745 11,483 1.6%
Luzerne $ 318,648 15,666 958 7,217 23,841 2.6%
Lycoming $ 426,782 9,634 2,742 4,007 16,383 6.8%
Mifflin $ 125,164 3,770 - 1,448 5,218 3.9%
Monroe $ 223,570 5,916 760 5,371 12,047 2.6%
Montour $ 47,399 1,171 - 1,140 2,311 5.2%
Northumberland $ 239,147 7,773 - 3,887 11,660 5.0%
Pike $ 59,675 1,461 - 1,930 3,391 3.2%
Schuylkill $ 254,662 5,404 1,107 3,010 9,521 3.1%
Snyder $ 47,891 1,167 - 1,168 2,335 3.8%
Sullivan $ 24,806 253 40 58 351 4.7%
Susquehanna $ 142,043 2,525 - 1,534 4,059 5.4%
Union $ 34,908 1,083 - 619 1,702 3.7%
Wayne $ 188,121 3,958 - 1,397 5,355 5.8%
Wyoming $ 72,654 1,939 - 476 2,415 3.5%
HC-Northeast Zone $ 3,391,070 88,314 8,888 43,323 140,525 3.5%
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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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