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: August 2, 2016

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 June 2016 ENROLLMENT BY PLAN AND BY COUNTY

SOUTHEAST

County 42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL

09 Bucks 4,973 7,280 10,684 37,563 60,500

15 Chester 11,868 7,130 2,227 21,691 42,916

23 Delaware 8,616 11,470 7,818 66,294 94,198

46 Montgomery 8,879 11,541 11,503 51,915 83,838

51 Philadelphia 54,213 36,409 204,568 231,852 527,042

TOTAL 88,549 73,830 236,800 409,315 808,494

PERCENTAGE 11% 9% 29% 51%

SOUTHWEST

County 31 Gateway 32 United 34 UPMC 59 Aetna TOTAL

02 Allegheny 60,154 19,167 96,369 6,740 182,430

03 Armstrong 1,208 473 10,155 461 12,297

04 Beaver 12,055 2,095 12,375 1,200 27,725

05 Bedford 784 1,148 5,847 747 8,526

07 Blair 7,057 3,877 12,064 2,151 25,149

10 Butler 5,677 949 12,935 858 20,419

11 Cambria 3,827 5,182 13,992 2,640 25,641

26 Fayette 4,355 9,485 18,498 764 33,102

30 Greene 858 3,515 2,914 383 7,670

32 Indiana 2,702 1,760 8,370 545 13,377

37 Lawrence 7,547 1,370 7,523 652 17,092

56 Somerset 1,979 2,823 5,952 1,088 11,842

63 Washington 5,882 4,950 17,409 1,273 29,514

65 Westmoreland 12,294 7,674 29,873 1,956 51,797

TOTAL 126,379 64,468 254,276 21,458 466,581

PERCENTAGE 27% 14% 54% 5%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

5

Mandatory June 2016 ENROLLMENT BY PLAN AND BY COUNTY

cont. LEHIGH/CAPITAL

County 51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL

01 Adams 4,260 4,480 1,069 1,192 1,414 12,415

06 Berks 15,427 8,337 5,759 5,965 38,643 74,131

21 Cumberland 12,027 3,300 3,675 1,277 4,730 25,009

22 Dauphin 28,217 9,396 6,693 3,980 5,082 53,368

28 Franklin 721 688 7,764 513 12,481 22,167

29 Fulton 136 338 686 589 656 2,405

31 Huntingdon 522 675 979 3,576 1,649 7,401

36 Lancaster 23,859 10,079 3,526 7,942 28,263 73,669

38 Lebanon 14,145 1,695 1,591 1,718 2,827 21,976

39 Lehigh 21,525 4,157 3,972 4,035 32,765 66,454

48 Northampton 13,385 2,296 3,117 2,139 22,176 43,113

50 Perry 3,696 571 565 209 798 5,839

67 York 22,399 20,961 6,206 6,083 13,043 68,692

TOTAL 160,319 66,973 45,602 39,218 164,527 476,639

PERCENTAGE 34% 14% 10% 8% 35%

NEW WEST

County 35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL

12 Cameron 782 33 129 54 998

16 Clarion 3,966 863 609 651 6,089

17 Clearfield 10,557 1,489 1,961 1,594 15,601

20 Crawford 11,695 932 1,126 1,272 15,025

24 Elk 3,408 438 251 255 4,352

25 Erie 29,795 15,135 5,943 9,377 60,250

27 Forest 509 106 85 57 757

33 Jefferson 6,574 1,012 388 466 8,440

42 McKean 5,922 353 1,253 736 8,264

43 Mercer 13,268 3,823 2,216 2,248 21,555

53 Potter 1,863 36 1,326 81 3,306

61 Venango 6,703 921 1,073 1,137 9,834

62 Warren 4,338 700 769 498 6,305

TOTAL 99,380 25,841 17,129 18,426 160,776

PERCENTAGE 62% 16% 11% 11%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

6

Mandatory June 2016 ENROLLMENT BY PLAN AND BY COUNTY

cont.

NEW EAST

County 41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

08 Bradford 2,762 4,389 3,585 10,736

13 Carbon 6,269 2,578 1,184 10,031

14 Centre 2,572 6,320 2,503 11,395

18 Clinton 1,087 4,962 782 6,831

19 Columbia 1,421 6,930 1,125 9,476

34 Juniata 747 1,636 657 3,040

35 Lackawanna 6,845 28,589 5,099 40,533

40 Luzerne 15,672 39,478 10,264 65,414

41 Lycoming 4,980 14,517 1,400 20,897

44 Mifflin 2,006 4,634 1,558 8,198

45 Monroe 13,294 12,070 4,141 29,505

47 Montour 369 1,540 289 2,198

49 Northumberland 3,123 9,967 3,467 16,557

52 Pike 2,817 4,977 1,097 8,891

54 Schuylkill 7,842 14,550 3,145 25,537

55 Snyder 1,133 3,034 926 5,093

57 Sullivan 163 508 124 795

58 Susquehanna 1,081 4,258 956 6,295

59 Tioga 5,916 965 612 7,493

60 Union 1,007 2,546 784 4,337

64 Wayne 1,504 5,408 1,049 7,961

66 Wyoming 762 3,213 643 4,618

TOTAL 83,372 177,069 45,390 305,831

PERCENTAGE 27% 59% 15%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

7

Mandatory June 2016 MARKET SHARE BY PLAN – STATEWIDE

Total Enrollment = 2,218,321

AmeriHealth NE 83,372

4% Aetna

204,706 9%

AmeriHealth 181,656

8%

Gateway 312,539

14%

Health Partners 236,800

11%

Keystone 409,315

18%

United 219,990

10%

UPMC 392,874

18%

Geisinger 177,069

8%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16 8

Mandatory June 2016 MARKET SHARE BY ZONE AND BY PLAN

Northwest

Aetna 18,426

11%

Gateway 25,841

16%

UPMC 99,380

62%

Ameri-Health 12,215

10%

Southwest Aetna 21,458

5%

Gateway 126,379

27%

United 64,468

14%

UPMC 254,276

54%

Southeast

Aetna 73,830

9%

Health Partners 236,800

29%

Keystone 409,315

51%

United 88,549

11%

Lehigh/Capital

UPMC 39,218

8%

Aetna 45,602

10%

Ameri-Health

164,527 34%

Gateway 160,319

34%

United 66,973

14%

Northeast

Aetna 45,390

15%

Ameri-Health NE

83,372 27%

Geisinger 177,069

58%

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

9

Mandatory June 2016 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 585 2,358 4,375 2,092 34,919 44,329

43 Aetna 726 1,220 5,120 2,535 22,871 32,472

45 Health Partners 1,263 413 4,398 3,483 101,766 111,323

47 Keystone 3,899 3,961 32,216 12,038 145,667 197,781

Southeast MCOs 6,473 7,952 46,109 20,148 305,223 385,905

American Indian or Alaskan

Native

42 United 10 36 16 12 55 129

43 Aetna 17 37 11 42 66 173

45 Health Partners 40 11 10 43 222 326

47 Keystone 88 78 114 155 274 709

Southeast MCOs 155 162 151 252 617 1,337

Asian

42 United 217 274 620 512 3,954 5,577

43 Aetna 294 159 545 803 1,517 3,318

45 Health Partners 519 55 354 642 7,117 8,687

47 Keystone 1,244 585 3,762 3,344 16,658 25,593

Southeast MCOs 2,274 1,073 5,281 5,301 29,246 43,175

White

42 United 3,419 6,587 2,748 4,528 7,354 24,636

43 Aetna 5,387 4,599 4,761 6,391 6,963 28,101

45 Health Partners 7,152 1,402 2,178 5,468 32,649 48,849

47 Keystone 27,488 13,274 24,971 27,794 38,705 132,232

Southeast MCOs 43,446 25,862 34,658 44,181 85,671 233,818

Other or system default

42 United 515 2,003 554 1,254 6,680 11,006

43 Aetna 510 792 639 1,133 3,991 7,065

45 Health Partners 1,279 214 624 1,388 59,643 63,148

47 Keystone 3,668 3,033 3,986 6,731 26,626 44,044

Southeast MCOs 5,972 6,042 5,803 10,506 96,940 125,263

Native Hawaiian or Other

Pacific Islander

42 United 3 17 1 7 55 83

43 Aetna 6 6 13 12 34 71

45 Health Partners 17 0 5 9 129 160

47 Keystone 31 16 36 41 120 244

Southeast MCOs 57 39 55 69 338 558

Unknown

42 United 224 593 302 474 1,196 2,789

43 Aetna 340 317 381 625 967 2,630

45 Health Partners 414 132 249 470 3,042 4,307

47 Keystone 1,145 744 1,209 1,812 3,802 8,712

Southeast MCOs 2,123 1,786 2,141 3,381 9,007 18,438

MCO TOTAL

42 United 4,973 11,868 8,616 8,879 54,213 88,549

43 Aetna 7,280 7,130 11,470 11,541 36,409 73,830

45 Health Partners 10,684 2,227 7,818 11,503 204,568 236,800

47 Keystone 37,563 21,691 66,294 51,915 231,852 409,315

TOTAL 60,500 42,916 94,198 83,838 527,042 808,494

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

10

Mandatory June 2016 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 28,838 43 2,802 16 477 205 447 396

32 United 7,972 7 415 12 243 16 794 833

34 UPMC 32,301 146 2,002 58 471 310 1,181 1,408

59 Aetna 2,411 8 240 10 129 23 624 78

Southwest MCOs 71,522 204 5,459 96 1,320 554 3,046 2,715

American Indian or

Alaskan Native

31 Gateway 110 1 15 0 2 2 4 8

32 United 41 1 0 1 8 0 3 7

34 UPMC 265 19 17 11 19 31 19 29

59 Aetna 13 0 7 2 6 0 1 4

Southwest MCOs 429 21 39 14 35 33 27 48

Asian

31 Gateway 770 1 26 1 29 29 10 16

32 United 381 2 19 4 23 12 14 13

34 UPMC 4,372 32 88 22 53 142 48 41

59 Aetna 158 0 10 3 13 7 11 5

Southwest MCOs 5,681 35 143 30 118 190 83 75

White

31 Gateway 27,718 1,149 8,943 752 6,463 5,323 3,272 3,867

32 United 9,637 453 1,586 1,115 3,533 887 4,239 8,488

34 UPMC 53,188 9,847 9,899 5,653 11,338 12,071 12,460 16,709

59 Aetna 3,627 448 904 717 1,973 798 1,946 659

Southwest MCOs 94,170 11,897 21,332 8,237 23,307 19,079 21,917 29,723

Other or system

default

31 Gateway 1,752 7 220 12 58 80 67 41

32 United 662 3 55 10 39 15 94 94

34 UPMC 3,708 55 237 85 100 181 182 127

59 Aetna 250 0 23 12 11 10 39 7

Southwest MCOs 6,372 65 535 119 208 286 382 269

Native Hawaiian or

Other Pacific Islander

31 Gateway 15 0 2 0 1 4 0 1

32 United 13 0 1 0 1 0 1 0

34 UPMC 49 1 2 5 2 1 6 13

59 Aetna 2 0 0 0 0 0 1 0

Southwest MCOs 79 1 5 5 4 5 8 14

Unknown

31 Gateway 951 7 47 3 27 34 27 26

32 United 461 7 19 6 30 19 37 50

34 UPMC 2,486 55 130 13 81 199 96 171

59 Aetna 279 5 16 3 19 20 18 11

Southwest MCOs 4,177 74 212 25 157 272 178 258

MCO TOTAL

31 Gateway 60,154 1,208 9,253 784 7,057 5,677 3,827 4,355

32 United 19,167 473 2,095 1,148 3,877 949 5,182 9,485

34 UPMC 96,369 10,155 12,375 5,847 12,064 12,935 13,992 18,498

59 Aetna 6,740 461 1,200 747 2,151 858 2,640 764

TOTAL 182,430 12,297 27,725 8,526 25,149 20,419 25,641 33,102

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

11

Mandatory June 2016 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 93 981 13 684 1,559 36,569

32 United 39 68 180 16 571 792 11,958

34 UPMC 36 224 779 39 1,488 2,014 42,457

59 Aetna 4 43 101 16 137 152 3,976

Southwest MCOs 94 428 2,041 84 2,880 4,517 94,960

American Indian or

Alaskan Native

31 Gateway 0 3 6 1 5 14 171

32 United 5 11 1 7 8 10 103

34 UPMC 7 7 13 18 30 49 534

59 Aetna 0 1 1 3 6 8 52

Southwest MCOs 12 22 21 29 49 81 860

Asian

31 Gateway 3 26 17 6 15 35 984

32 United 3 5 1 4 17 30 528

34 UPMC 9 62 39 10 91 224 5,233

59 Aetna 3 4 2 2 9 12 239

Southwest MCOs 18 97 59 22 132 301 6,984

White

31 Gateway 831 2,522 6,443 1,923 5,026 10,387 84,619

32 United 3,452 1,630 1,163 2,763 4,207 6,608 49,761

34 UPMC 2,829 7,904 6,571 5,797 15,224 26,679 196,169

59 Aetna 367 479 529 1,046 1,066 1,697 16,256

Southwest MCOs 7,479 12,535 14,706 11,529 25,523 45,371 346,805

Other or system

default

31 Gateway 7 33 53 25 76 183 2,614

32 United 9 26 15 19 72 126 1,239

34 UPMC 22 91 62 43 236 400 5,529

59 Aetna 2 10 12 10 19 37 442

Southwest MCOs 40 160 142 97 403 746 9,824

Native Hawaiian or

Other Pacific Islander

31 Gateway 0 1 2 1 1 2 30

32 United 1 2 1 0 4 2 26

34 UPMC 2 0 1 0 6 8 96

59 Aetna 0 0 0 1 0 1 5

Southwest MCOs 3 3 4 2 11 13 157

Unknown

31 Gateway 2 24 45 10 75 114 1,392

32 United 6 18 9 14 71 106 853

34 UPMC 9 82 58 45 334 499 4,258

59 Aetna 7 8 7 10 36 49 488

Southwest MCOs 24 132 119 79 516 768 6,991

MCO TOTAL

31 Gateway 858 2,702 7,547 1,979 5,882 12,294 126,379

32 United 3,515 1,760 1,370 2,823 4,950 7,674 64,468

34 UPMC 2,914 8,370 7,523 5,952 17,409 29,873 254,276

59 Aetna 383 545 652 1,088 1,273 1,956 21,458

TOTAL 7,670 13,377 17,092 11,842 29,514 51,797 466,581

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

12

Mandatory June 2016 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 170 1,481 1,375 11,209 70 1 27

52 United 232 737 371 3,614 52 6 28

53 Aetna 45 669 381 2,190 662 12 50

54 UPMC 35 492 99 1,197 38 9 119

57 AmeriHealth 65 3,390 463 1,579 1,052 14 50

Lehigh/Capital MCOs 547 6,769 2,689 19,789 1,874 42 274

American Indian or Alaskan

Native

51 Gateway 10 15 36 75 2 0 0

52 United 8 20 10 26 2 0 0

53 Aetna 2 6 10 30 20 2 0

54 UPMC 2 15 2 6 3 1 1

57 AmeriHealth 3 46 14 19 40 3 1

Lehigh/Capital MCOs 25 102 72 156 67 6 2

Asian

51 Gateway 30 176 311 1,469 6 0 1

52 United 16 123 125 424 4 0 1

53 Aetna 5 103 109 248 46 0 3

54 UPMC 13 66 36 175 2 0 13

57 AmeriHealth 10 283 116 167 104 0 3

Lehigh/Capital MCOs 74 751 697 2,483 162 0 21

White

51 Gateway 3,727 7,185 8,631 8,966 550 135 483

52 United 3,539 4,703 2,240 3,428 576 324 631

53 Aetna 915 3,474 2,747 3,145 6,163 663 914

54 UPMC 1,009 3,462 961 1,894 430 579 3,386

57 AmeriHealth 1,210 13,291 3,545 2,151 9,337 622 1,570

Lehigh/Capital MCOs 10,400 32,115 18,124 19,584 17,056 2,323 6,984

Other or system default

51 Gateway 221 6,278 1,284 5,687 54 0 9

52 United 578 2,502 414 1,528 31 5 11

53 Aetna 68 1,312 264 786 592 8 8

54 UPMC 78 1,700 119 523 25 0 43

57 AmeriHealth 90 20,866 393 905 1,409 14 12

Lehigh/Capital MCOs 1,035 32,658 2,474 9,429 2,111 27 83

Native Hawaiian or Other

Pacific Islander

51 Gateway 1 3 13 27 0 0 0

52 United 2 10 2 3 0 0 0

53 Aetna 1 9 2 4 10 0 0

54 UPMC 2 3 1 1 1 0 2

57 AmeriHealth 0 22 9 5 14 1 1

Lehigh/Capital MCOs 6 47 27 40 25 1 3

Unknown

51 Gateway 101 289 377 784 39 0 2

52 United 105 242 138 373 23 3 4

53 Aetna 33 186 162 290 271 1 4

54 UPMC 53 227 59 184 14 0 12

57 AmeriHealth 36 745 190 256 525 2 12

Lehigh/Capital MCOs 328 1,689 926 1,887 872 6 34

MCO TOTAL

51 Gateway 4,260 15,427 12,027 28,217 721 136 522

52 United 4,480 8,337 3,300 9,396 688 338 675

53 Aetna 1,069 5,759 3,675 6,693 7,764 686 979

54 UPMC 1,192 5,965 1,277 3,980 513 589 3,576

57 AmeriHealth 1,414 38,643 4,730 5,082 12,481 656 1,649

TOTAL 12,415 74,131 25,009 53,368 22,167 2,405 7,401 13

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

Mandatory June 2016 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 2,020 578 2,930 1,837 50 2,376 24,124

52 United 1,207 92 624 243 10 3,770 10,986

53 Aetna 390 71 718 406 21 1,005 6,620

54 UPMC 715 107 554 257 11 905 4,538

57 AmeriHealth 3,179 160 3,694 2,358 16 2,155 18,175

Lehigh/Capital MCOs 7,511 1,008 8,520 5,101 108 10,211 64,443

American Indian or Alaskan

Native

51 Gateway 41 13 32 30 2 69 325

52 United 34 1 6 3 0 49 159

53 Aetna 16 1 2 8 1 16 114

54 UPMC 24 5 8 8 0 13 88

57 AmeriHealth 48 5 38 52 0 56 325

Lehigh/Capital MCOs 163 25 86 101 3 203 1,011

Asian

51 Gateway 975 119 281 180 7 211 3,766

52 United 310 24 79 45 3 226 1,380

53 Aetna 106 13 120 86 5 90 934

54 UPMC 286 19 97 57 0 63 827

57 AmeriHealth 685 44 563 432 0 158 2,565

Lehigh/Capital MCOs 2,362 219 1,140 800 15 748 9,472

White

51 Gateway 15,245 9,670 15,267 7,804 3,530 16,531 97,724

52 United 5,679 1,209 2,928 1,633 534 12,039 39,463

53 Aetna 2,230 1,195 2,649 2,136 518 4,108 30,857

54 UPMC 5,138 1,197 2,831 1,442 188 4,071 26,588

57 AmeriHealth 14,565 1,599 24,261 14,161 764 7,934 95,010

Lehigh/Capital MCOs 42,857 14,870 47,936 27,176 5,534 44,683 289,642

Other or system default

51 Gateway 4,789 3,483 2,693 3,267 86 2,760 30,611

52 United 2,458 323 381 285 19 4,429 12,964

53 Aetna 605 266 375 345 12 752 5,393

54 UPMC 1,333 326 406 267 8 815 5,643

57 AmeriHealth 8,745 925 3,684 4,689 10 2,440 44,182

Lehigh/Capital MCOs 17,930 5,323 7,539 8,853 135 11,196 98,793

Native Hawaiian or Other

Pacific Islander

51 Gateway 3 10 11 10 0 16 94

52 United 10 1 12 4 1 20 65

53 Aetna 3 2 10 11 0 3 55

54 UPMC 5 1 10 6 0 4 36

57 AmeriHealth 17 2 20 21 0 7 119

Lehigh/Capital MCOs 38 16 63 52 1 50 369

Unknown

51 Gateway 786 272 311 257 21 436 3,675

52 United 381 45 127 83 4 428 1,956

53 Aetna 176 43 98 125 8 232 1,629

54 UPMC 441 63 129 102 2 212 1,498

57 AmeriHealth 1,024 92 505 463 8 293 4,151

Lehigh/Capital MCOs 2,808 515 1,170 1,030 43 1,601 12,909

MCO TOTAL

51 Gateway 23,859 14,145 21,525 13,385 3,696 22,399 160,319

52 United 10,079 1,695 4,157 2,296 571 20,961 66,973

53 Aetna 3,526 1,591 3,972 3,117 565 6,206 45,602

54 UPMC 7,942 1,718 4,035 2,139 209 6,083 39,218

57 AmeriHealth 28,263 2,827 32,765 22,176 798 13,043 164,527

TOTAL 73,669 21,976 66,454 43,113 5,839 68,692 476,639

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

14

Mandatory June 2016 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 12 108 103 402 33 4,583 3

36 Gateway 1 26 21 39 6 3,804 1

37 AmeriHealth 5 19 31 26 1 1,334 0

56 Aetna 4 16 17 50 2 2,203 0

New West MCOs 22 169 172 517 42 11,924 4

American Indian or Alaskan

Native

35 UPMC 1 8 6 21 10 71 2

36 Gateway 0 0 0 3 0 29 4

37 AmeriHealth 0 3 2 1 3 14 0

56 Aetna 0 1 0 0 0 30 0

New West MCOs 1 12 8 25 13 144 6

Asian

35 UPMC 0 11 50 35 2 1,511 0

36 Gateway 0 8 1 1 2 263 0

37 AmeriHealth 0 5 8 2 4 191 0

56 Aetna 0 4 7 1 3 103 0

New West MCOs 0 28 66 39 11 2,068 0

White

35 UPMC 763 3,781 10,306 11,069 3,332 21,908 497

36 Gateway 32 822 1,452 874 430 10,020 100

37 AmeriHealth 123 572 1,907 1,081 238 4,078 84

56 Aetna 49 624 1,547 1,215 250 6,448 56

New West MCOs 967 5,799 15,212 14,239 4,250 42,454 737

Other or system default

35 UPMC 4 30 44 95 16 1,438 5

36 Gateway 0 2 9 5 0 904 1

37 AmeriHealth 1 4 6 8 5 272 1

56 Aetna 1 3 12 5 0 509 1

New West MCOs 6 39 71 113 21 3,123 8

Native Hawaiian or Other

Pacific Islander

35 UPMC 0 1 0 5 1 8 1

36 Gateway 0 0 0 0 0 10 0

37 AmeriHealth 0 0 0 0 0 1 0

56 Aetna 0 1 1 0 0 4 0

New West MCOs 0 2 1 5 1 23 1

Unknown

35 UPMC 2 27 48 68 14 276 1

36 Gateway 0 5 6 10 0 105 0

37 AmeriHealth 0 6 7 8 0 53 0

56 Aetna 0 2 10 1 0 80 0

New West MCOs 2 40 71 87 14 514 1

MCO TOTAL

35 UPMC 782 3,966 10,557 11,695 3,408 29,795 509

36 Gateway 33 863 1,489 932 438 15,135 106

37 AmeriHealth 129 609 1,961 1,126 251 5,943 85

56 Aetna 54 651 1,594 1,272 255 9,377 57

TOTAL 998 6,089 15,601 15,025 4,352 60,250 757

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

15

Mandatory June 2016 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 53 52 1,717 10 145 36 7,257

36 Gateway 10 2 726 0 33 10 4,679

37 AmeriHealth 9 7 446 15 30 10 1,933

56 Aetna 7 4 446 0 36 5 2,790

New West MCOs 79 65 3,335 25 244 61 16,659

American Indian or Alaskan

Native

35 UPMC 9 8 8 3 9 11 167

36 Gateway 1 4 2 0 4 1 48

37 AmeriHealth 0 0 7 2 3 2 37

56 Aetna 1 2 1 0 4 2 41

New West MCOs 11 14 18 5 20 16 293

Asian

35 UPMC 16 21 76 2 20 15 1,759

36 Gateway 4 0 19 0 4 0 302

37 AmeriHealth 2 6 19 0 3 2 242

56 Aetna 0 1 15 0 1 2 137

New West MCOs 22 28 129 2 28 19 2,440

White

35 UPMC 6,443 5,789 11,171 1,822 6,446 4,241 87,568

36 Gateway 990 345 3,002 36 860 684 19,647

37 AmeriHealth 372 1,227 1,689 1,293 1,021 746 14,431

56 Aetna 453 726 1,739 79 1,085 484 14,755

New West MCOs 8,258 8,087 17,601 3,230 9,412 6,155 136,401

Other or system default

35 UPMC 35 30 164 12 50 22 1,945

36 Gateway 5 1 44 0 9 2 982

37 AmeriHealth 3 5 32 9 10 4 360

56 Aetna 4 1 21 0 7 3 567

New West MCOs 47 37 261 21 76 31 3,854

Native Hawaiian or Other

Pacific Islander

35 UPMC 2 5 6 0 3 1 33

36 Gateway 0 0 1 0 0 0 11

37 AmeriHealth 0 4 2 1 1 1 10

56 Aetna 0 0 0 0 0 0 6

New West MCOs 2 9 9 1 4 2 60

Unknown

35 UPMC 16 17 126 14 30 12 651

36 Gateway 2 1 29 0 11 3 172

37 AmeriHealth 2 4 21 6 5 4 116

56 Aetna 1 2 26 2 4 2 130

New West MCOs 21 24 202 22 50 21 1,069

MCO TOTAL

35 UPMC 6,574 5,922 13,268 1,863 6,703 4,338 99,380

36 Gateway 1,012 353 3,823 36 921 700 25,841

37 AmeriHealth 388 1,253 2,216 1,326 1,073 769 17,129

56 Aetna 466 736 2,248 81 1,137 498 18,426

TOTAL 8,440 8,264 21,555 3,306 9,834 6,305 160,776

Racial/Ethnic information is self-reported by consumers. Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

16

Mandatory June 2016 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 29 159 135 23 84 13 753 1,764

44 Geisinger 43 99 241 88 229 17 2,171 3,708

50 Aetna Better Health 59 40 130 20 61 12 594 1,216

New East MCOs 131 298 506 131 374 42 3,518 6,688

American Indian or Alaskan

Native

41 AmeriHealth NE 12 9 3 2 6 1 18 23

44 Geisinger 4 6 22 5 8 0 48 44

50 Aetna Better Health 3 4 18 2 4 7 8 10

New East MCOs 19 19 43 9 18 8 74 77

Asian

41 AmeriHealth NE 11 16 68 4 12 1 208 100

44 Geisinger 22 18 134 10 38 8 956 338

50 Aetna Better Health 11 4 107 1 14 2 216 75

New East MCOs 44 38 309 15 64 11 1,380 513

White

41 AmeriHealth NE 2,677 5,835 2,273 1,041 1,275 674 4,857 9,562

44 Geisinger 4,283 2,332 5,768 4,769 6,493 1,476 21,408 28,803

50 Aetna Better Health 3,467 1,055 2,164 733 1,000 596 3,597 6,534

New East MCOs 10,427 9,222 10,205 6,543 8,768 2,746 29,862 44,899

Other or system default

41 AmeriHealth NE 21 178 51 12 32 48 899 4,040

44 Geisinger 27 89 71 56 106 123 3,576 6,092

50 Aetna Better Health 29 56 46 13 30 33 581 2,283

New East MCOs 77 323 168 81 168 204 5,056 12,415

Native Hawaiian or Other

Pacific Islander

41 AmeriHealth NE 0 2 0 0 0 0 4 4

44 Geisinger 0 0 4 2 2 0 12 27

50 Aetna Better Health 1 2 2 0 1 0 6 8

New East MCOs 1 4 6 2 3 0 22 39

Unknown

41 AmeriHealth NE 12 70 42 5 12 10 106 179

44 Geisinger 10 34 80 32 54 12 418 466

50 Aetna Better Health 15 23 36 13 15 7 97 138

New East MCOs 37 127 158 50 81 29 621 783

MCO TOTAL

41 AmeriHealth NE 2,762 6,269 2,572 1,087 1,421 747 6,845 15,672

44 Geisinger 4,389 2,578 6,320 4,962 6,930 1,636 28,589 39,478

50 Aetna Better Health 3,585 1,184 2,503 782 1,125 657 5,099 10,264

TOTAL 10,736 10,031 11,395 6,831 9,476 3,040 40,533 65,414

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

17

Mandatory June 2016 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 892 46 2,216 13 156 352 275 41 44 Geisinger 2,044 86 2,126 40 341 289 483 103 50 Aetna Better Health 176 40 935 4 156 107 123 23 New East MCOs 3,112 172 5,277 57 653 748 881 167

American Indian or

Alaskan Native

41 AmeriHealth NE 1 6 21 0 4 9 13 0 44 Geisinger 36 6 35 4 11 12 18 2 50 Aetna Better Health 0 0 9 1 7 6 9 5 New East MCOs 37 12 65 5 22 27 40 7

Asian

41 AmeriHealth NE 34 8 167 6 15 25 39 16 44 Geisinger 54 13 182 18 49 67 74 6 50 Aetna Better Health 13 12 54 5 15 2 13 3 New East MCOs 101 33 403 29 79 94 126 25

White

41 AmeriHealth NE 3,935 1,913 8,253 342 2,751 2,093 7,073 1,034 44 Geisinger 12,138 4,435 7,351 1,421 9,104 4,279 13,363 2,819 50 Aetna Better Health 1,175 1,471 2,269 273 3,140 851 2,860 869 New East MCOs 17,248 7,819 17,873 2,036 14,995 7,223 23,296 4,722

Other or system default

41 AmeriHealth NE 73 27 2,244 6 162 265 371 34 44 Geisinger 161 80 2,029 39 353 252 487 72 50 Aetna Better Health 14 31 725 5 125 101 122 13 New East MCOs 248 138 4,998 50 640 618 980 119

Native Hawaiian or

Other Pacific Islander

41 AmeriHealth NE 6 1 25 0 0 1 4 0 44 Geisinger 9 2 7 4 6 6 9 3 50 Aetna Better Health 2 1 9 0 2 2 0 0 New East MCOs 17 4 41 4 8 9 13 3

Unknown

41 AmeriHealth NE 39 5 368 2 35 72 67 8 44 Geisinger 75 12 340 14 103 72 116 29 50 Aetna Better Health 20 3 140 1 22 28 18 13 New East MCOs 134 20 848 17 160 172 201 50

MCO TOTAL

41 AmeriHealth NE 4,980 2,006 13,294 369 3,123 2,817 7,842 1,133

44 Geisinger 14,517 4,634 12,070 1,540 9,967 4,977 14,550 3,034

50 Aetna Better Health 1,400 1,558 4,141 289 3,467 1,097 3,145 926

TOTAL 20,897 8,198 29,505 2,198 16,557 8,891 25,537 5,093

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

18

Mandatory June 2016 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 1 3 94 46 42 8 7,145

44 Geisinger 3 19 19 165 103 26 12,443

50 Aetna Better Health 6 8 13 48 26 7 3,804

New East MCOs 10 30 126 259 171 41 23,392

American Indian or Alaskan

Native

41 AmeriHealth NE 1 0 16 0 5 0 150

44 Geisinger 1 3 1 4 18 3 291

50 Aetna Better Health 0 0 1 1 2 1 98

New East MCOs 2 3 18 5 25 4 539

Asian

41 AmeriHealth NE 1 2 12 5 6 0 756

44 Geisinger 1 14 5 17 30 9 2,063

50 Aetna Better Health 0 2 0 0 6 2 557

New East MCOs 2 18 17 22 42 11 3,376

White

41 AmeriHealth NE 155 1,055 5,735 920 1,419 739 65,611

44 Geisinger 498 4,152 918 2,260 5,106 3,131 146,307

50 Aetna Better Health 115 925 585 722 977 620 35,998

New East MCOs 768 6,132 7,238 3,902 7,502 4,490 247,916

Other or system default

41 AmeriHealth NE 4 17 38 29 27 8 8,586

44 Geisinger 5 37 8 79 102 20 13,864

50 Aetna Better Health 1 15 7 8 20 11 4,269

New East MCOs 10 69 53 116 149 39 26,719

Native Hawaiian or Other

Pacific Islander

41 AmeriHealth NE 0 0 0 0 0 2 49

44 Geisinger 0 1 0 2 2 1 99

50 Aetna Better Health 0 0 1 0 0 0 37

New East MCOs 0 1 1 2 2 3 185

Unknown

41 AmeriHealth NE 1 4 21 7 5 5 1,075

44 Geisinger 0 32 14 19 47 23 2,002

50 Aetna Better Health 2 6 5 5 18 2 627

New East MCOs 3 42 40 31 70 30 3,704

MCO TOTAL

41 AmeriHealth NE 163 1,081 5,916 1,007 1,504 762 83,372

44 Geisinger 508 4,258 965 2,546 5,408 3,213 177,069

50 Aetna Better Health 124 956 612 784 1,049 643 45,390

TOTAL 795 6,295 7,493 4,337 7,961 4,618 305,831

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

19

Mandatory June 2016 ENROLLMENT BY ETHNICITY, BY PLAN AND BY COUNTY

Southeast

09 Bucks 15 Chester 23 Delaware 46 Montgomery 51 Philadelphia Southeast

Other/Unknown

42 United 1 0 0 1 7 9

43 Aetna 2 0 0 2 3 7

45 Health Partners 0 0 0 0 7 7

47 Keystone 6 4 3 3 11 27

Southeast MCOs 9 4 3 6 28 50

Non-Hispanic

42 United 4,407 8,892 8,183 7,669 47,804 76,955

43 Aetna 6,709 5,998 10,914 10,667 32,596 66,884

45 Health Partners 9,251 1,969 7,252 10,271 140,955 169,698

47 Keystone 33,688 17,659 63,028 46,271 207,094 367,740

Southeast MCOs 54,055 34,518 89,377 74,878 428,449 681,277

Hispanic

42 United 565 2,976 433 1,209 6,402 11,585

43 Aetna 569 1,132 556 872 3,810 6,939

45 Health Partners 1,433 258 566 1,232 63,606 67,095

47 Keystone 3,869 4,028 3,263 5,641 24,747 41,548

Southeast MCOs 6,436 8,394 4,818 8,954 98,565 127,167

TOTAL 60,500 42,916 94,198 83,838 527,042 808,494

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

20

Mandatory June 2016 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 5 0 2 1 0 0 0 1

32 United 1 0 0 1 0 0 0 0

34 UPMC 4 0 1 0 0 2 1 1

59 Aetna 1 0 0 0 0 0 0 0

Southwest MCOs 11 0 3 2 0 2 1 2

Non-Hispanic

31 Gateway 59,344 1,197 11,917 775 6,976 5,570 3,770 4,321

32 United 18,844 469 2,062 1,139 3,819 929 5,095 9,420

34 UPMC 94,362 10,096 12,217 5,783 11,935 12,727 13,832 18,343

59 Aetna 6,602 461 1,182 738 2,127 844 2,599 754

Southwest MCOs 179,152 12,223 27,378 8,435 24,857 20,070 25,296 32,838

Hispanic

31 Gateway 805 11 136 8 81 107 57 33

32 United 322 4 33 8 58 20 87 65

34 UPMC 2,003 59 157 64 129 206 159 154

59 Aetna 137 0 18 9 24 14 41 10

Southwest MCOs 3,267 74 344 89 292 347 344 262

TOTAL 182,430 12,297 27,725 8,526 25,149 20,419 25,641 33,102

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

21

Mandatory June 2016 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 0 0 0 0 0 3 12

32 United 1 0 0 1 0 0 4

34 UPMC 0 1 0 0 4 1 15

59 Aetna 0 0 0 0 0 0 1

Southwest MCOs 1 1 0 1 4 4 32

Non-Hispanic

31 Gateway 856 2,676 7,490 1,960 5,799 12,178 124,829

32 United 3,506 1,730 1,351 2,796 4,883 7,580 63,623

34 UPMC 2,895 8,277 7,439 5,900 17,166 29,532 250,504

59 Aetna 381 531 644 1,076 1,260 1,918 21,117

Southwest MCOs 7,638 13,214 16,924 11,732 29,108 51,208 460,073

Hispanic

31 Gateway 2 26 57 19 83 113 1,538

32 United 8 30 19 26 67 94 841

34 UPMC 19 92 84 52 239 340 3,757

59 Aetna 2 14 8 12 13 38 340

Southwest MCOs 31 162 168 109 402 585 6,476

TOTAL 7,670 13,377 17,092 11,842 29,514 51,797 466,581

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

22

Mandatory June 2016 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 1 1 1 2 0 0 0

52 United 3 1 1 1 0 0 0

53 Aetna 0 2 1 0 1 0 0

54 UPMC 0 2 0 0 0 0 0

57 AmeriHealth 0 2 3 1 0 0 0

Lehigh/Capital MCOs 4 8 6 4 1 0 0

Non-Hispanic

51 Gateway 3,933 8,442 11,214 22,494 661 135 510

52 United 3,589 5,602 2,949 7,923 643 334 662

53 Aetna 958 4,276 3,473 5,980 7,184 675 970

54 UPMC 1,042 4,039 1,191 3,513 489 585 3,540

57 AmeriHealth 1,258 15,775 4,393 4,144 10,741 643 1,635

Lehigh/Capital MCOs 10,780 38,134 23,220 44,054 19,718 2,372 7,317

Hispanic

51 Gateway 326 6,984 812 5,721 60 1 12

52 United 888 2,734 350 1,472 45 4 13

53 Aetna 111 1,481 201 713 579 11 9

54 UPMC 150 1,924 86 467 24 4 36

57 AmeriHealth 156 22,866 334 937 1,740 13 14

Lehigh/Capital MCOs 1,631 35,989 1,783 9,310 2,448 33 84

TOTAL 12,415 74,131 25,009 53,368 22,167 2,405 7,401

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

23

Mandatory June 2016 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 2 0 1 0 0 0 8

52 United 1 0 1 0 0 2 10

53 Aetna 0 0 1 3 0 2 10

54 UPMC 1 1 0 0 0 0 4

57 AmeriHealth 0 0 1 2 0 1 10

Lehigh/Capital MCOs 4 1 4 5 0 5 42

Non-Hispanic

51 Gateway 18,683 9,294 10,034 8,859 3,600 19,593 117,452

52 United 7,305 1,257 2,401 1,918 550 16,112 51,245

53 Aetna 2,848 1,229 2,525 2,621 548 5,416 38,703

54 UPMC 6,432 1,238 2,622 1,736 199 5,198 31,824

57 AmeriHealth 18,243 1,566 16,896 15,792 790 10,311 102,187

Lehigh/Capital MCOs 53,511 14,584 34,478 30,926 5,687 56,630 341,411

Hispanic

51 Gateway 5,174 4,851 11,490 4,526 96 2,806 42,859

52 United 2,773 438 1,755 378 21 4,847 15,718

53 Aetna 678 362 1,446 493 17 788 6,889

54 UPMC 1,509 479 1,413 403 10 885 7,390

57 AmeriHealth 10,020 1,261 15,868 6,382 8 2,731 62,330

Lehigh/Capital MCOs 20,154 7,391 31,972 12,182 152 12,057 135,186

TOTAL 73,669 21,976 66,454 43,113 5,839 68,692 476,639

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

24

Mandatory June 2016 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 1 1 1 0 2 0

36 Gateway 0 0 0 0 0 0 0

37 AmeriHealth 0 0 0 1 0 0 0

56 Aetna 0 0 0 0 0 0 0

New West MCOs 0 1 1 2 0 2 0

Non-Hispanic

35 UPMC 764 3,933 10,488 11,568 3,381 28,055 508

36 Gateway 32 861 1,482 924 437 13,872 102

37 AmeriHealth 127 606 1,943 1,118 246 5,579 85

56 Aetna 53 643 1,584 1,258 251 8,698 57

New West MCOs 976 6,043 15,497 14,868 4,315 56,204 752

Hispanic

35 UPMC 18 32 68 126 27 1,738 1

36 Gateway 1 2 7 8 1 1,263 4

37 AmeriHealth 2 3 18 7 5 364 0

56 Aetna 1 8 10 14 4 679 0

New West MCOs 22 45 103 155 37 4,044 5

TOTAL 998 6,089 15,601 15,025 4,352 60,250 757

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

25

Mandatory June 2016 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 0 1 0 0 0 0 6

36 Gateway 0 0 1 0 0 0 1

37 AmeriHealth 0 0 0 0 0 0 1

56 Aetna 0 0 0 0 0 1 1

New West MCOs 0 1 1 0 0 1 9

Non-Hispanic

35 UPMC 6,516 5,851 13,128 1,849 6,628 4,319 96,988

36 Gateway 1,007 349 3,781 36 914 693 24,490

37 AmeriHealth 385 1,249 2,185 1,316 1,057 762 16,658

56 Aetna 465 730 2,217 79 1,125 497 17,657

New West MCOs 8,373 8,179 21,311 3,280 9,724 6,271 155,793

Hispanic

35 UPMC 58 70 140 14 75 19 2,386

36 Gateway 5 4 41 0 7 7 1,350

37 AmeriHealth 3 4 31 10 16 7 470

56 Aetna 1 6 31 2 12 0 768

New West MCOs 67 84 243 26 110 33 4,974

TOTAL 8,440 8,264 21,555 3,306 9,834 6,305 160,776

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

26

Mandatory June 2016 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 0 0 0 0 2 0 1 2

44 Geisinger 0 0 0 0 2 0 1 5

50 Aetna 1 1 0 0 0 0 0 0

New East MCOs 1 1 0 0 4 0 2 7

Non-Hispanic

41 AmeriHealth NE 2,731 5,855 2,524 1,073 1,351 689 5,704 10,948

44 Geisinger 4,343 2,418 6,194 4,885 6,721 1,502 24,314 32,154

50 Aetna 3,557 1,088 2,440 773 1,067 612 4,352 7,548

New East MCOs 10,631 9,361 11,158 6,731 9,139 2,803 34,370 50,650

Hispanic

41 AmeriHealth NE 31 414 48 14 68 58 1,140 4,722

44 Geisinger 46 160 126 77 207 134 4,274 7,319

50 Aetna 27 95 63 9 58 45 747 2,716

New East MCOs 104 669 237 100 333 237 6,161 14,757

TOTAL 10,736 10,031 11,395 6,831 9,476 3,040 40,533 65,414

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16 27

Mandatory June 2016 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 0 1 1 0 0 0 0 0

44 Geisinger 1 2 1 0 0 0 0 0

50 Aetna 0 1 0 0 1 0 0 0

New East MCOs 1 4 2 0 1 0 0 0

Non-Hispanic

41 AmeriHealth NE 4,879 1,963 10,893 356 2,864 2,394 7,182 1,086

44 Geisinger 14,296 4,493 9,925 1,483 9,388 4,535 13,637 2,938

50 Aetna 1,372 1,499 3,292 280 3,307 961 2,936 912

New East MCOs 20,547 7,955 24,110 2,119 15,559 7,890 23,755 4,936

Hispanic

41 AmeriHealth NE 101 42 2,400 13 259 423 660 47

44 Geisinger 220 139 2,144 57 579 442 913 96

50 Aetna 28 58 849 9 159 136 209 14

New East MCOs 349 239 5,393 79 997 1,001 1,782 157

TOTAL 20,897 8,198 29,505 2,198 16,557 8,891 25,537 5,093

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

28

Mandatory June 2016 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 0 0 0 0 7

44 Geisinger 0 0 3 0 0 1 16

50 Aetna 0 0 0 0 0 0 4

New East MCOs 0 0 3 0 0 1 27

Non-Hispanic

41 AmeriHealth NE 156 1,057 5,861 930 1,459 751 72,706

44 Geisinger 494 4,177 959 2,389 5,192 3,159 159,596

50 Aetna 123 935 603 745 1,002 635 40,039

New East MCOs 773 6,169 7,423 4,064 7,653 4,545 272,341

Hispanic

41 AmeriHealth NE 7 24 55 77 45 11 10,659

44 Geisinger 14 81 3 157 216 53 17,457

50 Aetna 1 21 9 39 47 8 5,347

New East MCOs 22 126 67 273 308 72 33,463

TOTAL 795 6,295 7,493 4,337 7,961 4,618 305,831

Racial/Ethnic information is self-reported by consumers.

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

29

Mandatory June 2016 PLAN MAKE UP BY AGE GROUP AND GENDER

SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL

< 21 Yrs

Female 23,343 18,529 58,727 111,937 212,536

Male 24,091 19,663 59,251 119,385 222,390

Total 47,434 38,192 117,978 231,322 434,926

22-45 Yrs

Female 15,821 13,871 49,831 75,995 155,518

Male 11,679 11,718 26,396 40,207 90,000

Total 27,500 25,589 76,227 116,202 245,518

46-64 Yrs

Female 6,537 4,422 23,102 32,957 67,018

Male 6,531 5,245 18,209 26,639 56,624

Total 13,068 9,667 41,311 59,596 123,642

Over 64

Yrs

Female 327 241 828 1,397 2,793

Male 220 141 456 798 1,615

Total 547 382 1,284 2,195 4,408

TOTAL 88,549 73,830 236,800 409,315 808,494

SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL

< 21 Yrs Female 33,618 17,122 61,347 4,632 116,719

Male 35,831 18,196 64,456 4,699 123,182

Total 69,449 35,318 125,803 9,331 239,901

22-45 Yrs Female 24,805 11,909 52,207 4,461 93,382

Male 13,087 8,127 31,356 4,096 56,666

Total 37,892 20,036 83,563 8,557 150,048

46-64 Yrs Female 10,824 4,796 24,832 1,677 42,129

Male 7,999 4,208 19,406 1,847 33,460

Total 18,823 9,004 44,238 3,524 75,589

Over 64

Yrs

Female 139 73 415 26 653

Male 76 37 257 20 390

Total 215 110 672 46 1,043

TOTAL 126,379 64,468 254,276 21,458 466,581

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16 30

Mandatory June 2016 PLAN MAKE UP BY AGE GROUP AND GENDER

LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL

< 21 Yrs

Female 46,998 19,478 11,557 9,284 46,770 134,087

Male 49,173 20,374 12,116 9,857 48,697 140,217

Total 96,171 39,852 23,673 19,141 95,467 274,304

22-45 Yrs

Female 30,693 12,076 9,270 8,465 32,038 92,542

Male 14,240 7,060 6,367 5,624 15,220 48,511

Total 44,933 19,136 15,637 14,089 47,258 141,053

46-64 Yrs

Female 10,822 4,318 3,210 3,124 12,609 34,083

Male 7,799 3,435 2,908 2,729 8,484 25,355

Total 18,621 7,753 6,118 5,853 21,093 59,438

Over 64

Yrs

Female 390 143 105 80 484 1,202

Male 204 89 69 55 225 642

Total 594 232 174 135 709 1,844

TOTAL 160,319 66,973 45,602 39,218 164,527 476,639

NEW WEST

35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL

< 21 Yrs Female 25,932 6,635 3,950 4,845 41,362

Male 27,298 6,992 4,060 5,086 43,436

Total 53,230 13,627 8,010 9,931 84,798

22-45 Yrs Female 19,801 5,201 3,611 3,460 32,073

Male 11,467 3,325 2,697 2,454 19,943

Total 31,268 8,526 6,308 5,914 52,016

46-64 Yrs Female 8,606 2,004 1,412 1,392 13,414

Male 6,092 1,653 1,370 1,163 10,278

Total 14,698 3,657 2,782 2,555 23,692

Over 64

Yrs

Female 109 17 13 15 154

Male 75 14 16 11 116

Total 184 31 29 26 270

TOTAL 99,380 25,841 17,129 18,426 160,776

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

31

Mandatory June 2016 PLAN MAKE UP BY AGE GROUP AND GENDER

NEW EAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

< 21 Yrs Female 21,459 46,440 11,994 79,893

Male 22,523 48,910 12,650 84,083

Total 43,982 95,350 24,644 163,976

22-45 Yrs Female 17,317 35,329 8,555 61,201

Male 9,886 19,355 5,994 35,235

Total 27,203 54,684 14,549 96,436

46-64 Yrs Female 6,836 15,366 3,409 25,611

Male 5,145 11,277 2,662 19,084

Total 11,981 26,643 6,071 44,695

Over 64 Yrs Female 138 236 84 458

Male 68 156 42 266

Total 206 392 126 724

TOTAL 83,372 177,069 45,390 305,831

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16 32

Mandatory June 2016 PLAN MAKE UP BY AGE GROUP

SOUTHEAST

42 United 43 Aetna 45 Health Partners 47 Keystone TOTAL

< 21 Yrs 47,434 38,192 117,978 231,322 434,926

22-45 Yrs 27,500 25,589 76,227 116,202 245,518

46-64 Yrs 13,068 9,667 41,311 59,596 123,642

Over 64 Yrs 547 382 1,284 2,195 4,408

TOTAL 88,549 73,830 236,800 409,315 808,494

SOUTHWEST

31 Gateway 32 United 34 UPMC 59 Aetna TOTAL

< 21 Yrs 69,449 35,318 125,803 9,331 239,901

22-45 Yrs 37,892 20,036 83,563 8,557 150,048

46-64 Yrs 18,823 9,004 44,238 3,524 75,589

Over 64 Yrs 215 110 672 46 1,043

TOTAL 126,379 64,468 254,276 21,458 466,581

LEHIGH/CAPITAL

51 Gateway 52 United 53 Aetna 54 UPMC 57 AmeriHealth TOTAL

< 21 Yrs 96,171 39,852 23,673 19,141 95,467 274,304

22-45 Yrs 44,933 19,136 15,637 14,089 47,258 141,053

46-64 Yrs 18,621 7,753 6,118 5,853 21,093 59,438

Over 64 Yrs 594 232 174 135 709 1,844

TOTAL 160,319 66,973 45,602 39,218 164,527 476,639

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

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Mandatory June 2016 PLAN MAKE UP BY AGE GROUP

NEW WEST

35 UPMC 36 Gateway 37 AmeriHealth 56 Aetna TOTAL

< 21 Yrs 53,230 13,627 8,010 9,931 84,798

22-45 Yrs 31,268 8,526 6,308 5,914 52,016

46-64 Yrs 14,698 3,657 2,782 2,555 23,692

Over 64 Yrs 184 31 29 26 270

TOTAL 99,380 25,841 17,129 18,426 160,776

NEW EAST

41 AmeriHealth NE 44 Geisinger 50 Aetna TOTAL

< 21 Yrs 43,982 95,350 24,644 163,976

22-45 Yrs 27,203 54,684 14,549 96,436

46-64 Yrs 11,981 26,643 6,071 44,695

Over 64 Yrs 206 392 126 724

TOTAL 83,372 177,069 45,390 305,831

Source: PA Department of Human Services Enterprise Data Warehouse – Updated 7/21/16

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HealthChoices Enrollment 3rd Quarter 2015 AID CATEGORY DISTRIBUTION

Southeast

TANF/HB/MAGI (Ages 21+)

13%

SSI & HH 25%

TANF/HB/MAGI (Ages 0-20)

51%

B&CC 1%

Newly Eligible (21+) 9%

Newly Eligible (19-20)

2%

Southwest B&CC 1%

TANF/HB/MAGI (Ages 21+)

13% Newly Eligible (21+) 11%

SSI & HH 26%

TANF/HB/MAGI (Ages 0-20)

48% Newly Eligible (19-20)

2%

Lehigh/Capital

TANF/HB/MAGI (Ages 21+)

13%

SSI & HH 21%

TANF/HB/MAGI (Ages 0-20)

55%

B&CC 1%

Newly Eligible (21+) 10%

Newly Eligible (19-20)

2%

Northeast

TANF/HB/MAGI (Ages 21+)

13%

Newly Eligible (21+) 10%

SSI & HH 22%

TANF/HB/MAGI (Ages 0-20)

52%

B&CC 1%

Newly Eligible (19-20)

2%

Northwest B&CC 1%

Newly Eligible (19-20)

2%

35

TANF/HB/MAGI (Ages 21+)

13% Newly Eligible

(21+) 10%

SSI & HH 26%

TANF/HB/MAGI (Ages 0-20)

49%

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 June 2016 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.

June 2016

Zone Percentage

Southeast 93.1%

Southwest 94.4%

Lehigh/Capital 94.2%

Northwest 94.4%

Northeast 94.5%

Total 93.9%

Source: Maximus

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Medical Assistance Transportation Program

Based on Data Submitted by Each County

37

MATP 4Q FY 14/15

Southeast

COUNTY Total Expenditure Para Transit Trips Mass Transit Trips

Mileage

Reimbursement

Trips

Total Trips Client Utilization

Bucks $ 586,793 20,603 - 12,096 32,699 6.6%

Chester $ 566,831 15,944 1,884 2,310 20,138 8.3%

Delaware $ 1,309,706 34,490 - 11,796 46,286 4.3%

Montgomery $ 629,167 21,004 - 7,251 28,255 7.5%

Philadelphia $ 9,560,604 284,893 835,468 17,552 1,137,913 2.0%

HC-SE Zone $ 12,653,101 376,934 837,352 51,005 1,265,291 5.7%

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MATP 4Q FY 14/15

Southwest

COUNTY Total Expenditure Para Transit Trips Mass Transit Trips

Mileage

Reimbursement

Trips

Total Trips Client Utilization

Allegheny $ 2,026,576 48,432 137,994 33,333 219,759 6.7%

Armstrong $ 467,523 10,720 - 6,550 17,270 7.9%

Beaver $ 442,233 11,250 314 21,698 33,262 4.4%

Bedford $ 119,716 10,797 - 5,309 16,106 4.9%

Blair $ 244,883 12,243 1,957 4,928 19,128 7.7%

Butler $ 574,807 14,651 - 2,544 17,195 9.6%

Cambria $ 879,835 27,756 4,525 4,274 36,555 8.0%

Fayette $ 294,768 15,199 322 15,035 30,556 5.8%

Greene $ 161,470 4,940 - 2,601 7,541 9.0%

Indiana $ 298,475 7,952 414 5,632 13,998 8.3%

Lawrence $ 244,172 7,349 322 15,361 23,032 5.4%

Somerset $ 218,953 5,166 - 7,868 13,034 7.1%

Washington $ 550,995 20,196 682 14,254 35,132 6.6%

Westmoreland $ 495,833 17,443 196 18,141 35,780 7.3%

HC-SW Zone $ 7,020,239 214,094 146,726 157,528 518,348 7.1%

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MATP 4Q FY 14/15

Lehigh/Capital

COUNTY Total Expenditure Para Transit Trips Mass Transit Trips

Mileage

Reimbursement

Trips

Total Trips Client Utilization

Berks $ 555,323 21,742 12,652 5,544 39,938 9.3%

Cumberland $ 101,421 5,163 340 2,162 7,665 9.4%

Dauphin $ 707,287 26,128 6,851 1,848 34,827 16.4%

Franklin $ 142,623 4,204 - 2,250 6,454 12.3%

Fulton $ 106,868 1,870 - 1,523 3,393 11.7%

Huntingdon $ 176,860 4,518 - 6,269 10,787 8.3%

Lancaster $ 541,084 20,730 618 5,845 27,193 7.6%

Lebanon $ 340,733 17,127 194 1,676 18,997 7.8%

Lehigh $ 689,230 25,696 - 15,282 40,978 3.0%

Northampton $ 512,912 17,717 - 17,911 35,628 2.6%

Perry $ 85,161 2,158 - 1,507 3,665 11.5%

York/Adams $ 302,631 8,896 914 5,496 15,306 8.7%

HC-L/C Zone $ 4,262,133 155,949 21,569 67,313 244,831 9.1%

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MATP 4Q FY 14/15

Northwest

COUNTY Total

Expenditure

Para Transit

Trips

Mass Transit

Trips

Mileage

Reimbursement

Trips

Total Trips Client Utilization

Cameron $ 25,082 446 10 279 735 9.7%

Clarion $ 146,480 2,913 - 1,996 4,909 10.2%

Clearfield $ 243,626 7,142 - 7,158 14,300 8.4%

Crawford $ 312,825 4,943 1,503 15,848 22,294 7.4%

Elk $ 88,858 2,822 2 984 3,808 8.2%

Erie $ 547,811 23,337 - 4,461 27,798 5.7%

Forest $ 18,160 528 - 277 805 6.8%

Jefferson $ 598,081 17,921 - 5,774 23,695 6.2%

McKean $ 120,806 2,249 41 647 2,937 14.5%

Mercer $ 185,658 8,571 10 3,480 12,061 9.5%

Potter $ 55,579 1,471 - 1,672 3,143 14.3%

Venango $ 287,933 5,666 425 1,659 7,750 15.0%

Warren $ 73,896 1,694 96 2,441 4,231 15.5%

HC-Northwest Zone $ 2,704,795 79,703 2,087 46,676 128,466 10.1%

41

MATP 4Q FY 14/15

Northeast

COUNTY Total

Expenditure

Para Transit

Trips

Mass Transit

Trips

Mileage

Reimbursement

Trips

Total Trips Client Utilization

Bradford/Tioga $ 248,886 6,172 167 1,706 8,045 10.1%

Carbon $ 273,190 6,761 - 2,582 9,343 5.5%

Centre $ 101,220 4,683 - 2,098 6,781 10.5%

Clinton $ 155,706 3,095 - 512 3,607 13.0%

Columbia $ 137,901 4,955 - 3,851 8,806 8.0%

Juniata $ 32,692 925 - 458 1,383 8.2%

Lackawanna $ 222,686 7,803 3,149 5,982 16,934 4.9%

Luzerne $ 293,461 14,914 1,148 7,682 23,744 13.7%

Lycoming $ 446,639 10,619 1,952 4,259 16,830 10.5%

Mifflin $ 94,115 4,346 - 1,249 5,595 10.7%

Monroe $ 198,370 5,930 1,401 4,170 11,501 9.1%

Montour $ 48,969 1,774 - 788 2,562 9.7%

Northumberland $ 151,404 8,062 - 3,227 11,289 9.1%

Pike $ 60,518 1,355 - 2,098 3,453 7.1%

Schuylkill $ 213,598 4,610 1,165 2,948 8,723 10.5%

Snyder $ 69,818 2,274 - 790 3,064 11.7%

Sullivan $ 19,607 347 37 120 504 7.3%

Susquehanna $ 121,062 2,376 - 1,364 3,740 10.8%

Union $ 44,323 1,554 - 603 2,157 15.3%

Wayne $ 124,885 3,625 - 1,592 5,217 11.8%

Wyoming $ 34,816 775 - 490 1,265 9.7%

HC-Northeast Zone $ 3,093,866 96,955 9,019 48,569 154,543 9.9%

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Useful Information

To view a complete Pennsylvania Medicaid Managed Care Organization Directory use this link, http://www.dpw.state.pa.us/provider/healthcaremedicalassistance/manage dcareinformation/index.htm, and choose the most current Directory.

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