DataPoint: Medicaid Managed Care Market Share

Five plans represent 48 percent of Medicaid only Managed Long Term Care (MLTC) enrollment in the State.  Over 14,000, or 11 percent, of the State's 131,300 enrollees are served by Guildnet.  Senior Health Partners and VNS Choice each represent over 10 percent of Medicaid MLTC enrollment with ElderPlan and Elderserv each accounting for more than 8 percent.  Fully Integrated Duals Advantage (FIDA) enrollment is even more concentrated with 38 percent of the 8,300 enrollees associated with VNS Choice FIDA and 13 percent with Guildnet FIDA.  Mainstream Medicaid managed care (for those not eligible for Medicare) is dominated by two plans:   24 percent of the 4.6 million enrollees are served by NYS Catholic Health Plan and 21 percent by HealthFirst.          

Geographically, 82 percent of all types of MLTC enrollment is concentrated in the downstate region comprised of NYC, Long Island and Westchester County, with Erie and Monroe counties each reporting about 2,350 enrolled.  Program of All Inclusive Care for the Elderly (PACE) enrollement stands at 5,500, of which 68 percent is in the downstate region.  Two thirds of the State's PACE participants are served by Comprehensive Care Management.  PACE enrollment is approaching 700 in Rochester and is nearly 500 in the Syracuse area.

Fall 2015 MLTC enrollment figures by plan and county are avilable on the LeadingAge NY Data Page.

Contact:  Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841