Care Coordination Organization & Health Home Care Management Profile

Care Coordination Organization & Health Home Care Management Profile
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Understanding the Data

  • The Care Coordination Organization/Health Home Care Management Profile provides an overview of enrollment and care planning information for individuals with intellectual and/or developmental disabilities receiving OPWDD services. 
  • The data displayed in this report represents an 18-month reporting period from July 1, 2018 through December 31, 2019. The data is compiled from CCO roster data as well as self-reported information from the CCOs that is submitted to OPWDD.
  • Health Home Care Management is also known as Care Coordination, which are services provided by Care Coordination Organizations (CCOs). There are seven CCOs operating across New York State.

Figure 1: People Receiving Care Management Services by Program Type (2019)

Pie graph of Figure 3 Percent of Total Enrollments by CCO

In July 2018, over 97,000 individuals receiving OPWDD Medicaid Service Coordination (MSC) transitioned to Health Home Care Management services provided by Care Coordination Organizations (CCOs). Approximately 9,700 additional people have also enrolled as of December 2019.

Individuals have a choice of two service options. The number of people receiving either Health Home or Home and Community Based Services (HCBS) Basic Plan Support has remained constant at 97% and 3% respectively, since the implementation of CCOs (see Figure1).
 

Figure 2: People Receiving Care Management Services by Program Type and Care Coordination Organization (2019)

  Advance Care Alliance Care Design NY Life Plan Person Centered Services Prime Care Coordination Southern Tier Connect Tri-County Care Total
Health Home Services 23,851 26,039 17,733 16,486 7,375 1,107 11,239 103,830
HCBS Basic Plan Support Services 1,098 769 331 517 176 41 191 3,123
Total 24,949 26,808 18,064 17,003 7,551 1,148 11,430 106,953

 

Figure 3: People Receiving Care Management Services by Care Coordination Organization (2019)

Pie graph of Figure 3 Percent of Total Enrollments by CCO

Figure 4: People New to Receiving Care Management Services (2019)

Care Coordination Organization Health Home HCBS Plan Support Total
Advance Care Alliance 1,281 31 1,312
Care Design NY 2,639 14 2,653
Life Plan 1,294 2 1,296
Person Centered Services 821 6 827
Prime Care Coordination 1,064 4 1,068
Southern Tier Connect 142 2 144
Tri-County Care 2,429 30 2,459
Total 9,670 89 9,759

Approximately 97,000 people (91%) transitioned from OPWDD Medicaid Service Coordination (MSC) to Health Home Care Management services provided by Care Coordination Organizations (CCOs). An additional 9,700 people (9%) newly enrolled in either Health Home or HCBS Basic Plan Services as of December 2019 (see Figure 4).

Figure 5: People Receiving an Initial Care Plan by Month (2019)

Figure 5: People Receiving an Initial Care Plan by Month (2019)

By December 2019, approximately 106,300 individuals (99%) received an initial care plan. CCOs have 90 days from the initial enrollment date to complete a Life Plan (see Figure 5).  

Figure 6: People Receiving an Initial Care Plan by Month and by Care Coordination Organization (2019)

  2018 Jan 19' Feb 19' Mar 19' Apr 19' May 19' Jun 19' Jul 19' Aug 19' Sep 19' Oct 19' Nov 19' Dec 19' Total
Advance Care Alliance 524 746 868 1,554 1,489 1,760 1,740 1,895 2,772 2,744 3,622 3,177 1,136 24,027
Care Design NY 823 1,368 1,629 2,169 2,489 2,702 3,401 2,862 2,525 1,660 2,572 1,308 708 26,216
Life Plan 567 1,062 1,295 1,985 2,409 2,876 2,650 2,255 1,502 513 336 345 1,011 18,806
Person Centered Services 803 1,349 1,270 1,763 2,050 2,337 2,089 1,717 1,044 836 1,395 427 902 17,982
Prime Care Coordination 424 536 386 680 782 843 835 641 519 366 488 254 514 7,268
Southern Tier Connect 131 62 84 111 144 162 135 119 75 40 17 15 21 1116
Tri-County Care 828 708 617 960 1,240 1,237 2,322 927 955 296 387 169 240 10,886
Total 4,100 5,831 6,149 9,222 10,603 11,917 13,172 10,416 9,392 6,455 8,817 5,695 4,532 106,301