Care Coordination Organization Health Home Care Management Profile

• It is important to note that the COVID-19 health emergency has had a significant impact on all CCOs’ operations, therefore, the data presented in this report may not be representative of timelines or demographical information during a typical year.
• 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 statistics as of the end of calendar year 2020 with accompanying detail on data movements during January - December 2020.
• 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 (2020)

A total of 17,060 individuals new to OPWDD care management enrolled in CCOs since the July 2018 implementation (7,301 of these individuals enrolled in the 2020 calendar year).

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 (as of December 31, 2020)

Figure 3: People Receiving Care Management Services by Care Coordination Organization (2020)

 Figure 4: People New to Receiving Care Management Services [1]

Figure 5:  Total People Disenrolled from a CCO (2020) [2]

[2] This data includes people who transferred from one CCO to another but who are still enrolled in a CCO (see figure 6).

Figure 6: Disenrollment Count by Reason (2020) [3]

[3] Data Source = Roster, CCO2 Forms Completed in CHOICES by CCOs.
[4] The Reason for Disenrollment “Transferred to another CCO” also includes 70 people (or 7% of the category total) who moved out of the CCO’s catchment area.
 

Figure 7: Completion of Life Plans for New Enrollees (Q1-Q3 2020) [5]

[5] Typically, CCOs have 90 days from CCO enrollment (or HCBS Waiver enrollment, whichever comes first) to finalize an initial Life Plan for individuals new to CCO services. During the COVID-19 health emergency timelines were extended. As such, calculations in Figure 7 were based on 120 days and 180 days instead of 90 days for Life Plan completion. Only enrollees new to care management who enrolled between January 1 and September 1, 2020 (Q1-Q3) were included in the data analysis as the majority of individuals enrolling in Q4 (October 1-December 1) have until on or after January 1, 2021 to finalize an initial Life Plan. 

Figure 8: Completion of Annual Life Plans for All Enrollees (2020) [6]

[6] CCOs perform annual assessments to inform the review and revision of Health Home and Basic Plan Support Life Plans annually for all enrollees. Figure 8 depicts the percent of total enrollee annual Life Plans finalized.