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.
- Health Home Care Management, also known as Care Coordination, is provided by Care Coordination Organizations (CCOs). There are seven CCOs operating across New York State.
- CCO Care Management is required for enrollment into OPWDD’s Home and Community Based Services (HCBS) Waiver.
- The data displayed in this report represents statistics as of the end of calendar year 2022 with accompanying detail on data movements during January – December 2022.
- The data is compiled from CCO roster data and self-reported information submitted to OPWDD through CCOs.
- 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.
Care Management Enrollment
Figure 1: People Receiving Care Management Services by Program Type (as of December 31, 2022)
Individuals have a choice of two service options, Health Home care management which is the more comprehensive option, or HCBS Basic Plan Support, which is designed for individuals who do not need or want ongoing comprehensive care management.
The number of people receiving either Health Home or HCBS Basic Plan Support has remained constant at 97% and 3% respectively, since the implementation of CCOs.
Figure 2: People Receiving Care Management Services by Program Type and Care Coordination Organization (as of December 31, 2022)
Advance Care Alliance | Care Design NY | Life Plan | Person Centered Services | Prime Care Coordination | Southern Tier Connect | Tri-County Care | Total | |
---|---|---|---|---|---|---|---|---|
Health Home Services | 22,891 | 26,919 | 18,492 | 16,957 | 8,339 | 1,262 | 17,627 | 112,487 |
HCBS Basic Plan Support Services | 1,141 | 865 | 474 | 563 | 136 | 37 | 233 | 3,449 |
Total | 24,032 | 27,784 | 18,966 | 17,520 | 8,475 | 1,299 | 17,860 | 115,936 |
Figure 3: People Receiving Care Management Services by Care Coordination Organization (2022)
Figure 4: People New to Receiving Care Management Services
A total of 30,398 people new to OPWDD Care Management services have enrolled since CCOs were implemented in 2018. Figure 4 breaks out this enrollment by years. On average only 1% of new enrollees select Basic HCSB Plan Support Services.
Figure 5: People New to Receiving Care Management Services by CCO
Care Coordination Organization | 2022 | Historical Data- 2021 | Historical Data- July 2018- December 2020 | Total |
---|---|---|---|---|
Advance Care Alliance | 733 | 802 | 2,197 | 3,732 |
Care Design NY | 1,177 | 1,362 | 4,034 | 6,573 |
Life Plan | 961 | 858 | 2,244 | 4,063 |
Person Centered Services | 823 | 668 | 1,551 | 3,042 |
Prime Care Coordination | 521 | 556 | 1,805 | 2,882 |
Southern Tier Connect | 86 | 75 | 268 | 429 |
Tri-County Care | 2424 | 2,292 | 4,961 | 9,677 |
Total | 6725 | 6,613 | 17,060 | 30,398 |
CCO Disenrollment
Figure 6: Disenrollment Count and Percentages by Reason (2022)1
(1) Data Source = Roster, CCO 2 Forms Completed in CHOICES by CCOs. This data includes people who transferred from one CCO to another but who are still enrolled in a CCO. Additionally, the Reason for Disenrollment “Transferred to another CCO” also includes people who moved out of the CCO’s catchment area.
Figure 7: Count of People Disenrolled from each CCO (2022)
Total Enrollments (as of December 31, 2022) |
Total Disenrolled 2022 January – December |
Percentage of Disenrolled compared to Total Enrollments | |
---|---|---|---|
Advance Care Alliance | 24,032 | 1,134 | 4.72% |
Care Design NY | 27,784 | 1,106 | 3.98% |
Life Plan | 18,966 | 846 | 4.46% |
Person Centered Services | 17,520 | 718 | 4.10% |
Prime Care Coordination | 8,475 | 468 | 5.52% |
Southern Tier Connect | 1,299 | 69 | 5.31% |
Tri-County Care | 17,860 | 759 | 4.25% |
Grand Total | 115,936 | 5,100 | 4.40% |
Figure 8: Disenrollment Count by Reason and CCO (2022)
Reason for Disenrollment | ACA | CDNY | LP | PCS | PCC | STC | TCC | Total |
---|---|---|---|---|---|---|---|---|
Enrolled in Another Comprehensive Care Management Program Not Delivered Through a CCO | 42 | 100 | 11 | 27 | 36 | 1 | 40 | 257 |
Ineligible for Medicaid | 8 | 13 | 1 | 6 | 3 | 0 | 15 | 46 |
Moved Out of State | 252 | 198 | 142 | 126 | 67 | 11 | 228 | 1,024 |
Not Residing in a CCO Eligible Setting | 139 | 116 | 113 | 105 | 38 | 8 | 68 | 587 |
Passed Away | 223 | 320 | 223 | 244 | 100 | 17 | 50 | 1,177 |
Requirements Not Met for Level of Care | 49 | 5 | 3 | - | 4 | - | 6 | 67 |
Transferred to Another CCO | 200 | 143 | 185 | 61 | 103 | 16 | 100 | 808 |
Voluntary Withdrawal from CCO | 221 | 211 | 168 | 149 | 117 | 16 | 252 | 1,134 |
Grand Total | 1,134 | 1,106 | 846 | 718 | 468 | 69 | 759 | 5,100 |
CCO/Health Home Care Management Care Planning
Figure 9: Completion of Life Plans for New Enrollees (2022)
CCO Name | % of Life Plans Completed for Individuals New to CCO Services- 90 Days | % of Life Plans Completed for Individuals New to CCO Services- 120 Days |
---|---|---|
Advance Care Alliance | 74% | 91% |
Care Design NY | 74% | 85% |
Life Plan | 87% | 94% |
Person Centered Services | 76% | 87% |
Prime Care Coordination | 74% | 85% |
Southern Tier Connect | 86% | 91% |
Tri-County Care | 92% | 94% |
Statewide Average | 82% | 90% |
Figure 10: Completion of Annual Life Plans for All Enrollees (2022)
CCO Name | Percent of Annual Life Plans Completed Timely |
---|---|
Advance Care Alliance | 88% |
Care Design NY | 99% |
Life Plan | 100% |
Person Centered Services | 99% |
Prime Care Coordination | 97% |
Southern Tier Connect | 98% |
Tri-County Care | 98% |
Statewide Average | 96% |