Medi-Cal Enrollment Report Fiscal Year Comparison
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1 Medi-Cal Enrollment Report Fiscal Year Comparison November 30, Jan-19
2 Total Medi-Cal Enrollment Fiscal Year Comparison November /31/2017 1/31/2018 2/28/2018 3/31/2018 4/30/2018 5/31/2018 6/30/2018 7/31/2018 8/31/2018 % of current enrollment Change in Enrollment - December 2017 to present (Change last year vs. prior month) Alameda Alliance for Health 258, , , , , , , , , , , ,138 81% % Blue Cross of California 62,059 61,880 60,907 60,931 60,529 60,055 59,623 59,172 59,054 58,941 59,291 58,857 19% -3, % Contra Costa Health Plan 178, , , , , , , , , , , ,613 87% % Blue Cross of California 27,607 27,587 27,374 27,300 27,127 27,001 26,758 26,462 26,258 26,064 26,246 26,083 13% -1, % Kern Family Health Care 247, , , , , , , , , , , ,196 78% 4, % Health Net 74,246 74,728 74,457 74,541 74,229 73,531 73,093 72,318 71,552 70,871 71,160 70,561 22% -3, % CalViva Health 357, , , , , , , , , , , ,083 71% 1, % Blue Cross of California 147, , , , , , , , , , , ,806 29% % L.A. Care Health Plan 2,029,252 2,040,429 2,056,640 2,050,394 2,051,782 2,052,609 2,052,928 2,050,323 2,046,829 2,040,656 2,055,011 2,053,425 68% 24, % Health Net 998, ,698 1,003, , , , , , , , , ,165 32% -20, % Inland Empire Health Plan 1,208,533 1,214,885 1,213,226 1,212,264 1,212,269 1,213,457 1,213,619 1,211,951 1,213,288 1,211,104 1,218,133 1,222,532 89% 13, % Molina Health Care of California 160, , , , , , , , , , , ,768 11% -9, % San Francisco Health Plan 130, , , , , , , , , , , ,239 87% -2, % Blue Cross of California 18,861 19,101 18,984 18,983 18,849 18,793 18,752 18,728 18,844 18,813 18,896 18,918 13% % Santa Clara Family Health Plan 252, , , , , , , , , , , ,862 78% -7, % Blue Cross of California 72,617 72,371 71,765 71,300 70,475 70,357 69,980 69,228 68,878 68,241 68,803 68,332 22% -4, % Community Health Group 274, , , , , , , , , , , ,890 38% -9, % Aetna, United, Hnet, KPCal, Molina, & Care1s 433, , , , , , , , , , , ,280 62% 5, % Health Plan of San Joaquin 215, , , , , , , , , , , ,758 91% % Health Net 21,264 21,219 21,040 20,859 20,819 20,929 20,921 20,843 20,819 20,731 20,815 20,698 9% % Health Plan of San Joaquin 128, , , , , , , , , , , ,778 66% -1, % Health Net 72,932 72,918 72,270 70,380 69,374 68,767 67,552 67,105 66,744 66,176 66,357 65,949 34% -6, % Marin, Mendocino, Napa, Solano, Sonoma, Yolo, Del Norte, Humbolt, Lake, Lassen, Modoc, Shasta, Siskiyou, Trinity Counties Partnership HealthPlan of California 567, , , , , , , , , , , , % -13, % Merced, Monterey, Santa Cruz Counties Central California Alliance for Health 350, , , , , , , , , , , , % -8, % Orange County CalOptima 767, , , , , , , , , , , , % -21, % Santa Barbara & San Luis Obispo CenCal Health 179, , , , , , , , , , , , % -3, % San Mateo County Health Plan of San Mateo 109, , , , , , , , , , , , % -5, % Ventura County Gold Coast Health Plan 202, , , , , , , , , , , , % -5, % Total Enrollment Medi-Cal Statewide * 10,562,912 10,581,559 10,591,284 10,573,093 10,565,071 10,550,074 10,530,535 10,492,738 10,474,500 10,441,624 10,496,836 10,481,687 In 36 LHPC Counties 9,549,117 9,562,615 9,574,749 9,555,377 9,548,745 9,535,456 9,517,297 9,487,900 9,470,335 9,439,299 9,483,048 9,469,773-79, % LHPC Plans only 7,459,402 7,469,041 7,481,880 7,471,739 7,471,322 7,463,528 7,449,686 7,430,750 7,421,103 7,400,322 7,430,112 7,424,356-35, % % LHPC in 36 LHPC Counties 78.12% 78.11% 78.14% 78.19% 78.24% 78.27% 78.28% 78.32% 78.36% 78.40% 78.35% 78.40% % LHPC Statewide 70.62% 70.59% 70.64% 70.67% 70.72% 70.74% 70.74% 70.82% 70.85% 70.87% 70.78% 70.83% *2-plan, Imperial/San Benito, Regional, GMC, & COHS Data source: DHCS Medi-Cal Managed Care Enrollment Report
3 November 2018 Total Medi-Cal Disenrollment 12/31/2017 1/31/2018 2/28/2018 3/31/2018 4/30/2018 5/31/2018 Alameda Alliance for Health % 3,933 (134) -33.5% Blue Cross of California % 3,866 (92) -25.6% Contra Costa Health Plan % 2,368 (60) -26.3% Blue Cross of California % 2,224 (39) -22.2% Kern Family Health Care % 2,472 (104) -42.8% Health Net % 5, % CalViva Health % 4,619 (20) -5.3% Blue Cross of California , % 6,963 (105) -20.3% L.A. Care Health Plan 2,693 3,282 2,913 3,229 2,899 3,088 2,911 3,053 3,288 2,589 3,260 2, % 35,824 (641) -19.7% Health Net 3,050 3,377 3,565 3,509 3,571 3,125 2,897 2,987 3,056 2,404 3,280 2, % 37,535 (566) -17.3% Riverside,San Bernardino Counties Inland Empire Health Plan 1,398 1,503 1,182 1,470 1,213 1,388 1,579 1,427 1,562 1,337 1,740 1, % 17,076 (463) -26.6% Molina Health Care of California 1,386 1,693 1,586 1,628 1,428 1,443 1,345 1,407 1,459 1,155 1,529 1, % 17,252 (336) -22.0% San Francisco Health Plan % 1,576 (47) -35.9% Blue Cross of California % 1,101 (10) -10.4% Santa Clara Family Health Plan % 4,554 (129) -28.7% Blue Cross of California % 3,689 (65) -18.8% Community Health Group % 6,179 (130) -22.5% Aetna, Hnet, KPCal, Molina, Care1st, United 1,586 2,001 1,961 1,838 1,640 1,271 1,135 1,579 1,703 1,295 1,599 1, % 19,078 (129) -8.1% Health Plan of San Joaquin % 2,019 (19) -9.7% Health Net % 1,646 (28) -25.5% Health Plan of San Joaquin % 1,494 (46) -27.9% Health Net % 3,393 (81) -28.4% 6/30/2018 7/31/2018 8/31/2018 Percent of Disenrollment Total Disenrollment (Since Dec. 2017) Change in Monthly Disenrollment Monthly Percent Change in Disenrollment Data source: COPS-17 Two-Plan Model & GMC Statewide 19,519 22,510 21,047 22,034 19,034 18,874 18,552 18,819 19,548 15,872 20,891 17, ,700 (3891) -18.6% In 14 LHPC Counties 14,967 17,422 16,541 17,257 15,302 15,125 14,331 15,066 15,865 12,682 16,465 13, ,252 (3236) -19.7% LHPC Plans only 6,465 7,717 6,532 7,342 6,252 6,923 6,838 6,893 7,353 6,060 7,766 5,973 82,114 (1793) -23.1%
4 Monthly Choice vs Default Enrollment as % of Total Enrollment November 2018 Choice through % of choice = LI * Def. Enrlmt through % Total Enrollment = Default ** Choice through % of choice = LI * Def. Enrlmt through % Total Enrollment = Default ** Alameda Alliance for Health 2,486 80% 1,322 35% 3,163 81% 1,529 33% 2,613 82% 1,676 39% Blue Cross of California % % % Contra Costa Health Plan 1,651 80% % 2,077 82% 1,007 33% 1,690 82% 1,077 39% Blue Cross of California % % % Kern Family Health Care 2,219 83% % 2,820 85% 1,029 27% 2,298 85% 1,389 38% Health Net % % % CalViva Health 2,287 63% 1,093 32% 2,931 65% 1,345 31% 2,196 63% 1,672 43% Blue Cross of California 1, % 1, % 1, % L.A. Care Health Plan 15,214 73% 8,781 37% 18,604 73% 11,273 38% 15,334 72% 12,497 45% Health Net 5,719 4,969 46% 6,900 4,551 40% 5,924 5,266 47% Inland Empire Health Plan 11,181 89% 5,715 34% 13,610 90% 7,008 34% 10,905 89% 7,794 42% Molina Healthcare Partner 1,362 1,782 57% 1,515 1,852 55% 1,369 2,080 60% San Francisco Health Plan 1,086 78% % 1,329 84% % 1,012 78% % Blue Cross of California % % % Santa Clara Family Health Plan 2,218 81% 1,014 31% 2,732 81% 1,350 33% 2,353 81% 1,544 40% Blue Cross of California % % % Community Health Group 1,997 29% % 2,126 27% 1,098 34% 1,893 28% 1,005 35% Aetna Better Health of CA % % % Care1st Partner Plan % 985 1,106 53% 823 1,613 66% Health Net % % % Kaiser % % % Molina Healthcare Partner 2, % 2,542 1,266 33% 2,094 1,494 42% United Healthcare % % % Health Plan of San Joaquin 1,599 91% % 2,011 91% % 1,558 90% % Health Net % % % Health Plan of San Joaquin 1,176 81% % 1,444 80% % 1,253 80% % Health Net % % % Choice through % of choice = LI * Def. Enrlmt through % Total Enrollment = Default ** Data obtained from the DHCS COPS-11 Enrollment Summary Report. This report does not include previous continuity of care members * % of choice=li calculation: LI choice / (LI choice + Commercial choice) ** % Total Enrollment = Default calculation: Default Enrollment/(Choice + Default) meaning x% of a plan's new members that month defaulted into the plan
5 % Comparison Choice and Default Enrollment LIs v. Commercial Plan November 2018 Choice Sep-18 Oct-18 Nov-18 Default Choice Default Choice Default Count % Count % Count % Count % Count % Count % Alameda Alliance for Health 2,486 80% 1,322 69% 3,163 81% 1,529 75% 2,613 82% 1,676 74% Blue Cross of California % % % % % % Contra Costa Health Plan 1,651 80% % 2,077 82% 1,007 88% 1,690 82% 1,077 88% Blue Cross of California % % % % % % Kern Family Health Care 2,219 83% % 2,820 85% 1,029 60% 2,298 85% 1,389 76% Health Net % % % % % % CalViva Health 2,287 63% 1,093 58% 2,931 65% 1,345 63% 2,196 63% 1,672 71% Blue Cross of California 1,354 37% % 1,583 35% % 1,312 37% % L.A. Care Health Plan 15,214 73% 8,781 64% 18,604 73% 11,273 71% 15,334 72% 12,497 70% Health Net 5,719 27% 4,969 36% 6,900 27% 4,551 29% 5,924 28% 5,266 30% Inland Empire Health Plan 11,181 89% 5,715 76% 13,610 90% 7,008 79% 10,905 89% 7,794 79% Molina Health Care 1,362 11% 1,782 24% 1,515 10% 1,852 21% 1,369 11% 2,080 21% San Francisco Health Plan 1,086 78% % 1,329 84% % 1,012 78% % Blue Cross of California % % % % % % Santa Clara Health Plan 2,218 81% 1,014 66% 2,732 81% 1,350 70% 2,353 81% 1,544 70% Blue Cross of California % % % % % % Community Health Group 1,997 29% % 2,126 27% 1,098 22% 1,893 28% 1,005 18% Aetna Better Health of CA 285 4% % 361 5% 407 8% 305 5% 434 8% Care1st Partner Plan % % % 1,106 23% % 1,613 29% Health Net 646 9% % % % % % Kaiser 547 8% 0 0% 697 9% 0 0% 571 9% 0 0% Molina Healthcare Partner 2,183 32% % 2,542 32% 1,266 26% 2,094 31% 1,494 27% United Healthcare 289 4% % 357 5% 438 9% 300 5% 457 8% Health Plan of San Joaquin 1,599 91% % 2,011 91% % 1,558 90% % Health Net 153 9% % 191 9% % % % Health Plan of San Joaquin 1,176 81% % 1,444 80% % 1,253 80% % Health Net % % % % % % Data Source: DHCS COPS-11 Enrollment Summary Report
6 Cal MediConnect Enrollment November /31/2017 1/31/2018 2/28/2018 3/31/2018 4/30/2018 5/31/2018 6/30/2018 7/31/2018 8/31/2018 % of current enrollment Change in Enrollment - December 2017 to present (Change last year vs. prior month) L.A. Care Health Plan 15,344 14,937 15,000 14,979 14,936 15,022 15,189 15,309 15,450 15,638 15,806 15,888 46% % Care 1st 3,404 3,268 3,200 3,155 3,089 3,066 3,052 3,017 3,002 2,990 2,947 2,918 15% % CareMore 3,592 3,543 3,507 3,497 3,439 3,427 3,406 3,381 3,366 3,326 3,314 3,270 11% % Health Net 12,120 11,699 11,542 11,415 11,197 11,093 10,944 10,838 10,710 10,589 10,460 10,279 38% -1, % Molina 2,673 2,619 2,589 2,571 2,536 2,527 2,500 2,479 2,476 2,454 2,432 2,380 6% % Orange County CalOptima (OneCare Connect) 15,110 14,805 14,734 14,617 14,527 14,533 14,535 14,409 14,386 14,370 14,349 14, % % Inland Empire Health Plan 24,896 24,376 24,547 24,599 24,459 24,646 24,872 25,091 25,344 25,535 25,708 25,798 87% % Molina 4,554 4,399 4,331 4,282 4,191 4,176 4,121 4,067 4,012 3,977 3,940 3,881 13% % Community Health Group (CommuniCare) 5,525 5,461 5,560 5,602 5,643 5,716 5,766 5,785 5,820 5,861 5,924 5,974 43% % Care 1st 2,356 2,331 2,233 2,201 2,183 2,165 2,154 2,154 2,144 2,138 2,140 2,141 27% % Health Net 2,127 2,059 1,921 1,840 1,785 1,773 1,750 1,719 1,688 1,668 1,650 1,629 11% % Molina 4,687 4,550 4,449 4,390 4,364 4,366 4,383 4,363 4,356 4,344 4,326 4,280 32% % San Mateo County Health Plan of San Mateo (CareAdvantage) 9,168 9,055 9,046 9,010 8,914 8,951 8,926 8,940 8,921 8,948 8,919 8, % % Santa Clara Family Health Plan 7,194 7,110 7,140 7,100 7,037 7,087 7,147 7,170 7,222 7,252 7,258 7,324 74% % Anthem Blue Cross 2,862 2,777 2,783 2,735 2,675 2,677 2,658 2,665 2,652 2,627 2,592 2,564 26% % Total Enrollment Cal MediConnect Statewide 115, , , , , , , , , , , ,509-4, % LHPC Plans only 77,237 75,744 76,027 75,907 75,516 75,955 76,435 76,704 77,143 77,604 77,964 78, % % LHPC Statewide 66.81% 67.04% 67.53% 67.78% 68.05% 68.29% 68.61% 68.86% 69.16% 69.46% 69.76% 70.10% Data source: Medi-Cal Managed Care Enrollment Report
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