Download - Monthly Operating Report February 2009. Total Active Enrollment Trend Tiger Teams, 0- 200% FPL
Monthly Operating ReportMonthly Operating Report
February 2009
Total Active Enrollment TrendActive Enrollees
84 117146 253
485
1,207
1,754
2,104
2,493
2,831
52293
3,213
3,540 3,545
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 Feb-09
Tiger Teams, 0-200% FPL
Enrollment Processing
Total Enrolled: 3,545
Total Applications Received: 4,502– Number Approved: 3,941– Number Pending: 32– Number Denied: 529
Enrollment by Income (% of FPL)
0-135% 2,838 80% 135%-165% 353 10% 165%-200% 354 10% Total 3,545 100%
Project Dulce Chronic Care Team # of patients: 882 # of visits: 1,694
Project Dulce Nuber of Patients and Visits
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
Nov-07
Dec-07
Jan-08
Feb-08
Mar-08
Apr-08
May-08
Jun-08
Jul-08
Aug-08
Sep-08
Oct-08
Nov-08
Dec-08
Jan-09
Feb-09
# of Patients in Project Dulce Chronic Care Team
# of Visits in Project Dulce Chronic Care Team
1,694
882
Enrollment by Diagnosis Diabetes: 858
Hypertension: 1,485
Dual: 1,152
Hyperlipidemia: 50
Enrollment by ClinicEnrollment by Clinic EnrollmentFamily Health Centers of San Diego (FHCSD)Logan Heights Family Health Center 302 San Diego Family CareMid-City Community Clinic 270 Family Health Centers of San DiegoNorth Park Family Health Center 163 Neighborhood Healthcare - El Cajon 328 Family Health Centers of San DiegoGrossmont Spring Valley Family Health Center 178 San Diego Family CareLinda Vista Health Care Center 222 Vista Community Clinic - Pierview Way 82 Vista Community ClinicTri-City Community Health Center 78 Vista Community Clinic - Main 221 Neighborhood Healthcare - Escondido 293 SYHC Comprehensive Health Center3177 Ocean View Blvd. 149 SYHC Comprehensive Health Center286 Euclid Avenue, Suite 302 61 San Ysidro Health CenterChula Vista Family Clinic 293 San Ysidro Health CenterNational City Family Clinic 173 San Ysidro Health CenterOtay Family Health Center 156 San Ysidro Health CenterSan Ysidro, CA 92173 576 HCA - UCSD - HCA - Scripps - HCA - Admin - Total 3,545
Reasons for Denials
Other: Other healthcare coverage, disability determination, Medi-Cal linkage, etc.
Reasons for Denials Denials To-DateAPPLICATION WITHDRAWN 6 EXCESS INCOME 170 FAILURE TO PROVIDE/COOPERATE 7 HAS OTHER HEALTH INSURANCE 5 LEG. PER. RES LESS THAN 5 YRS 23 NOT A CITIZEN/ELIGIBLE ALIEN 22 NOT A COUNTY RESIDENT 23 OTHER 170 YOU APPEAR TO BE CMS ELIGIBLE 31 YOU APPEAR TO BE MEDI-CAL ELIGI 72 TOTAL 529
CI Enrollee DemographicsActive Enrollees by Age Group
0%
5%
10%
15%
20%
25%
30%
21-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
CI Enrollee DemographicsActive Enrollees by Gender
Male41%
Female59%
Utilization Services(Cumulative)
Total Claims/Visits: Total: 122,381– Primary Care Physician: 6,556 visits– Pharmacy: 98,432 claims– Ancillary: 9,378 claims– Specialty Care: 5,126 claims– Emergency: 466 claims– Inpatient: 2,049 visits– Dental: 374 visits
Utilization Expenditures(Through January 2009)
Utilization Expenditures ($) Program Year 1 Program Year 2 - YTDPrimary Care Physician (Visits) 191,372 658,573 Pharmacy (Claims) 251,372 1,614,227 Ancillary (Claims) 67,698 92,773 Specialty Care (Claims) 119,565 276,144 Emergency Department (Claims) 18,663 41,805 Inpatient (Visits) 538,068 1,075,338 Dental (Visits) 5,401 37,007 Total 1,192,139 3,795,867
Total Expenditures TrendProgram-to-Date Total Expenditures
$-
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
Nov-07
Dec-07
Jan-08
Feb-08
Mar-08
Apr-08
May-08
Jun-08
Jul-08
Aug-08
Sep-08
Oct-08
Nov-08
Dec-08
Jan-09
Feb-09
$4,988,006
CI Recap
CI final enrollment: 3,545 Implementing data and evaluation plan. Focus on utilization, quality and outcomes.