Dual enrollees fast facts, 10/2012

              American
Indian, 7,550,
7%
Asian or Pacific
Islander, 1,537,
1%
Black or
African
American,
13,811, 13%
Caucasian,
84,154, 78%
Multiple Race,
1,523, 1%
Dual Enrollees by Race
108,199
108,253
107,911
108,252 108,415
108,575
107,000
108,000
109,000
110,000
May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12
Dual Enrollees Enrollment Trend
18 and Under,
38
19 to 54,
34,241
55 to 64,
18,890
65 and Over,
55,406
Dual Enrollees by Age
$603
$502 $500
$608
$520
$658
$400
$450
$500
$550
$600
$650
$700
Per Member Per Month
Dual Enrollees Fast Facts
11/14/2012
Race is self-reported by members at the time of enrollment. The multiple race members have selected two or
more races. Hispanic is an ethnicity not a race. Hispanics can be of any race and are accounted for in a race
category above.
This publication is authorized by the Oklahoma Health Care Authority in accordance with state and federal regulations. OHCA is in compliance with the Title VI and Title VII of the 1964 Civil
Rights Act and the Rehabilitation Act of 1973. For additional copies, you can go online to OHCA’s web site www.okhca.org under Research/Statistics and Data (www.okhca.org/research/data).
The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, gender, religion, age or disability in employment or the provision of services. The data is valid
as of the report date and is subject to change.
CHILD is defined as an individual age 18 and under.
Total Enrollment excludes Insure Oklahoma.
October 2012
Dual Enrollees are members who are enrolled in both SoonerCare and Medicare. Dual Enrollees are entitled to Medicare Part A and/or
Part B or Part C and qualify for some form of SoonerCare benefit. These members receive SoonerCare Supplemental or SoonerCare
Traditional benefits. For more information go to our website at www.okhca.org.
Dual Enrollees with Long-Term Care - 13,437
Dual Enrollees in PACE program - 101
Dual Enrollees in Waiver program - 17,877
Child Adult Total
Female 14 67,872 67,886
Male 24 40,665 40,689
Total 38 108,537 108,575
Dual Enrollees by Gender and Age
Hispanic Ethnicity - 3,557
Top 10 Paid Dual Enrollee Services
Categorized as:
Members Served
(Unduplicated)
Claims
Paid Amount Paid
Nursing Home Services 13,250 46,776 $45,211,001
ICF-ID Services 1,138 3,000 $6,792,361
Physician Services 48,549 142,058 $3,974,399
Inpatient Services 6,590 9,400 $2,974,678
Behavioral Health 4,530 34,114 $2,412,689
Targeted Case Manager (TCM) Services 2,828 4,571 $1,938,457
MSDG Services 14,352 27,039 $1,287,395
Non-Emergency Transportation (NET) Services 83,131 1 $1,224,760
Outpatient Services 19,050 30,454 $1,176,265
Community Mental Health Services 3,487 12,185 $755,516
All Paid Services in Reporting Month:
Members Served
(Unduplicated)
Claims
Paid Amount Paid
91,049 419,092 $71,390,921
NET and other capitated claims will show Claims Paid count of 1.
Dual Enrollment Total Enrollment Percent of Total
Child 38 487,843 0.01%
Adult 108,537 290,033 37.4%
Total 108,575 777,876 14.0%