Dual enrollees fast facts, 11/2012

              American
Indian, 7,451,
7%
Asian or Pacific
Islander, 1,542,
1%
Black or
African
American,
13,801, 13%
Caucasian,
84,089, 78%
Multiple Race,
1,590, 1%
Dual Enrollees by Race
108,253
107,911
108,252
108,415 108,575 108,473
107,000
108,000
109,000
110,000
Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12
Dual Enrollees Enrollment Trend
18 and Under,
39
19 to 54,
34,305
55 to 64,
18,948
65 and Over,
55,181
Dual Enrollees by Age
$502
$500
$608
$520
$658
$554
$400
$450
$500
$550
$600
$650
$700
Per Member Per Month
Dual Enrollees Fast Facts
12/12/2012
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.
November 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 - 13,305
Dual Enrollees in PACE program - 104
Dual Enrollees in Waiver program - 17,901
Child Adult Total
Female 16 67,783 67,799
Male 23 40,651 40,674
Total 39 108,434 108,473
Dual Enrollees by Gender and Age
Hispanic Ethnicity - 3,583
Top 10 Paid Dual Enrollee Services
Categorized as:
Members Served
(Unduplicated)
Claims
Paid Amount Paid
Nursing Home Services 12,514 42,201 $37,993,069
ICF-ID Services 1,141 2,855 $6,637,047
Physician Services 42,336 105,127 $3,058,328
Inpatient Services 5,110 7,255 $2,291,013
Behavioral Health 4,477 29,975 $2,075,866
Targeted Case Manager (TCM) Services 2,692 2,802 $1,504,713
Non-Emergency Transportation (NET) Services 82,967 1 $1,223,150
MSDG Services 13,233 21,876 $1,000,925
Outpatient Services 15,517 22,271 $902,237
Personal Care Services 1,778 7,434 $609,460
All Paid Services in Reporting Month:
Members Served
(Unduplicated)
Claims
Paid Amount Paid
90,532 335,712 $60,059,651
NET and other capitated claims will show Claims Paid count of 1.
Dual Enrollment Total Enrollment Percent of Total
Child 39 492,290 0.01%
Adult 108,434 292,976 37.0%
Total 108,473 785,266 13.8%