Dual enrollees fast facts, 01/2013

              American
Indian, 7,355,
7%
Asian or Pacific
Islander, 1,543,
1%
Black or
African
American,
13,797, 13%
Caucasian,
83,961, 77%
Multiple Race,
1,723, 2%
Dual Enrollees by Race
108,252
108,415
108,575 108,473
108,457 108,379
107,000
108,000
109,000
110,000
Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13
Dual Enrollees Enrollment Trend
18 and Under,
36
19 to 54,
34,215
55 to 64,
19,071
65 and Over,
55,057
Dual Enrollees by Age
$608
$520
$658
$554 $551
$632
$400
$450
$500
$550
$600
$650
$700
Per Member Per Month
Dual Enrollees Fast Facts
2/13/2013
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.
January 2013
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 - 13,247
Dual Enrollees in PACE program - 109
Dual Enrollees in Waiver program - 17,833
Child Adult Total
Female 15 67,671 67,686
Male 21 40,672 40,693
Total 36 108,343 108,379
Dual Enrollees by Gender and Age
Hispanic Ethnicity - 3,619
Top 10 Paid Dual Enrollee Services
Categorized as:
Members Served
(Unduplicated)
Claims
Paid Amount Paid
Nursing Home Services 12,777 46,472 $44,722,717
ICF-ID Services 1,135 2,965 $7,167,223
Physician Services 43,608 112,556 $3,068,719
Inpatient Services 5,586 7,627 $2,391,662
Behavioral Health 4,683 31,443 $2,259,673
Targeted Case Manager (TCM) Services 2,667 2,769 $1,453,448
Non-Emergency Transportation (NET) Services 83,382 1 $1,229,329
MSDG Services 13,496 23,024 $1,151,498
Outpatient Services 16,361 24,680 $1,020,798
Community Mental Health Services 3,452 11,528 $813,575
All Paid Services in Reporting Month:
Members Served
(Unduplicated)
Claims
Paid Amount Paid
90,602 348,182 $68,492,504
NET and other capitated claims will show Claims Paid count of 1.
Dual Enrollment Total Enrollment Percent of Total
Child 36 488,882 0.01%
Adult 108,343 290,683 37.3%
Total 108,379 779,565 13.9%