MLTC Data

MMC, MLTC, FIDA, DUAL, EPP, PACE, MAP & HIV/SNP DataSets

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We have the MLTC 2020 Year End and 2021 Q2 Datasets processed and ready to go. Call or email if you are interested in purchasing them.

Here is a look at the MLTC Community Program highlighting how Statewide PMPM has grown 13.2% from 2017 – 2019. CDPAP for the same period has increased by 133% and represented 35% of 2019 Gross Medical and Hospital Expense. Owners of our DataSet(s) can access more granualarity across Plans and Regions to provide insight into whether Cost and/or Utilization are the drivers behind these and many other trends. You can find more insights and other tables at NYSHCDATA.com that highlight the valueand uses of our DataSets.
*Data taken from Appended MLTC DataSet, Measures Added.

MLTC Community PMPM

Per Member Per Month (PMPM) Percent of Total
2017 2018 2019 Pct Change 2017 2018 2019
Personal Care  $  2,440  $  2,434  $  2,199 -9.9% 67.1% 61.2% 53.4%
CDPAP  $     618  $  1,026  $  1,439 132.7% 17.0% 25.8% 35.0%
All other Medical Expenses  $     580  $     516  $     480 -17.3% 15.9% 13.0% 11.6%
Gross Medical and Hospital Expenses  $  3,638  $  3,976  $  4,117 13.2%

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Below, are 2 MLTC Tables.
The first is Utilization & Cost of Service which details the Per Member Per Month (PMPM), # of Services Per Enrollee Per Year (PEPY), Unit Cost and Avg Members across 15 “Categories of Service”. The Data covers ALL PLANS AND REGIONS for those plans participating in Managed Long Term Care from 2014 to 2017 Q3.

The second Table displays Medical Loss Ratios (MLR), Administrative Loss Ratios (ALR) and Operating Gain/Loss(-) for ALL PLANS AND REGIONS plans participating in Managed Long Term Care from 2014 to 2017 Q3.

Feel free to export any table you create if you want to see how you can use the data in your own analysis (you must “Show All Entries” before you export)

Utilization & Cost of Service

Instructions – You may select any number of Period(s), Region(s), Plan(s) or Category of Service (15 Total). You can see how many entries your filter is producing (“Showing x of x entries…”) at the bottom left below the table and choose how many to display (“Show x entries”) at the top left above the table.

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