PA MEDICAID MARKET

Pennsylvania

Name: Pennsylvania Medicaid Managed Care RFP & Procurement Intelligence | Precapture
Creator: Precapture

procurement

Pennsylvania issues HealthChoices Physical Health RFI 26-RFI-20476

Last verified 40 days ago

Last verified 40 days ago · unknown because newest item is older than 21 days

Current procurement

PROCUREMENT

Verification tier 2

Pennsylvania issues HealthChoices Physical Health RFI 26-RFI-20476

October 6, 2026

The Pennsylvania eMarketplace advertisement for solicitation 26-RFI-20476 lists the title HealthChoices for Physical Health Services, a solicitation start date of October 6, 2026, and a due date of November 20, 2026 at 12:00 p.m. The advertisement is issued by the Department of Human Services Bureau of Procurement and Contract Management and asks for input toward a future HealthChoices Physical Health RFA and improvements to the mandatory managed care program. FindMyBids and ContractRadar list the same solicitation number, title, October 6 posting, and November 20 deadline.

Precapture analysis

This RFI is a pre-solicitation signal for a later RFA. It is not an award and it is not a contract proposal deadline. Responses are due November 20, 2026. The official advertisement is the controlling record.

POLICY

Verification tier 2

Pennsylvania’s updated Community HealthChoices waiver takes effect

July 1, 2026

Pennsylvania and the Rehabilitation & Community Providers Association report that CMS approved the Community HealthChoices Section 1915(c) waiver amendment effective July 1, 2026.

Precapture analysis

CHC contractors must align HCBS oversight, participant protections, authorizations and grievance operations with the renewed authorities and agreement.

Plans in this market

Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.

Plans in this market 225

Parent	Plan	Programs	Latest CMS enrollment	Share	MCPAR operations
not reported	Albright LIFE H-9068	not reported	202 (2017)	3.2% calculated	not reported
not reported	Albright LIFE H-9068	not reported	213 (2020)	3.0% calculated	not reported
not reported	Albright LIFE H-9068	not reported	220 (2024)	2.8% calculated	not reported
not reported	Allegheny County HealthChoices	not reported	273,332 (2022)	8.2% calculated	not reported
not reported	Beaver County HealthChoices	not reported	11,186 (2018)	1.2% calculated	not reported

show all 225

Parent	Plan	Programs	Latest CMS enrollment	Share	MCPAR operations
not reported	Cambria County HealthChoices	not reported	10,779 (2018)	1.2% calculated	not reported
not reported	Fayette County HealthChoices	not reported	13,232 (2018)	1.5% calculated	not reported
not reported	Greene County (Commonwealth)	not reported	3,304 (2018)	0.4% calculated	not reported
not reported	Northwest Behavioral Health Partnership	not reported	19,702 (2018)	2.2% calculated	not reported
not reported	Southwest Behavioral Health Management	not reported	59,615 (2018)	6.7% calculated	not reported
CVS/Aetna	Aetna Better Health	not reported	202,617 (2017)	9.0% calculated	not reported
CVS/Aetna	Aetna Better Health	not reported	290,670 (2022)	10.1% calculated	not reported
Centene	Bucks County HealthChoices	not reported	23,806 (2018)	2.7% calculated	not reported
Centene	Bucks County HealthChoices	not reported	82,835 (2024)	3.0% calculated	not reported
Centene	Cambria County HealthChoices	not reported	30,445 (2017)	1.2% calculated	not reported
Centene	Cambria County HealthChoices	not reported	31,514 (2024)	1.1% calculated	not reported
Centene	Delaware County HealthChoices	not reported	39,777 (2018)	4.4% calculated	not reported
Centene	Delaware County HealthChoices	not reported	131,797 (2021)	4.2% calculated	not reported
Centene	Lehigh County HealthChoices	not reported	30,127 (2018)	3.4% calculated	not reported
Centene	Lehigh County HealthChoices	not reported	88,583 (2024)	3.2% calculated	not reported
Centene	Montgomery County HealthChoices	not reported	33,318 (2018)	3.7% calculated	not reported
Centene	Montgomery County HealthChoices	not reported	112,886 (2024)	4.1% calculated	not reported
Centene	Northampton County HealthChoices	not reported	19,513 (2018)	2.2% calculated	not reported
Centene	Northampton County HealthChoices	not reported	50,549 (2024)	1.8% calculated	1 sanctions
Centene	Northampton county HealthChoices	not reported	49,583 (2017)	1.9% calculated	not reported
Centene	Pennsylvania Health & Wellness	not reported	78,600 (2024)	20.8% calculated	3 sanctions, 6,932 appeals resolved
Centene	Pennsylvania Health and Wellness	not reported	90,220 (2020)	24.5% calculated	not reported
not reported	Philadelphia County HealthChoices	not reported	645,875 (2024)	23.2% calculated	not reported
not reported	Allegheny County HealthChoices	not reported	225,296 (2024)	8.1% calculated	not reported
not reported	Behavioral Health Alliance of Rural Pennsylvania	not reported	219,770 (2024)	7.9% calculated	not reported
not reported	Behavioral Health Services of Somerset and Bedford Counties	not reported	23,492 (2024)	0.8% calculated	not reported
not reported	Behavioral Health Services of Somerset and Bedford counties	not reported	27,439 (2021)	0.9% calculated	not reported
not reported	Berks County HealthChoices	not reported	93,545 (2024)	3.4% calculated	not reported
not reported	Blair County HealthChoices	not reported	30,277 (2024)	1.1% calculated	not reported
not reported	Carbon-Monroe-Pike Joinder Board	not reported	58,868 (2024)	2.1% calculated	not reported
not reported	Chester County HealthChoices	not reported	56,261 (2024)	2.0% calculated	not reported
not reported	Community Care Behavioral Health Organization	not reported	241,550 (2021)	7.8% calculated	21 sanctions, 118 appeals resolved
not reported	Delaware County HealthChoices	not reported	121,150 (2024)	4.4% calculated	3 sanctions
not reported	Erie County HealthChoices	not reported	71,065 (2024)	2.6% calculated	not reported
not reported	Lycoming-Clinton Joinder Board	not reported	33,194 (2024)	1.2% calculated	not reported
not reported	Northeast Behavioral Health Care Consortium	not reported	161,348 (2024)	5.8% calculated	not reported
not reported	York/Adams HealthChoices Joinder Governing Board	not reported	102,158 (2024)	3.7% calculated	not reported
not reported	Allegheny County HealthChoices	not reported	209,885 (2017)	8.2% calculated	not reported
not reported	Berks County HealthChoices	not reported	86,190 (2017)	3.4% calculated	not reported
not reported	Blair County HealthChoices	not reported	29,104 (2017)	1.1% calculated	not reported
not reported	Carbon-Monroe-Pike Joinder Board	not reported	55,904 (2017)	2.2% calculated	not reported
not reported	Chester County HealthChoices	not reported	48,845 (2017)	1.9% calculated	not reported
not reported	Erie County HealthChoices	not reported	69,403 (2017)	2.7% calculated	not reported
not reported	Lycoming-Clinton Joinder Board	not reported	31,925 (2017)	1.3% calculated	not reported
not reported	North Central State Option	not reported	202,238 (2017)	7.9% calculated	not reported
not reported	Northeast Behavioral Healthcare Consortium	not reported	139,497 (2017)	5.5% calculated	not reported
not reported	Philadelphia County HealthChoices	not reported	600,809 (2017)	23.5% calculated	not reported
not reported	York-Adams Joinder Board	not reported	90,324 (2017)	3.5% calculated	not reported
not reported	Allegheny County HealthChoices	not reported	66,664 (2018)	7.4% calculated	not reported
not reported	Behavioral Health Services of Somerset and Bedford Counties	not reported	23,253 (2019)	0.9% calculated	not reported
not reported	Berks County HealthChoices	not reported	30,123 (2018)	3.4% calculated	not reported
not reported	Blair County HealthChoices	not reported	9,983 (2018)	1.1% calculated	not reported
not reported	Carbon-Monroe-Pike Joinder Board	not reported	22,932 (2018)	2.6% calculated	not reported
not reported	Chester County HealthChoices	not reported	16,791 (2018)	1.9% calculated	not reported
not reported	Erie County HealthChoices	not reported	22,812 (2018)	2.5% calculated	not reported
not reported	Lycoming-Clinton Joinder Board	not reported	11,547 (2018)	1.3% calculated	not reported
not reported	North Central State Option	not reported	77,720 (2018)	8.7% calculated	not reported
not reported	Northeast Behavioral Health Care Consortium	not reported	50,733 (2018)	5.7% calculated	not reported
not reported	York/Adams County HealthChoices	not reported	36,061 (2018)	4.0% calculated	not reported
not reported	Community LIFE H- 3917	not reported	749 (2022)	10.0% calculated	not reported
not reported	Community LIFE H- 3917	not reported	825 (2024)	10.5% calculated	not reported
not reported	Community LIFE H-3917	not reported	779 (2023)	9.7% calculated	not reported
Elevance	Beaver County HealthChoices	not reported	39,986 (2022)	1.2% calculated	not reported
Elevance	Beaver County HealthChoices	not reported	40,115 (2023)	1.2% calculated	not reported
Elevance	Beaver County HealthChoices	not reported	33,053 (2024)	1.2% calculated	not reported
Elevance	Fayette County HealthChoices	not reported	45,349 (2022)	1.4% calculated	not reported
Elevance	Fayette County HealthChoices	not reported	44,674 (2023)	1.3% calculated	not reported
Elevance	Fayette County HealthChoices	not reported	37,268 (2024)	1.3% calculated	not reported
Elevance	Greene County (Commonwealth)	not reported	9,882 (2021)	0.3% calculated	not reported
Elevance	Northwest Behavioral Health Partnership	not reported	66,587 (2022)	2.0% calculated	not reported
Elevance	Northwest Behavioral Health Partnership	not reported	66,194 (2023)	2.0% calculated	not reported
Elevance	Northwest Behavioral Health Partnership	not reported	54,965 (2024)	2.0% calculated	not reported
Elevance	Southwest Behavioral Health Management	not reported	214,593 (2022)	6.5% calculated	not reported
Elevance	Southwest Behavioral Health Management	not reported	215,199 (2023)	6.4% calculated	not reported
Elevance	Southwest Behavioral Health Management	not reported	177,424 (2024)	6.4% calculated	not reported
not reported	Gateway Health	not reported	326,965 (2022)	11.3% calculated	not reported
not reported	Highmark Wholecare	not reported	121,751 (2024)	5.2% calculated	4 sanctions, 8,254 appeals resolved
Geisinger	LIFE Geisinger H-2064	not reported	212 (2017)	3.4% calculated	not reported
Geisinger	Geisinger Health Plan	not reported	428,376 (2024)	18.1% calculated	13 sanctions, 2,516 appeals resolved
Geisinger	LIFE Geisinger H-2064	not reported	400 (2024)	5.1% calculated	not reported
Health Partners Plans	Health Partners Plans, Inc.	not reported	244,713 (2017)	10.8% calculated	4 sanctions
Health Partners Plans	Health Partners Plan	not reported	310,182 (2024)	13.1% calculated	1,801 appeals resolved
Highmark	Highmark Wholecare	not reported	150,074 (2023)	5.2% calculated	not reported
not reported	InnovAge LIFE H-9830	not reported	520 (2024)	6.6% calculated	not reported
not reported	Innovage LIFE H-9830	not reported	638 (2020)	9.0% calculated	not reported
not reported	Innovage LIFE H-9830	not reported	704 (2022)	9.4% calculated	not reported
not reported	Adult Community Autism Program	not reported	184 (2024)	100.0% calculated	not reported
not reported	LIFE NWPA H-4999	not reported	387 (2020)	5.5% calculated	not reported
not reported	LIFE NWPA H-4999	not reported	728 (2024)	9.2% calculated	not reported
not reported	LIFE Pittsburgh H-3918	not reported	539 (2023)	6.7% calculated	not reported
not reported	LIFE Pittsburgh H-3918	not reported	518 (2024)	6.6% calculated	not reported
not reported	LIFE St. Mary H-6551	not reported	225 (2020)	3.2% calculated	not reported
not reported	LIFE St. Mary H-6551	not reported	222 (2024)	2.8% calculated	not reported
not reported	LogistiCare	not reported	650,241 (2020)	100.0% calculated	not reported
not reported	LIFE NWPA H-4999	not reported	129 (2017)	2.1% calculated	not reported
not reported	VieCare Armstrong H-6188	not reported	51 (2017)	0.8% calculated	not reported
not reported	VieCare Beaver H-7660	not reported	496 (2017)	7.9% calculated	not reported
not reported	VieCare Butler H-3060	not reported	188 (2017)	3.0% calculated	not reported
not reported	SpiriTrust LIFE H-2537	not reported	80 (2017)	1.3% calculated	not reported
not reported	Mercy LIFE H-3919	not reported	844 (2019)	11.6% calculated	not reported
not reported	Mercy LIFE H-3919	not reported	816 (2024)	10.3% calculated	not reported
not reported	Mercy LIFE West Philadelphia H-3908	not reported	385 (2020)	5.4% calculated	not reported
not reported	Mercy LIFE West Philadelphia H-3908	not reported	292 (2024)	3.7% calculated	not reported
not reported	Modivcare	not reported	646,232 (2024)	100.0% calculated	not reported
not reported	Behavioral Health Services of Bedford and Somerset	not reported	9,011 (2018)	1.0% calculated	not reported
not reported	Capital Area Behavioral Health Collaborative	not reported	240,690 (2024)	8.6% calculated	not reported
not reported	Cumberland County HealthChoices	not reported	12,731 (2018)	1.4% calculated	not reported
not reported	Dauphin County HealthChoices	not reported	24,388 (2018)	2.7% calculated	not reported
not reported	Lancaster County HealthChoices	not reported	31,615 (2018)	3.5% calculated	not reported
not reported	Lebanon County HealthChoices	not reported	10,072 (2018)	1.1% calculated	not reported
not reported	Perry County HealthChoices	not reported	2,708 (2018)	0.3% calculated	not reported
not reported	Tuscarora Managed Care Alliance	not reported	30,783 (2024)	1.1% calculated	1 sanctions
not reported	Community LIFE H-3917	not reported	592 (2017)	9.4% calculated	not reported
not reported	LIFE - Pittsburgh H-3918	not reported	592 (2017)	9.4% calculated	not reported
not reported	New Courtland LIFE H-9830	not reported	564 (2017)	9.0% calculated	not reported
not reported	Senior LIFE Altonna H-5902	not reported	301 (2018)	4.5% calculated	not reported
not reported	Senior LIFE Altoona H- 5902	not reported	594 (2024)	7.5% calculated	not reported
not reported	Senior LIFE Greensburg - H-2937	not reported	190 (2017)	3.0% calculated	not reported
not reported	Senior LIFE Greensburg H- 2937	not reported	238 (2022)	100.0% calculated	not reported
not reported	Senior LIFE Greensburg H-2937	not reported	218 (2024)	2.8% calculated	not reported
not reported	Senior LIFE Johnstown - H-3925	not reported	196 (2017)	3.1% calculated	not reported
not reported	Senior LIFE Johnstown H- 3925	not reported	242 (2022)	3.2% calculated	not reported
not reported	Senior LIFE Johnstown H-3925	not reported	253 (2024)	3.2% calculated	not reported
not reported	Senior LIFE Lehigh H- 5978	not reported	599 (2024)	7.6% calculated	not reported
not reported	Senior LIFE Lehigh H-5978	not reported	334 (2018)	5.0% calculated	not reported
not reported	Senior LIFE Washington H- 2992	not reported	646 (2022)	8.6% calculated	not reported
not reported	Senior LIFE Washington H-2992	not reported	582 (2024)	7.4% calculated	not reported
not reported	Senior LIFE York H- 0819	not reported	433 (2024)	5.5% calculated	not reported
not reported	Senior LIFE York H-0819	not reported	222 (2018)	3.3% calculated	not reported
not reported	Senior LIFE Altoona H-5902	not reported	260 (2017)	4.1% calculated	not reported
not reported	SpiriTrust LIFE H-2537	not reported	97 (2018)	1.5% calculated	not reported
not reported	SpiriTrust LIFE H-2537	not reported	78 (2023)	1.0% calculated	not reported
not reported	LIFE St. Mary H-6551	not reported	233 (2017)	3.7% calculated	not reported
not reported	Mercy LIFE H-3919	not reported	784 (2017)	12.5% calculated	not reported
not reported	Mercy LIFE West Philadelphia H-3908	not reported	462 (2017)	7.3% calculated	not reported
UPMC	UPMC Community HealthChoices	not reported	130,300 (2024)	34.5% calculated	9 sanctions, 4,286 appeals resolved
UPMC	UPMC for You	not reported	583,460 (2024)	24.7% calculated	5 sanctions, 6,102 appeals resolved
UPMC	UPMC for You, Inc.	not reported	409,451 (2017)	18.1% calculated	not reported
UPMC	UPMC for You	not reported	514,204 (2021)	19.2% calculated	not reported
UnitedHealth	United Healthcare Community Plan of Pennsylvania	not reported	222,560 (2017)	9.9% calculated	not reported
UnitedHealth	United Healthcare Community Plan, Inc	not reported	237,812 (2020)	10.0% calculated	not reported
UnitedHealth	United Healthcare Community Plan, Inc	not reported	270,413 (2021)	10.1% calculated	not reported
UnitedHealth	United Healthcare Community Plan, Inc.	not reported	124,822 (2023)	4.3% calculated	not reported
UnitedHealth	United Healthcare Community Plan, Inc.	not reported	292,541 (2022)	10.2% calculated	not reported
UnitedHealth	UnitedHealthcare Community Plan, Inc.	not reported	95,611 (2024)	4.0% calculated	1 sanctions, 937 appeals resolved
not reported	Beaver County HealthChoices	not reported	31,717 (2017)	1.2% calculated	not reported
not reported	Fayette County HealthChoices	not reported	38,747 (2017)	1.5% calculated	not reported
not reported	Greene County (Commonwealth)	not reported	9,093 (2017)	0.4% calculated	not reported
not reported	Northwest Behavioral Health Partnership	not reported	54,567 (2017)	2.1% calculated	not reported
not reported	Southwest Behavioral Health Management	not reported	168,821 (2017)	6.6% calculated	not reported
not reported	VieCare Armstrong H- 6118	not reported	90 (2024)	1.1% calculated	not reported
not reported	VieCare Armstrong H-6118	not reported	67 (2018)	1.0% calculated	not reported
not reported	VieCare Beaver H- 7660	not reported	409 (2024)	5.2% calculated	not reported
not reported	VieCare Beaver H-7660	not reported	426 (2023)	5.3% calculated	not reported
not reported	VieCare Butler H-3060	not reported	167 (2024)	2.1% calculated	not reported
not reported	VieCare Butler H-3060	not reported	168 (2021)	2.2% calculated	not reported
not reported	AmeriHealth Caritas	not reported	72,928 (2024)	19.3% calculated	not reported
not reported	AmeriHealth Caritas/AmeriHealth Caritas Northeast	not reported	353,403 (2024)	15.0% calculated	23 sanctions, 23,702 appeals resolved
not reported	Amerihealth Caritas / Keystone First	not reported	15,154 (2018)	19.0% calculated	not reported
not reported	Keystone First	not reported	96,030 (2024)	25.4% calculated	20,881 appeals resolved
not reported	Vista	not reported	693,951 (2017)	30.7% calculated	not reported
not reported	Adams County HealthChoices - Community Care Behavioral Health Organization	not reported	13,847 (2016)	0.6% calculated	not reported
not reported	Adult Community Autism Program	not reported	144 (2016)	100.0% calculated	not reported
not reported	Aetna Better Health	not reported	205,979 (2016)	9.2% calculated	not reported
not reported	Albright LIFE H-9068	not reported	180 (2016)	3.1% calculated	not reported
not reported	Allegheny County HealthChoices - Community Care Behavioral Health Organization	not reported	209,469 (2016)	8.3% calculated	not reported
not reported	Beaver County HealthChoices - Value Behavioral Health of Pennsylvania	not reported	31,835 (2016)	1.3% calculated	not reported
not reported	Behavioral Health Services of Bedford and Somerset - Performcare	not reported	23,641 (2016)	0.9% calculated	not reported
not reported	Berks County HealthChoices - Community Care Behavioral Health Organization	not reported	83,958 (2016)	3.3% calculated	not reported
not reported	Blair County HealthChoices - Community Care Behavioral Health Organization	not reported	28,915 (2016)	1.1% calculated	not reported
not reported	Bucks County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	68,936 (2016)	2.7% calculated	not reported
not reported	Cambria County HealthChoices - Value Behavioral Health of Pennsylvania	not reported	29,972 (2016)	1.2% calculated	not reported
not reported	Carbon-Monroe-Pike Joinder Board - Community Care Behavioral Health Organization	not reported	54,021 (2016)	2.1% calculated	not reported
not reported	Chester County HealthCHoices - Community Care Behavioral Health Organization	not reported	47,997 (2016)	1.9% calculated	not reported
not reported	Community LIFE H-3917	not reported	580 (2016)	10.1% calculated	not reported
not reported	Cumberland County HealthChoices - PerformCare	not reported	28,028 (2016)	1.1% calculated	not reported
not reported	Dauphin County HealthChoices - PerformCare	not reported	59,609 (2016)	2.4% calculated	not reported
not reported	Delaware County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	104,902 (2016)	4.2% calculated	not reported
not reported	Erie County HealthChoices - Community Care Behavioral Health Organization	not reported	67,885 (2016)	2.7% calculated	not reported
not reported	Fayette County HealthChoices - Value Behavioral Health of Pennsylvania	not reported	38,497 (2016)	1.5% calculated	not reported
not reported	Gateway Health Plan	not reported	312,401 (2016)	14.0% calculated	not reported
not reported	Geisinger Health Plan	not reported	177,566 (2016)	8.0% calculated	not reported
not reported	Greene County (Commonwealth) - Value Behavioral Health of Pennsylvania	not reported	8,892 (2016)	0.4% calculated	not reported
not reported	Health Partners of Philadelphia, Inc.	not reported	238,394 (2016)	10.7% calculated	not reported
not reported	LIFE Geisinger H-2064	not reported	186 (2016)	3.2% calculated	not reported
not reported	LIFE NWPA H-4999	not reported	98 (2016)	1.7% calculated	not reported
not reported	LIFE St. Mary H-6551	not reported	226 (2016)	3.9% calculated	not reported
not reported	LIFE-Pittsburgh H-3918	not reported	579 (2016)	10.1% calculated	not reported
not reported	Lancaster County HealthChoices - PerformCare	not reported	82,845 (2016)	3.3% calculated	not reported
not reported	Lebanon County HealthChoices - PerformCare	not reported	24,548 (2016)	1.0% calculated	not reported
not reported	Lehigh County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	75,557 (2016)	3.0% calculated	not reported
not reported	Logisticare	not reported	611,477 (2016)	100.0% calculated	not reported
not reported	Logisticare	not reported	622,053 (2017)	100.0% calculated	not reported
not reported	Lycoming-Clinton Joinder Board - Community Care Behavioral Health Organization	not reported	31,640 (2016)	1.3% calculated	not reported
not reported	Mercy LIFE H-3919	not reported	698 (2016)	12.2% calculated	not reported
not reported	Mercy LIFE West Philadelphia H-3908	not reported	462 (2016)	8.1% calculated	not reported
not reported	Montgomery County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	93,643 (2016)	3.7% calculated	not reported
not reported	New Courtland LIFE H-9830	not reported	488 (2016)	8.5% calculated	not reported
not reported	North Central State Option - Community Care Behavioral Health Organization	not reported	201,548 (2016)	8.0% calculated	not reported
not reported	Northampton County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	48,795 (2016)	1.9% calculated	not reported
not reported	Northeast Behavioral Health Care Consortium - Community Care Behavioral Health Organization	not reported	133,930 (2016)	5.3% calculated	not reported
not reported	Northwest Behavioral Health Partnership - Value Behavioral Health of Pennsylvania	not reported	53,963 (2016)	2.1% calculated	not reported
not reported	Perry County HealthChoices - PerformCare	not reported	6,602 (2016)	0.3% calculated	not reported
not reported	Philadelphia County HealthChoices - Community Behavioral Health	not reported	590,576 (2016)	23.5% calculated	not reported
not reported	Senior LIFE Altoona H-5902	not reported	239 (2016)	4.2% calculated	not reported
not reported	Senior LIFE Greensburg H-2937	not reported	164 (2016)	2.9% calculated	not reported
not reported	Senior LIFE Johnstown H-3925	not reported	188 (2016)	3.3% calculated	not reported
not reported	Senior LIFE Lehigh H-5978	not reported	242 (2016)	4.2% calculated	not reported
not reported	Senior LIFE Washington H-2992	not reported	513 (2016)	8.9% calculated	not reported
not reported	Senior LIFE York H-0819	not reported	125 (2016)	2.2% calculated	not reported
not reported	Southwest Behavioral Health Management - Value Behavioral Health of Pennsylvnia	not reported	166,958 (2016)	6.6% calculated	not reported
not reported	SpiriTrust LIFE H-2537	not reported	90 (2016)	1.6% calculated	not reported
not reported	Tuscarora Managed Care Alliance - PeformCare	not reported	27,692 (2016)	1.1% calculated	not reported
not reported	UPMC for You Inc.	not reported	394,578 (2016)	17.7% calculated	not reported
not reported	United Healthcare Community Plan of Pennsylvania	not reported	221,161 (2016)	9.9% calculated	not reported
not reported	VieCare Armstrong H-6188	not reported	32 (2016)	0.6% calculated	not reported
not reported	VieCare Beaver H-7660	not reported	484 (2016)	8.4% calculated	not reported
not reported	VieCare Butler H-3060	not reported	158 (2016)	2.8% calculated	not reported
not reported	Vista	not reported	677,304 (2016)	30.4% calculated	not reported
not reported	York County HealthChoices - Community Care Behavioral Health Organization	not reported	76,075 (2016)	3.0% calculated	not reported

CMS reported enrollment

CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.

National market share

Adult Community Autism Program (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Adult Community Autism Program	not reported	unmatched	Cumberland, Dauphin, Chester and Lancaster	not reported	not reported	not reported	not reported	2016: 144

Adult Community Autism Program (Other PHP (limited benefits)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Adult Community Autism Program	Keystone Autism Services	Keystone Autism Services	Dauphin, Cumberland, Lancaster, and Chester Counties	CMS reported 184 (2024)	100.0%	not reported	not reported	2024: 184

Adult Community Autism Program (Other Prepaid Health Plan (PHP) (limited benefits))

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Adult Community Autism Program	Keystone Autism Services	Keystone Autism Services	Dauphin, Cumberland, Lancaster and Chester Counties	not reported	not reported	not reported	not reported	2018: 151; 2019: 172; 2020: 185
Adult Community Autism Program	Keystone Autism Services	Keystone Autism Services	Dauphin, Cumberland, Lancaster and Chester counties	not reported	not reported	not reported	not reported	2017: 149; 2021: 183
Adult Community Autism Program	Keystone Autism Services	Keystone Autism Services	Dauphin, Cumberland, Lancaster, and Chester Counties	not reported	not reported	not reported	not reported	2023: 189

Adult Community Autism Program (Other Prepaid Health Plan - limited benefits)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Adult Community Autism Program	Keystone Autism Services	Keystone Autism Services	Dauphin, Cumberland, Lancaster, and Chester Counties	not reported	not reported	not reported	not reported	2022: 182

Behavioral Health Health Choices (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))

Behavioral Health Health Choices (Behavioral Health Organization (BHO) only (PIHP and/or PAHP)) 25

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Allegheny County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Allegheny county	not reported	not reported	not reported	not reported	2021: 257,264
Beaver County HealthChoices	Beacon Health Options	Elevance	Beaver county	not reported	not reported	not reported	not reported	2021: 37,666
Behavioral Health Services of Somerset and Bedford counties	Community Care Behavioral Health	Community Care Behavioral Health	Bedford and Somerset counties	not reported	not reported	not reported	not reported	2021: 27,439
Berks County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Berks county	not reported	not reported	not reported	not reported	2021: 107,621
Blair County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Blair county	not reported	not reported	not reported	not reported	2021: 33,597

show all 25

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Bucks County HealthChoices	Magellan Behavioral Health	Centene	Bucks county	not reported	not reported	not reported	not reported	2021: 92,864
Cambria County HealthChoices	Magellan Behavioral Health	Centene	Cambria county	not reported	not reported	not reported	not reported	2021: 35,101
Capital Area Behavioral Health Collaborative	PerformCare	PerformCare	Cumberland, Dauphin, Lancaster, Lebanon and Perry counties	not reported	not reported	not reported	not reported	2021: 266,128
Carbon-Monroe-Pike Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Carbon-Monroe-Pike	not reported	not reported	not reported	not reported	2021: 69,624
Chester County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Chester county	not reported	not reported	not reported	not reported	2021: 63,656
Community Care Behavioral Health Organization	Community Care Behavioral Health	Community Care Behavioral Health	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren and Wayne counties	not reported	not reported	not reported	not reported	2021: 241,550
Delaware County HealthChoices	Magellan Behavioral Health	Centene	Delaware county	not reported	not reported	not reported	not reported	2021: 131,797
Erie County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Erie county	not reported	not reported	not reported	not reported	2021: 79,989
Fayette County HealthChoices	Beacon Health Options	Elevance	Fayette county	not reported	not reported	not reported	not reported	2021: 43,069
Greene County (Commonwealth)	Beacon Health Options	Elevance	Greene county	not reported	not reported	not reported	not reported	2021: 9,882
Lehigh County HealthChoices	Magellan Behavioral Health	Centene	Lehigh county	not reported	not reported	not reported	not reported	2021: 101,640
Lycoming-Clinton Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Lycoming-Clinton	not reported	not reported	not reported	not reported	2021: 37,870
Montgomery County HealthChoices	Magellan Behavioral Health	Centene	Montgomery county	not reported	not reported	not reported	not reported	2021: 121,368
Northampton County HealthChoices	Magellan Behavioral Health	Centene	Northampton county	not reported	not reported	not reported	not reported	2021: 60,493
Northeast Behavioral Health Care Consortium	Community Care Behavioral Health	Community Care Behavioral Health	Lackawanna, Luzerne, Susquehanna and Wyoming counties	not reported	not reported	not reported	not reported	2021: 175,930
Northwest Behavioral Health Partnership	Beacon Health Options	Elevance	Crawford, Mercer and Venango counties	not reported	not reported	not reported	not reported	2021: 62,810
Philadelphia County HealthChoices	Community Behavioral Health	Community Behavioral Health	Philadelphia county	not reported	not reported	not reported	not reported	2021: 702,657
Southwest Behavioral Health Management	Beacon Health Options	Elevance	Armstrong, Butler, Indiana, Lawrence, Washington and Westmoreland counties	not reported	not reported	not reported	not reported	2021: 201,554
Tuscarora Managed Care Alliance	PerformCare	PerformCare	Franklin and Fulton counties	not reported	not reported	not reported	not reported	2021: 34,721
York/Adams HealthChoices Joinder Governing Board	Community Care Behavioral Health	Community Care Behavioral Health	York/Adams	not reported	not reported	not reported	not reported	2021: 114,188

Behavioral Health HealthChoices (BHO only (PIHP and/or PAHP))

Behavioral Health HealthChoices (BHO only (PIHP and/or PAHP)) 24

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Allegheny County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Allegheny County	CMS reported 225,296 (2024)	8.1%	not reported	not reported	2024: 225,296
Beaver County HealthChoices	Carelon	Elevance	Beaver County	CMS reported 33,053 (2024)	1.2%	not reported	not reported	2024: 33,053
Behavioral Health Alliance of Rural Pennsylvania	Community Care Behavioral Health	Community Care Behavioral Health	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Greene Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren, and Wayne Counties	CMS reported 219,770 (2024)	7.9%	not reported	not reported	2024: 219,770
Behavioral Health Services of Somerset and Bedford Counties	Community Care Behavioral Health	Community Care Behavioral Health	Bedford and Somerset Counties	CMS reported 23,492 (2024)	0.8%	not reported	not reported	2024: 23,492
Berks County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Berks County	CMS reported 93,545 (2024)	3.4%	not reported	not reported	2024: 93,545

show all 24

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Blair County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Blair County	CMS reported 30,277 (2024)	1.1%	not reported	not reported	2024: 30,277
Bucks County HealthChoices	Magellan Behavioral Health	Centene	Bucks County	CMS reported 82,835 (2024)	3.0%	not reported	not reported	2024: 82,835
Cambria County HealthChoices	Magellan Behavioral Health	Centene	Cambria County	CMS reported 31,514 (2024)	1.1%	not reported	not reported	2024: 31,514
Capital Area Behavioral Health Collaborative	PerformCare	PerformCare	Cumberland, Dauphin, Lancaster, Lebanon, and Perry Counties	CMS reported 240,690 (2024)	8.6%	not reported	not reported	2024: 240,690
Carbon-Monroe-Pike Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Carbon, Monroe, and Pike Counties	CMS reported 58,868 (2024)	2.1%	not reported	not reported	2024: 58,868
Chester County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Chester County	CMS reported 56,261 (2024)	2.0%	not reported	not reported	2024: 56,261
Delaware County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Delaware County	CMS reported 121,150 (2024)	4.4%	not reported	not reported	2024: 121,150
Erie County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Erie County	CMS reported 71,065 (2024)	2.6%	not reported	not reported	2024: 71,065
Fayette County HealthChoices	Carelon	Elevance	Fayette County	CMS reported 37,268 (2024)	1.3%	not reported	not reported	2024: 37,268
Lehigh County HealthChoices	Magellan Behavioral Health	Centene	Lehigh County	CMS reported 88,583 (2024)	3.2%	not reported	not reported	2024: 88,583
Lycoming-Clinton Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Clinton and Lycoming Counties	CMS reported 33,194 (2024)	1.2%	not reported	not reported	2024: 33,194
Montgomery County HealthChoices	Magellan Behavioral Health	Centene	Montgomery County	CMS reported 112,886 (2024)	4.1%	not reported	not reported	2024: 112,886
Northampton County HealthChoices	Magellan Behavioral Health	Centene	Northampton County	CMS reported 50,549 (2024)	1.8%	not reported	not reported	2024: 50,549
Northeast Behavioral Health Care Consortium	Community Care Behavioral Health	Community Care Behavioral Health	Lackawanna, Luzerne, Susquehanna, and Wyoming Counties	CMS reported 161,348 (2024)	5.8%	not reported	not reported	2024: 161,348
Northwest Behavioral Health Partnership	Carelon	Elevance	Crawford, Mercer, and Venango Counties	CMS reported 54,965 (2024)	2.0%	not reported	not reported	2024: 54,965
Philadelphia County HealthChoices	Community Behavioral Health	Community Behavioral Health	Philadelphia County	CMS reported 645,875 (2024)	23.2%	not reported	not reported	2024: 645,875
Southwest Behavioral Health Management	Carelon	Elevance	Armstrong, Butler, Indiana, Lawrence, Washington, and Westmoreland Counties	CMS reported 177,424 (2024)	6.4%	not reported	not reported	2024: 177,424
Tuscarora Managed Care Alliance	PerformCare	PerformCare	Franklin and Fulton Counties	CMS reported 30,783 (2024)	1.1%	not reported	not reported	2024: 30,783
York/Adams HealthChoices Joinder Governing Board	Community Care Behavioral Health	Community Care Behavioral Health	York and Adams Counties	CMS reported 102,158 (2024)	3.7%	not reported	not reported	2024: 102,158

Behavioral Health HealthChoices (BHO only - PIHP and/or PAHP)

Behavioral Health HealthChoices (BHO only - PIHP and/or PAHP) 24

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Allegheny County HealthChoices	Allegheny County HealthChoices Community Care Behavioral Health	Allegheny County HealthChoices Community Care Behavioral Health	Allegheny County	not reported	not reported	not reported	not reported	2022: 273,332
Beaver County HealthChoices	Beacon Health Options	Elevance	Beaver County	not reported	not reported	not reported	not reported	2022: 39,986
Behavioral Health Alliance of Rural Pennsylvania	Community Care Behavioral Health	Community Care Behavioral Health	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Greene Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren, and Wayne Counties	not reported	not reported	not reported	not reported	2022: 269,390
Behavioral Health Services of Somerset and Bedford Counties	Community Care Behavioral Health	Community Care Behavioral Health	Bedford and Somerset Counties	not reported	not reported	not reported	not reported	2022: 29,265
Berks County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Berks County	not reported	not reported	not reported	not reported	2022: 114,803

show all 24

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Blair County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Blair County	not reported	not reported	not reported	not reported	2022: 35,647
Bucks County HealthChoices	Magellan Behavioral Health	Centene	Bucks County	not reported	not reported	not reported	not reported	2022: 99,973
Cambria County HealthChoices	Magellan Behavioral Health	Centene	Cambria County	not reported	not reported	not reported	not reported	2022: 37,327
Capital Area Behavioral Health Collaborative	PerformCare	PerformCare	Cumberland, Dauphin, Lancaster, Lebanon, and Perry Counties	not reported	not reported	not reported	not reported	2022: 290,013
Carbon-Monroe-Pike Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Carbon, Monroe, and Pike Counties	not reported	not reported	not reported	not reported	2022: 74,662
Chester County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Chester County	not reported	not reported	not reported	not reported	2022: 69,193
Delaware County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	–	not reported	not reported	not reported	not reported	2022: 145,221
Erie County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Erie County	not reported	not reported	not reported	not reported	2022: 84,823
Fayette County HealthChoices	Beacon Health Options	Elevance	Fayette County	not reported	not reported	not reported	not reported	2022: 45,349
Lehigh County HealthChoices	Magellan Behavioral Health	Centene	Lehigh County	not reported	not reported	not reported	not reported	2022: 109,678
Lycoming-Clinton Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Clinton and Lycoming Counties	not reported	not reported	not reported	not reported	2022: 40,400
Montgomery County HealthChoices	Magellan Behavioral Health	Centene	Montgomery County	not reported	not reported	not reported	not reported	2022: 133,114
Northampton County HealthChoices	Magellan Behavioral Health	Centene	Northampton County	not reported	not reported	not reported	not reported	2022: 64,723
Northeast Behavioral Health Care Consortium	Community Care Behavioral Health	Community Care Behavioral Health	Lackawanna, Luzerne, Susquehanna, and Wyoming Counties	not reported	not reported	not reported	not reported	2022: 189,206
Northwest Behavioral Health Partnership	Beacon Health Options	Elevance	Crawford, Mercer, and Venango Counties	not reported	not reported	not reported	not reported	2022: 66,587
Philadelphia County HealthChoices	Community Behavioral Health	Community Behavioral Health	Philadelphia County	not reported	not reported	not reported	not reported	2022: 737,713
Southwest Behavioral Health Management	Beacon Health Options	Elevance	Armstrong, Butler, Indiana, Lawrence, Washington, and Westmoreland Counties	not reported	not reported	not reported	not reported	2022: 214,593
Tuscarora Managed Care Alliance	PerformCare	PerformCare	Franklin and Fulton Counties	not reported	not reported	not reported	not reported	2022: 37,413
York/Adams HealthChoices Joinder Governing Board	Community Care Behavioral Health	Community Care Behavioral Health	York and Adams Counties	not reported	not reported	not reported	not reported	2022: 123,862

Behavioral Health HealthChoices (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))

Behavioral Health HealthChoices (Behavioral Health Organization (BHO) only (PIHP and/or PAHP)) 40

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Allegheny County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Allegheny County	not reported	not reported	not reported	not reported	2018: 66,664; 2019: 218,212; 2020: 232,467; 2023: 274,108
Beaver County HealthChoices	Beacon Health Options Name Change Only to Carelon Effective 3/1/2023	Elevance	Beaver County	not reported	not reported	not reported	not reported	2018: 11,186; 2019: 32,021; 2020: 33,897; 2023: 40,115
Behavioral Health Alliance of Rural Pennsylvania	Community Care Behavioral Health	Community Care Behavioral Health	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Greene Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren, and Wayne Counties	not reported	not reported	not reported	not reported	2023: 268,253
Behavioral Health Services of Bedford and Somerset	PerformCare	PerformCare	Bedford and Somerset Counties	not reported	not reported	not reported	not reported	2018: 9,011
Behavioral Health Services of Somerset and Bedford Counties	Community Care Behavioral Health	Community Care Behavioral Health	Bedford and Somerset Counties	not reported	not reported	not reported	not reported	2019: 23,253; 2020: 24,859; 2023: 28,956

show all 40

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Berks County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Berks County	not reported	not reported	not reported	not reported	2018: 30,123; 2019: 86,702; 2020: 95,341; 2023: 116,693
Blair County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Blair County	not reported	not reported	not reported	not reported	2018: 9,983; 2019: 29,161; 2020: 30,700; 2023: 35,916
Bucks County HealthChoices	Magellan Behavioral Health	Centene	Bucks County	not reported	not reported	not reported	not reported	2018: 23,806; 2019: 75,984; 2020: 82,239; 2023: 102,775
Cambria County HealthChoices	Magellan Behavioral Health	Centene	Cambria County	not reported	not reported	not reported	not reported	2018: 10,779; 2019: 30,478; 2020: 32,132; 2023: 37,312
Capital Area Behavioral Health Collaborative	PerformCare	PerformCare	Cumberland, Dauphin, Lancaster, Lebanon and Perry Counties	not reported	not reported	not reported	not reported	2019: 203,772; 2020: 232,710
Capital Area Behavioral Health Collaborative	PerformCare	PerformCare	Cumberland, Dauphin, Lancaster, Lebanon, and Perry Counties	not reported	not reported	not reported	not reported	2023: 295,827
Carbon-Monroe-Pike Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Carbon, Monroe and Pike Counties	not reported	not reported	not reported	not reported	2018: 22,932; 2019: 56,331; 2020: 62,227
Carbon-Monroe-Pike Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Carbon, Monroe, and Pike Counties	not reported	not reported	not reported	not reported	2023: 74,410
Chester County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Chester County	not reported	not reported	not reported	not reported	2018: 16,791; 2019: 50,969; 2020: 56,096; 2023: 68,894
Community Care Behavioral Health Organization	Community Care Behavioral Health	Community Care Behavioral Health	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren and Wayne Counties	not reported	not reported	not reported	not reported	2019: 195,200; 2020: 217,828
Cumberland County HealthChoices	PerformCare	PerformCare	Cumberland County	not reported	not reported	not reported	not reported	2018: 12,731
Dauphin County HealthChoices	PerformCare	PerformCare	Dauphin County	not reported	not reported	not reported	not reported	2018: 24,388
Delaware County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Delaware County	not reported	not reported	not reported	not reported	2018: 39,777; 2019: 108,183; 2020: 118,349; 2023: 148,137
Erie County HealthChoices	Community Care Behavioral Health	Community Care Behavioral Health	Erie County	not reported	not reported	not reported	not reported	2018: 22,812; 2019: 67,197; 2020: 73,226; 2023: 84,099
Fayette County HealthChoices	Beacon Health Options Name Change Only to Carelon Effective 3/1/2023	Elevance	Fayette County	not reported	not reported	not reported	not reported	2018: 13,232; 2019: 37,492; 2020: 39,679; 2023: 44,674
Greene County (Commonwealth)	Beacon Health Options	Elevance	Greene County	not reported	not reported	not reported	not reported	2018: 3,304; 2019: 8,583; 2020: 9,073
Lancaster County HealthChoices	PerformCare	PerformCare	Lancaster County	not reported	not reported	not reported	not reported	2018: 31,615
Lebanon County HealthChoices	PerformCare	PerformCare	Lebanon County	not reported	not reported	not reported	not reported	2018: 10,072
Lehigh County HealthChoices	Magellan Behavioral Health	Centene	Lehigh County	not reported	not reported	not reported	not reported	2018: 30,127; 2019: 80,488; 2020: 90,249; 2023: 109,600
Lycoming-Clinton Joinder Board	Community Care Behavioral Health	Community Care Behavioral Health	Clinton and Lycoming Counties	not reported	not reported	not reported	not reported	2018: 11,547; 2019: 31,197; 2020: 34,192; 2023: 40,447
Montgomery County HealthChoices	Magellan Behavioral Health	Centene	Montgomery County	not reported	not reported	not reported	not reported	2018: 33,318; 2019: 99,550; 2020: 107,115; 2023: 137,259
North Central State Option	Community Care Health Plan (WI)	Community Care Health Plan (WI)	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren and Wayne Counties	not reported	not reported	not reported	not reported	2018: 77,720
Northampton County HealthChoices	Magellan Behavioral Health	Centene	Northampton County	not reported	not reported	not reported	not reported	2018: 19,513; 2019: 48,235; 2020: 53,966; 2023: 64,350
Northeast Behavioral Health Care Consortium	Community Care Behavioral Health	Community Care Behavioral Health	Lackawanna, Luzerne, Susquehanna and Wyoming Counties	not reported	not reported	not reported	not reported	2018: 50,733; 2019: 141,228; 2020: 157,368
Northeast Behavioral Health Care Consortium	Community Care Behavioral Health	Community Care Behavioral Health	Lackawanna, Luzerne, Susquehanna, and Wyoming Counties	not reported	not reported	not reported	not reported	2023: 191,915
Northwest Behavioral Health Partnership	Beacon Health Options Name Change Only to Carelon Effective 3/1/2023	Elevance	Crawford, Mercer, and Venango Counties	not reported	not reported	not reported	not reported	2023: 66,194
Northwest Behavioral Health Partnership	Beacon Health Options	Elevance	Crawford, Mercer and Venango Counties	not reported	not reported	not reported	not reported	2018: 19,702; 2019: 52,179; 2020: 57,255
Perry County HealthChoices	PerformCare	PerformCare	Perry County	not reported	not reported	not reported	not reported	2018: 2,708
Philadelphia County HealthChoices	Community Behavioral Health	Community Behavioral Health	Philadelphia County	not reported	not reported	not reported	not reported	2018: 185,254; 2019: 622,854; 2020: 650,782; 2023: 746,301
Southwest Behavioral Health Management	Beacon Health Options Name Change Only to Carelon Effective 3/1/2023	Elevance	Armstrong, Butler, Indiana, Lawrence, Washington, and Westmoreland Counties	not reported	not reported	not reported	not reported	2023: 215,199
Southwest Behavioral Health Management	Beacon Health Options	Elevance	Armstrong, Butler, Indiana, Lawrence, Washington and Westmoreland Counties	not reported	not reported	not reported	not reported	2019: 170,227; 2020: 182,122
Southwest Behavioral Health Management	Beacon	Beacon	Armstrong, Butler, Indianna, Lawrence, Washington and Westmoreland Counties	not reported	not reported	not reported	not reported	2018: 59,615
Tuscarora Managed Care Alliance	PerformCare	PerformCare	Franklin and Fulton Counties	not reported	not reported	not reported	not reported	2018: 10,962; 2019: 27,649; 2020: 30,515; 2023: 38,197
York/Adams County HealthChoices	Community Care Health Plan (WI)	Community Care Health Plan (WI)	York and Adams Counties	not reported	not reported	not reported	not reported	2018: 36,061
York/Adams HealthChoices Joinder Governing Board	Community Care Behavioral Health	Community Care Behavioral Health	York and Adams Counties	not reported	not reported	not reported	not reported	2019: 90,509; 2020: 100,413; 2023: 126,974

Community HealthChoices (Comprehensive MCO + MLTSS)

Community HealthChoices (Comprehensive MCO + MLTSS) 20

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
AmeriHealth Caritas	Vista	Vista	All counties EXCEPT the following in SE PA: Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties	CMS reported 72,928 (2024)	19.3%	-11,487 (-13.6%)	-1.0 pts	2023: 84,415; 2024: 72,928
AmeriHealth Caritas	Vista	Vista	All counties in PA except Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties	not reported	not reported	not reported	not reported	2022: 81,979
AmeriHealth Caritas	Vista	Vista	Southwest PA: Allegheny County, Armstrong County, Beaver County, Bedford County, Blair County, Butler County, Cambria County, Fayette County, Greene County, Indiana County, Lawrence County, Somerset County, Washington County and Westmoreland County	not reported	not reported	not reported	not reported	2019: 15,125
AmeriHealth Caritas	Vista	Vista	Southwest PA: Allegheny county, Armstrong county, Beaver county, Bedford county, Blair county, Butler county, Cambria county, Fayette county, Greene county, Indiana county, Lawrence county, Somerset county, Washington county and Westmoreland county Lehigh/Capital Zone: Adams, Berks, Cumberland, Dauphin, Fulton, Franklin, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry, and York counties Northeast Zone: Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne and Wyoming Northwest Zone: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango, and Warren counties	not reported	not reported	not reported	not reported	2021: 81,975
AmeriHealth Caritas	Vista	Vista	Southwest zone, Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2020: 73,536

show all 20

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Amerihealth Caritas / Keystone First	Vista	Vista	Southwest PA: Allegheny County, Armstrong County, Beaver County, Bedford County, Blair County, Butler County, Cambria County, Fayette County, Greene County, Indiana County, Lawrence County, Somerset County, Washington County and Westmoreland County	not reported	not reported	not reported	not reported	2018: 15,154
Keystone First	Vista	Vista	Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties	CMS reported 96,030 (2024)	25.4%	-3,675 (-3.7%)	+1.5 pts	2022: 93,579; 2023: 99,705; 2024: 96,030
Keystone First	Vista	Vista	Southeast PA: Bucks County, Chester County, Delaware County, Montgomery County, Philadelphia County	not reported	not reported	not reported	not reported	2019: 75,484
Keystone First	Vista	Vista	Southeast PA: Bucks county, Chester county, Delaware county, Montgomery county, Philadelphia county	not reported	not reported	not reported	not reported	2021: 93,576
Keystone First	Vista	Vista	Southeast zone	not reported	not reported	not reported	not reported	2020: 78,977
Pennsylvania Health & Wellness	Centene Corporation	Centene	Southwest PA: Allegheny County, Armstrong County, Beaver County, Bedford County, Blair County, Butler County, Cambria County, Fayette County, Greene County, Indiana County, Lawrence County, Somerset County, Washington County and Westmoreland County. Southeast PA: Bucks County, Chester County, Delaware County, Montgomery County, Philadelphia County	not reported	not reported	not reported	not reported	2019: 50,936
Pennsylvania Health & Wellness	Centene Corporation	Centene	Southwest PA: Allegheny County, Armstrong County, Beaver County, Bedford County, Blair County, Butler County, Cambria County, Fayette County, Greene County, Indiana County, Lawrence County, Somerset County, Washington County and Westmoreland County	not reported	not reported	not reported	not reported	2018: 21,720
Pennsylvania Health & Wellness	Centene Corporation	Centene	Southwest PA: Allegheny county, Armstrong county, Beaver county, Bedford county, Blair county, Butler county, Cambria county, Fayette county, Greene county, Indiana county, Lawrence county, Somerset county, Washington county and Westmoreland county Southeast PA: Bucks county, Chester county, Delaware county, Montgomery county, Philadelphia county Lehigh/Capital Zone: Adams, Berks, Cumberland, Dauphin, Fulton, Franklin, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry, and York counties Northeast Zone: Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne and Wyoming	not reported	not reported	not reported	not reported	2021: 88,197
Pennsylvania Health & Wellness	Centene Corporation	Centene	Statewide	CMS reported 78,600 (2024)	20.8%	-10,291 (-11.6%)	-0.6 pts	2022: 88,198; 2023: 88,891; 2024: 78,600
Pennsylvania Health and Wellness	Centene Corporation	Centene	Southeast zone, Southwest zone, Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2020: 90,220
UPMC Community HealthChoices	UPMC	UPMC	Southeast zone, Southwest zone, Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2020: 125,311
UPMC Community HealthChoices	UPMC	UPMC	Southwest PA: Allegheny County, Armstrong County, Beaver County, Bedford County, Blair County, Butler County, Cambria County, Fayette County, Greene County, Indiana County, Lawrence County, Somerset County, Washington County and Westmoreland County. Southeast PA: Bucks County, Chester County, Delaware County, Montgomery County, Philadelphia County	not reported	not reported	not reported	not reported	2019: 70,679
UPMC Community HealthChoices	UPMC	UPMC	Southwest PA: Allegheny County, Armstrong County, Beaver County, Bedford County, Blair County, Butler County, Cambria County, Fayette County, Greene County, Indiana County, Lawrence County, Somerset County, Washington County and Westmoreland County	not reported	not reported	not reported	not reported	2018: 43,044
UPMC Community HealthChoices	UPMC	UPMC	Southwest PA: Allegheny county, Armstrong county, Beaver county, Bedford county, Blair county, Butler county, Cambria county, Fayette county, Greene county, Indiana county, Lawrence county, Somerset county, Washington county and Westmoreland county Southeast PA: Bucks county, Chester county, Delaware county, Montgomery county, Philadelphia county	not reported	not reported	not reported	not reported	2021: 135,835
UPMC Community HealthChoices	UPMC	UPMC	Statewide	CMS reported 130,300 (2024)	34.5%	-12,833 (-9.0%)	+0.1 pts	2022: 135,841; 2023: 143,133; 2024: 130,300

HealthChoices - Behavioral Health (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))

HealthChoices - Behavioral Health (Behavioral Health Organization (BHO) only (PIHP and/or PAHP)) 59

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Adams County HealthChoices - Community Care Behavioral Health Organization	not reported	unmatched	Adams County	not reported	not reported	not reported	not reported	2016: 13,847
Allegheny County HealthChoices - Community Care Behavioral Health Organization	not reported	unmatched	Allegheny County	not reported	not reported	not reported	not reported	2016: 209,469
Allegheny County HealthChoices	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Allegheny county	not reported	not reported	not reported	not reported	2017: 209,885
Beaver County HealthChoices - Value Behavioral Health of Pennsylvania	not reported	unmatched	Beaver County	not reported	not reported	not reported	not reported	2016: 31,835
Beaver County HealthChoices	Value Behavioral Health of PA	Value Behavioral Health of PA	Beaver county	not reported	not reported	not reported	not reported	2017: 31,717

show all 59

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Behavioral Health Services of Bedford and Somerset - Performcare	not reported	unmatched	Bedford and Somerset Counties	not reported	not reported	not reported	not reported	2016: 23,641
Behavioral Health Services of Bedford and Somerset	PerformCare	PerformCare	Bedford and Somerset counties	not reported	not reported	not reported	not reported	2017: 23,579
Berks County HealthChoices - Community Care Behavioral Health Organization	not reported	unmatched	Berks County	not reported	not reported	not reported	not reported	2016: 83,958
Berks County HealthChoices	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Berks county	not reported	not reported	not reported	not reported	2017: 86,190
Blair County HealthChoices - Community Care Behavioral Health Organization	not reported	unmatched	Blair County	not reported	not reported	not reported	not reported	2016: 28,915
Blair County HealthChoices	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Blair county	not reported	not reported	not reported	not reported	2017: 29,104
Bucks County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	unmatched	Bucks County	not reported	not reported	not reported	not reported	2016: 68,936
Bucks County HealthChoices	Magellan Health	Centene	Bucks county	not reported	not reported	not reported	not reported	2017: 70,266
Cambria County HealthChoices - Value Behavioral Health of Pennsylvania	not reported	unmatched	Cambria County	not reported	not reported	not reported	not reported	2016: 29,972
Cambria County HealthChoices	Magellan Health	Centene	Cambria County	not reported	not reported	not reported	not reported	2017: 30,445
Carbon-Monroe-Pike Joinder Board - Community Care Behavioral Health Organization	not reported	unmatched	Carbon, Monroe & Pike Counties	not reported	not reported	not reported	not reported	2016: 54,021
Carbon-Monroe-Pike Joinder Board	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Carbon, Monroe and Pike counties	not reported	not reported	not reported	not reported	2017: 55,904
Chester County HealthCHoices - Community Care Behavioral Health Organization	not reported	unmatched	Chester County	not reported	not reported	not reported	not reported	2016: 47,997
Chester County HealthChoices	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Chester county	not reported	not reported	not reported	not reported	2017: 48,845
Cumberland County HealthChoices - PerformCare	not reported	unmatched	Cumberland County	not reported	not reported	not reported	not reported	2016: 28,028
Cumberland County HealthChoices	PerformCare	PerformCare	Cumberland county	not reported	not reported	not reported	not reported	2017: 28,994
Dauphin County HealthChoices - PerformCare	not reported	unmatched	Dauphin County	not reported	not reported	not reported	not reported	2016: 59,609
Dauphin County HealthChoices	PerformCare	PerformCare	Dauphin county	not reported	not reported	not reported	not reported	2017: 60,556
Delaware County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	unmatched	Delaware County	not reported	not reported	not reported	not reported	2016: 104,902
Delaware County HealthChoices	Magellan Health	Centene	Delaware county	not reported	not reported	not reported	not reported	2017: 106,835
Erie County HealthChoices - Community Care Behavioral Health Organization	not reported	unmatched	Erie County	not reported	not reported	not reported	not reported	2016: 67,885
Erie County HealthChoices	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Erie county	not reported	not reported	not reported	not reported	2017: 69,403
Fayette County HealthChoices - Value Behavioral Health of Pennsylvania	not reported	unmatched	Fayette County	not reported	not reported	not reported	not reported	2016: 38,497
Fayette County HealthChoices	Value Behavioral Health of PA	Value Behavioral Health of PA	Fayette county	not reported	not reported	not reported	not reported	2017: 38,747
Greene County (Commonwealth) - Value Behavioral Health of Pennsylvania	not reported	unmatched	Greene County	not reported	not reported	not reported	not reported	2016: 8,892
Greene County (Commonwealth)	Value Behavioral Health of PA	Value Behavioral Health of PA	Greene County	not reported	not reported	not reported	not reported	2017: 9,093
Lancaster County HealthChoices - PerformCare	not reported	unmatched	Lancaster County	not reported	not reported	not reported	not reported	2016: 82,845
Lancaster County HealthChoices	PerformCare	PerformCare	Lancaster County	not reported	not reported	not reported	not reported	2017: 83,054
Lebanon County HealthChoices - PerformCare	not reported	unmatched	Lebanon County	not reported	not reported	not reported	not reported	2016: 24,548
Lebanon County HealthChoices	PerformCare	PerformCare	Lebanon County	not reported	not reported	not reported	not reported	2017: 24,851
Lehigh County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	unmatched	Lehigh County	not reported	not reported	not reported	not reported	2016: 75,557
Lehigh County HealthChoices	Magellan Health	Centene	Lehigh County	not reported	not reported	not reported	not reported	2017: 78,034
Lycoming-Clinton Joinder Board - Community Care Behavioral Health Organization	not reported	unmatched	Clinton & Lycoming Counties	not reported	not reported	not reported	not reported	2016: 31,640
Lycoming-Clinton Joinder Board	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Clinton and Lycoming counties	not reported	not reported	not reported	not reported	2017: 31,925
Montgomery County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	unmatched	Montgomery County	not reported	not reported	not reported	not reported	2016: 93,643
Montgomery County HealthChoices	Magellan Health	Centene	Montgomery county	not reported	not reported	not reported	not reported	2017: 94,547
North Central State Option - Community Care Behavioral Health Organization	not reported	unmatched	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potters, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren & Wayne Counties	not reported	not reported	not reported	not reported	2016: 201,548
North Central State Option	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren, Wayne counties	not reported	not reported	not reported	not reported	2017: 202,238
Northampton County HealthChoices - Magellan Behavioral Health of Pennsylvania	not reported	unmatched	Northampton County	not reported	not reported	not reported	not reported	2016: 48,795
Northampton county HealthChoices	Magellan Health	Centene	Northampton county	not reported	not reported	not reported	not reported	2017: 49,583
Northeast Behavioral Health Care Consortium - Community Care Behavioral Health Organization	not reported	unmatched	Lackawanna, Luzerne, Susquehanna & Wyoming Counties	not reported	not reported	not reported	not reported	2016: 133,930
Northeast Behavioral Healthcare Consortium	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Lackawanna, Luzerne, Susquehanna, Wyoming Counties	not reported	not reported	not reported	not reported	2017: 139,497
Northwest Behavioral Health Partnership - Value Behavioral Health of Pennsylvania	not reported	unmatched	Crawford, Mercer & Venango Counties	not reported	not reported	not reported	not reported	2016: 53,963
Northwest Behavioral Health Partnership	Value Behavioral Health of PA	Value Behavioral Health of PA	Crawford, Mercer, Venango counties	not reported	not reported	not reported	not reported	2017: 54,567
Perry County HealthChoices - PerformCare	not reported	unmatched	Perry County	not reported	not reported	not reported	not reported	2016: 6,602
Perry County HealthChoices	PerformCare	PerformCare	Perry county	not reported	not reported	not reported	not reported	2017: 6,804
Philadelphia County HealthChoices - Community Behavioral Health	not reported	unmatched	Philadelphia County	not reported	not reported	not reported	not reported	2016: 590,576
Philadelphia County HealthChoices	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	Philadelphia county	not reported	not reported	not reported	not reported	2017: 600,809
Southwest Behavioral Health Management - Value Behavioral Health of Pennsylvnia	not reported	unmatched	Armstrong, Butler, Indiana, Lawrence, Washington & Westmoreland Counties	not reported	not reported	not reported	not reported	2016: 166,958
Southwest Behavioral Health Management	Value Behavioral Health of PA	Value Behavioral Health of PA	Armstrong, Butler, Indiana, Lawrence, Washington, Westmoreland counties	not reported	not reported	not reported	not reported	2017: 168,821
Tuscarora Managed Care Alliance - PeformCare	not reported	unmatched	Franklin & Fulton Counties	not reported	not reported	not reported	not reported	2016: 27,692
Tuscarora Managed Care Alliance	PerformCare	PerformCare	Franklin and Fulton counties	not reported	not reported	not reported	not reported	2017: 27,970
York County HealthChoices - Community Care Behavioral Health Organization	not reported	unmatched	York County	not reported	not reported	not reported	not reported	2016: 76,075
York-Adams Joinder Board	Community Care Behavioral Health Organization	Community Care Behavioral Health Organization	York county	not reported	not reported	not reported	not reported	2017: 90,324

HealthChoices - Physical Health (Comprehensive MCO)

HealthChoices - Physical Health (Comprehensive MCO) 23

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Aetna Better Health	Aetna Inc.	CVS/Aetna	Southeast, Southwest, Lehigh/Capital, Northwest, Northeast	not reported	not reported	not reported	not reported	2017: 202,617
Aetna Better Health	Aetna	CVS/Aetna	Southeast zone, Southwest zone, Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2018: 200,113; 2019: 198,455
Aetna Better Health	not reported	unmatched	Southeast, Southwest, Lehigh/Capital, Northeast, and Northwest	not reported	not reported	not reported	not reported	2016: 205,979
AmeriHealth Caritas/AmeriHealth Caritas Northeast	Vista	Vista	Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2019: 281,769
AmeriHealth Caritas/AmeriHealth Caritas Northeast	Vista	Vista	Lehigh/Capital, Northwest, Northeast	not reported	not reported	not reported	not reported	2018: 282,611

show all 23

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Gateway Health Plan	not reported	unmatched	Southwest, Lehigh/Capital, and Northwest	not reported	not reported	not reported	not reported	2016: 312,401
Gateway Health	Gateway Health	Gateway Health	Southwest zone, Lehigh/Capital zone, Northwest zone	not reported	not reported	not reported	not reported	2018: 290,732; 2019: 277,493
Gateway Health	Gateway Health	Gateway Health	Southwest, Lehigh/Capital, Northwest	not reported	not reported	not reported	not reported	2017: 302,166
Geisinger Health Plan	Geisinger Health Plan	Geisinger Health Plan	Northeast zone	not reported	not reported	not reported	not reported	2019: 179,324
Geisinger Health Plan	Geisinger Health Plan	Geisinger Health Plan	Northeast	not reported	not reported	not reported	not reported	2016: 177,566; 2017: 183,921; 2018: 183,774
Health Partners Plan	Health Partners Plan	Health Partners Plan	Southeast zone	not reported	not reported	not reported	not reported	2018: 245,742; 2019: 231,733
Health Partners Plans, Inc.	Health Partners Inc.	Health Partners	Southeast	not reported	not reported	not reported	not reported	2017: 244,713
Health Partners of Philadelphia, Inc.	not reported	unmatched	Southeast	not reported	not reported	not reported	not reported	2016: 238,394
Keystone First	Vista	Vista	Southeast zone	not reported	not reported	not reported	not reported	2019: 421,910
Keystone First	Vista	Vista	Southeast	not reported	not reported	not reported	not reported	2018: 431,461
UPMC for You Inc.	not reported	unmatched	Lehigh/Capital, Southwest, Northwest	not reported	not reported	not reported	not reported	2016: 394,578
UPMC for You, Inc.	UPMC, Inc.	UPMC	Southwest, Lehigh/Capital, Northwest	not reported	not reported	not reported	not reported	2017: 409,451
UPMC for You	UPMC Health Plan	UPMC Health Plan	Southwest zone, Lehigh/Capital zone, Northwest zone	not reported	not reported	not reported	not reported	2018: 415,254; 2019: 414,066
United Healthcare Community Plan of Pennsylvania	UnitedHealth Group, Inc.	UnitedHealth	Southeast, Southwest, Lehigh/Capital	not reported	not reported	not reported	not reported	2017: 222,560
United Healthcare Community Plan of Pennsylvania	not reported	unmatched	Southeast, Lehigh/Capital, and Southwest	not reported	not reported	not reported	not reported	2016: 221,161
United Healthcare Community Plan, Inc.	UnitedHealthcare	UnitedHealth	Southeast zone, Southwest zone, Lehigh/Capital zone	not reported	not reported	not reported	not reported	2018: 223,022; 2019: 217,982
Vista	Vista	Vista	Southeast, Lehigh/Capital, Northwest, Northeast	not reported	not reported	not reported	not reported	2017: 693,951
Vista	not reported	unmatched	Southeast, Lehigh/Capital, Notheast, and Northwest	not reported	not reported	not reported	not reported	2016: 677,304

LIFE PACE

LIFE PACE 18

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Albright LIFE H-9068	Albright LIFE H- 9068	Albright LIFE H- 9068	Lancaster, Lebanon, Lycoming, Clinton, Union, and Chester Counties	not reported	not reported	not reported	not reported	2022: 178
Community LIFE H- 3917	Community LIFE H- 3917	Community LIFE H-3917	Allegheny, Westmoreland, and Washington Counties	not reported	not reported	not reported	not reported	2022: 749
Innovage LIFE H-9830	Innovage LIFE H- 9830	Innovage LIFE H-9830	Philadelphia County	not reported	not reported	not reported	not reported	2022: 704
LIFE Geisinger H-2064	Geisinger Health Plan	Geisinger Health Plan	Luzerne, Lackawanna, Columbia, Montour, Northumberland, and Schuylkill Counties	not reported	not reported	not reported	not reported	2022: 365
LIFE NWPA H-4999	LIFE NWPA H- 4999	LIFE NWPA H- 4999	Erie, Mercer, Crawford, and Warren Counties	not reported	not reported	not reported	not reported	2022: 520

show all 18

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LIFE Pittsburgh H-3918	LIFE Pittsburgh H- 3918	LIFE Pittsburgh H-3918	Allegheny County	not reported	not reported	not reported	not reported	2022: 541
LIFE St. Mary H-6551	LIFE St. Mary H- 6551	LIFE St. Mary H- 6551	Bucks County	not reported	not reported	not reported	not reported	2022: 248
Mercy LIFE H-3919	Mercy LIFE H- 3919	Mercy LIFE H- 3919	Philadelphia and Delaware Counties	not reported	not reported	not reported	not reported	2022: 835
Mercy LIFE West Philadelphia H-3908	Mercy LIFE West Philadelphia H- 3908	Mercy LIFE West Philadelphia H- 3908	Philadelphia County	not reported	not reported	not reported	not reported	2022: 386
Senior LIFE Altoona H- 5902	Senior LIFE	Senior LIFE	Blair, Cambria, and Indiana Counties	not reported	not reported	not reported	not reported	2022: 494
Senior LIFE Johnstown H- 3925	Senior LIFE	Senior LIFE	Cambria and Somerset Counties (partial)	not reported	not reported	not reported	not reported	2022: 242
Senior LIFE Lehigh H- 5978	Senior LIFE	Senior LIFE	Lehigh, Berks, and Northampton Counties	not reported	not reported	not reported	not reported	2022: 475
Senior LIFE Washington H- 2992	Senior LIFE	Senior LIFE	Washington, Fayette, and Greene Counties	not reported	not reported	not reported	not reported	2022: 646
Senior LIFE York H- 0819	Senior LIFE	Senior LIFE	York and Dauphin Counties	not reported	not reported	not reported	not reported	2022: 299
SpiriTrust LIFE H-2537	SpiriTrust LIFE H- 2537	SpiriTrust LIFE H- 2537	Franklin, Cumberland, and Perry Counties	not reported	not reported	not reported	not reported	2022: 84
VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	Armstrong County	not reported	not reported	not reported	not reported	2022: 89
VieCare Beaver H- 7660	VieCare Beaver H- 7660	VieCare Beaver H- 7660	Beaver and Lawrence Counties	not reported	not reported	not reported	not reported	2022: 457
VieCare Butler H-3060	VieCare Butler H-3060	VieCare Butler H-3060	Butler County	not reported	not reported	not reported	not reported	2022: 172

Living Independence for the Elderly (LIFE) Program of All- Inclusive Care for the Elderly (PACE)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Senior LIFE Greensburg H- 2937	Senior LIFE	Senior LIFE	Westmoreland County	not reported	not reported	not reported	not reported	2022: 238

Living Independence for the Elderly (PACE)

Living Independence for the Elderly (PACE) 23

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Albright LIFE H-9068	Albright LIFE H- 9068	Albright LIFE H- 9068	Lancaster, Lebanon, Lycoming, Clinton, Union, Chester, Franklin, Cumberland, and Perry Counties	CMS reported 220 (2024)	2.8%	not reported	not reported	2024: 220
Albright LIFE H-9068	Albright LIFE H- 9068	Albright LIFE H- 9068	Lancaster, Lebanon, Lycoming, Clinton, Union, and Chester Counties	not reported	not reported	not reported	not reported	2023: 181
Community LIFE H- 3917	Community LIFE H-3917	Community LIFE H-3917	Allegheny, Westmoreland, and Washington Counties	CMS reported 825 (2024)	10.5%	not reported	not reported	2024: 825
Community LIFE H-3917	Community LIFE H-3917	Community LIFE H-3917	Allegheny, Westmoreland, and Washington Counties	not reported	not reported	not reported	not reported	2023: 779
InnovAge LIFE H-9830	InnovAge LIFE H- 9830	Innovage LIFE H-9830	Philadelphia County	CMS reported 520 (2024)	6.6%	-180 (-25.7%)	-2.2 pts	2023: 700; 2024: 520

show all 23

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LIFE Geisinger H-2064	Geisinger Health Plan	Geisinger Health Plan	Luzerne, Lackawanna, Columbia, Montour, Northumberland, and Schuylkill Counties	CMS reported 400 (2024)	5.1%	-7 (-1.7%)	-0.0 pts	2023: 407; 2024: 400
LIFE NWPA H-4999	LIFE NWPA H- 4999	LIFE NWPA H- 4999	Erie, Mercer, Crawford, and Warren Counties	CMS reported 728 (2024)	9.2%	+70 (+10.6%)	+1.0 pts	2023: 658; 2024: 728
LIFE Pittsburgh H-3918	LIFE Pittsburgh H- 3918	LIFE Pittsburgh H-3918	Allegheny County	CMS reported 518 (2024)	6.6%	-21 (-3.9%)	-0.2 pts	2023: 539; 2024: 518
LIFE St. Mary H-6551	LIFE St. Mary H- 6551	LIFE St. Mary H- 6551	Bucks County	CMS reported 222 (2024)	2.8%	-21 (-8.6%)	-0.2 pts	2023: 243; 2024: 222
Mercy LIFE H-3919	Mercy LIFE H- 3919	Mercy LIFE H- 3919	Philadelphia and Delaware Counties	CMS reported 816 (2024)	10.3%	+16 (+2.0%)	+0.3 pts	2023: 800; 2024: 816
Mercy LIFE West Philadelphia H-3908	Mercy LIFE West Philadelphia H- 3908	Mercy LIFE West Philadelphia H- 3908	Philadelphia County	CMS reported 292 (2024)	3.7%	-58 (-16.6%)	-0.7 pts	2023: 350; 2024: 292
Senior LIFE Altoona H- 5902	Senior LIFE	Senior LIFE	Blair, Cambria, and Indiana Counties	CMS reported 594 (2024)	7.5%	+32 (+5.7%)	+0.5 pts	2023: 562; 2024: 594
Senior LIFE Greensburg H-2937	Senior LIFE	Senior LIFE	Westmoreland County	CMS reported 218 (2024)	2.8%	-12 (-5.2%)	-0.1 pts	2023: 230; 2024: 218
Senior LIFE Johnstown H-3925	Senior LIFE	Senior LIFE	Cambria and Somerset (partial counties)	CMS reported 253 (2024)	3.2%	not reported	not reported	2024: 253
Senior LIFE Johnstown H-3925	Senior LIFE	Senior LIFE	Cambria and Somerset (partial) Counties	not reported	not reported	not reported	not reported	2023: 250
Senior LIFE Lehigh H- 5978	Senior LIFE	Senior LIFE	Lehigh, Berks, and Northampton Counties	CMS reported 599 (2024)	7.6%	+67 (+12.6%)	+0.9 pts	2023: 532; 2024: 599
Senior LIFE Washington H-2992	Senior LIFE	Senior LIFE	Washington, Fayette, and Greene Counties	CMS reported 582 (2024)	7.4%	-41 (-6.6%)	-0.4 pts	2023: 623; 2024: 582
Senior LIFE York H- 0819	Senior LIFE	Senior LIFE	York and Dauphin Counties	CMS reported 433 (2024)	5.5%	+57 (+15.2%)	+0.8 pts	2023: 376; 2024: 433
SpiriTrust LIFE H-2537	SpiriTrust LIFE H- 2537	SpiriTrust LIFE H- 2537	Franklin, Cumberland, and Perry Counties	not reported	not reported	not reported	not reported	2023: 78
VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	Armstrong County	CMS reported 90 (2024)	1.1%	-4 (-4.3%)	-0.0 pts	2023: 94; 2024: 90
VieCare Beaver H- 7660	VieCare Beaver H- 7660	VieCare Beaver H- 7660	Beaver and Lawrence Counties	CMS reported 409 (2024)	5.2%	not reported	not reported	2024: 409
VieCare Beaver H-7660	VieCare Beaver H-7660	VieCare Beaver H- 7660	Beaver and Lawrence Counties	not reported	not reported	not reported	not reported	2023: 426
VieCare Butler H-3060	VieCare Butler H-3060	VieCare Butler H-3060	Butler County	CMS reported 167 (2024)	2.1%	+4 (+2.5%)	+0.1 pts	2023: 163; 2024: 167

MATP (Medical Assistance Transportation Program) (Non-Emergency Medical Transportation)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LogistiCare	LogistiCare	LogistiCare	Philadelphia	not reported	not reported	not reported	not reported	2018: 622,053
Logisticare	N/A	unmatched	Philadelphia County	not reported	not reported	not reported	not reported	2017: 622,053
Logisticare	not reported	unmatched	Philadelphia County	not reported	not reported	not reported	not reported	2016: 611,477

Medical Assistance Transportation Program (MATP) (Non-Emergency Medical Transportation)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LogistiCare	LogistiCare	LogistiCare	Philadelphia	not reported	not reported	not reported	not reported	2019: 621,588

Medical Assistance Transportation Program (MATP) Non-Emergency Medical Transportation (NEMT)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Modivcare	Modivcare	Modivcare	Philadelphia	not reported	not reported	not reported	not reported	2022: 742,598

Medical Assistance Transportation Program (NEMT)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Modivcare	Modivcare	Modivcare	Philadelphia	CMS reported 646,232 (2024)	100.0%	-106,057 (-14.1%)	0.0 pts	2023: 752,289; 2024: 646,232

Medical Assistance Transportation Program (Non-Emergency Medical Transportation)

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LogistiCare	LogistiCare	LogistiCare	Philadelphia	not reported	not reported	not reported	not reported	2020: 650,241
Modivcare	Modivcare	Modivcare	Philadelphia	not reported	not reported	not reported	not reported	2021: 705,163

PA Living Independence For the Elderly (LIFE) (Program of All-inclusive Care for the Elderly (PACE))

PA Living Independence For the Elderly (LIFE) (Program of All-inclusive Care for the Elderly (PACE)) 19

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Albright LIFE H-9068	not reported	unmatched	Lancaster , Lebanon , Clinton , Lycoming Counties; part of Chester County	not reported	not reported	not reported	not reported	2016: 180
Community LIFE H-3917	not reported	unmatched	Allegheny, parts of Westmoreland Counties	not reported	not reported	not reported	not reported	2016: 580
LIFE Geisinger H-2064	not reported	unmatched	Luzerne (partial), Lackawanna, Columbia (partial ), Montour (partial), Northumberland (partial), Schuylkill (partial)	not reported	not reported	not reported	not reported	2016: 186
LIFE NWPA H-4999	not reported	unmatched	Erie County	not reported	not reported	not reported	not reported	2016: 98
LIFE St. Mary H-6551	not reported	unmatched	Bucks County (partial)	not reported	not reported	not reported	not reported	2016: 226

show all 19

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LIFE-Pittsburgh H-3918	not reported	unmatched	Allegheny County (partial)	not reported	not reported	not reported	not reported	2016: 579
Mercy LIFE H-3919	not reported	unmatched	Mercy LIFE H-3919	not reported	not reported	not reported	not reported	2016: 698
Mercy LIFE West Philadelphia H-3908	not reported	unmatched	Philadelphia County (partial)	not reported	not reported	not reported	not reported	2016: 462
New Courtland LIFE H-9830	not reported	unmatched	Philadelphia County (partial)	not reported	not reported	not reported	not reported	2016: 488
Senior LIFE Altoona H-5902	not reported	unmatched	Blair County, Cambria County (partial), Indiana County	not reported	not reported	not reported	not reported	2016: 239
Senior LIFE Greensburg H-2937	not reported	unmatched	Westmoreland County (majority)	not reported	not reported	not reported	not reported	2016: 164
Senior LIFE Johnstown H-3925	not reported	unmatched	Cambria County (partial), Somerset County (partial)	not reported	not reported	not reported	not reported	2016: 188
Senior LIFE Lehigh H-5978	not reported	unmatched	Lehigh, Northampton, Berks Counties	not reported	not reported	not reported	not reported	2016: 242
Senior LIFE Washington H-2992	not reported	unmatched	Washington , Fayette , Greene Counties	not reported	not reported	not reported	not reported	2016: 513
Senior LIFE York H-0819	not reported	unmatched	York County	not reported	not reported	not reported	not reported	2016: 125
SpiriTrust LIFE H-2537	not reported	unmatched	Franklin (partial), Cumberland Counties	not reported	not reported	not reported	not reported	2016: 90
VieCare Armstrong H-6188	not reported	unmatched	Armstrong County	not reported	not reported	not reported	not reported	2016: 32
VieCare Beaver H-7660	not reported	unmatched	Beaver and Lawrence Counties	not reported	not reported	not reported	not reported	2016: 484
VieCare Butler H-3060	not reported	unmatched	Butler County	not reported	not reported	not reported	not reported	2016: 158

PA Living Independence for the Elderly (LIFE) (Program of All-inclusive Care for the Elderly (PACE))

PA Living Independence for the Elderly (LIFE) (Program of All-inclusive Care for the Elderly (PACE)) 19

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Albright LIFE H-9068	Albright Care services	Albright Care services	Lancaster, Lebanon, Clinton, Lycoming counties and part of Chester County	not reported	not reported	not reported	not reported	2017: 202
Community LIFE H-3917	Pittsburgh Care Partnership	Pittsburgh Care Partnership	Allegheny, parts of Westmoreland counties	not reported	not reported	not reported	not reported	2017: 592
LIFE - Pittsburgh H-3918	Pittsburgh Mercy Health System and Lutheran SeniorLife	Pittsburgh Mercy Health System and Lutheran SeniorLife	Allegheny county	not reported	not reported	not reported	not reported	2017: 592
LIFE Geisinger H-2064	Geisinger Community Health Services	Geisinger Community Health Services	Luzerne, Lackawanna, Columbia, Montour, Northumberland, Schuylkill counties	not reported	not reported	not reported	not reported	2017: 212
LIFE NWPA H-4999	Lutheran Homes for the Aged	Lutheran Homes for the Aged	Erie, Mercer, Crawford, Warren counties	not reported	not reported	not reported	not reported	2017: 129

show all 19

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LIFE St. Mary H-6551	Trinity Health Corp.	Trinity Health	Bucks county (partial)	not reported	not reported	not reported	not reported	2017: 233
Mercy LIFE H-3919	Trinity Health Corp.	Trinity Health	Philadelphia (partial), Delaware counties	not reported	not reported	not reported	not reported	2017: 784
Mercy LIFE West Philadelphia H-3908	Trinity Health Corp.	Trinity Health	Philadelphia county	not reported	not reported	not reported	not reported	2017: 462
New Courtland LIFE H-9830	Presbyterian Foundation for Philadelphia; Innovage as of 8/2018	Presbyterian Foundation for Philadelphia; Innovage as of 8/2018	Philadelphia County (partial)	not reported	not reported	not reported	not reported	2017: 564
Senior LIFE Altoona H-5902	Senor LIFE	Senor LIFE	Blair, Cambria, Indiana counties	not reported	not reported	not reported	not reported	2017: 260
Senior LIFE Greensburg - H-2937	Senior LIFE	Senior LIFE	Westmoreland county	not reported	not reported	not reported	not reported	2017: 190
Senior LIFE Johnstown - H-3925	Senior LIFE	Senior LIFE	Cambria County, Somerset County (partial)	not reported	not reported	not reported	not reported	2017: 196
Senior LIFE Lehigh H-5978	Senior LIFE	Senior LIFE	Lehigh, Northampton and Berks counties	not reported	not reported	not reported	not reported	2017: 313
Senior LIFE Washington H-2992	Senior LIFE	Senior LIFE	Washington, Fayette, Greene counties	not reported	not reported	not reported	not reported	2017: 576
Senior LIFE York H-0819	Senior LIFE	Senior LIFE	York and Dauphin counties	not reported	not reported	not reported	not reported	2017: 169
SpiriTrust LIFE H-2537	Lutheran Social Services of South Central PA	Lutheran Social Services of South Central PA	Franklin (partial), Cumberland, Perry counties	not reported	not reported	not reported	not reported	2017: 80
VieCare Armstrong H-6188	Lutheran SeniorLife	Lutheran SeniorLife	Armstrong County	not reported	not reported	not reported	not reported	2017: 51
VieCare Beaver H-7660	Lutheran SeniorLife	Lutheran SeniorLife	Beaver and Lawrence counties	not reported	not reported	not reported	not reported	2017: 496
VieCare Butler H-3060	Lutheran SeniorLife	Lutheran SeniorLife	Butler county	not reported	not reported	not reported	not reported	2017: 188

PA Living Independence for the Elderly (Program of All-inclusive Care for the Elderly (PACE))

PA Living Independence for the Elderly (Program of All-inclusive Care for the Elderly (PACE)) 25

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Albright LIFE H-9068	Albright LIFE H-9068	Albright LIFE H- 9068	Lancaster County, Lebanon County, Lycoming County, Clinton County, Union County and Chester County	not reported	not reported	not reported	not reported	2018: 185; 2019: 201; 2020: 213
Community LIFE H- 3917	Community LIFE H- 3917	Community LIFE H-3917	Allegheny County, Westmoreland County and Washington County	not reported	not reported	not reported	not reported	2019: 629; 2020: 714
Community LIFE H-3917	Community LIFE H-3917	Community LIFE H-3917	Allegheny County, Westmoreland County and Washington County	not reported	not reported	not reported	not reported	2018: 588
Innovage LIFE H-9830	Innovage LIFE H-9830	Innovage LIFE H-9830	Philadelphia County	not reported	not reported	not reported	not reported	2018: 646; 2019: 725; 2020: 638
LIFE Geisinger H-2064	Geisinger Health Plan	Geisinger Health Plan	Luzerne County, Lackawanna County, Columbia County, Montour County, Northumberland County and Schuylkill County	not reported	not reported	not reported	not reported	2018: 201; 2019: 254; 2020: 284

show all 25

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LIFE NWPA H-4999	LIFE NWPA H-4999	LIFE NWPA H- 4999	Erie County, Mercer County, Crawford County and Warren County	not reported	not reported	not reported	not reported	2018: 216; 2019: 328; 2020: 387
LIFE Pittsburgh H-3918	LIFE Pittsburgh H-3918	LIFE Pittsburgh H-3918	Allegheny County	not reported	not reported	not reported	not reported	2018: 592; 2019: 591; 2020: 572
LIFE St. Mary H-6551	LIFE St. Mary H-6551	LIFE St. Mary H- 6551	Bucks County	not reported	not reported	not reported	not reported	2018: 230; 2019: 255; 2020: 225
Mercy LIFE H-3919	Mercy LIFE H- 3919	Mercy LIFE H- 3919	Philadelphia County and Delaware County	not reported	not reported	not reported	not reported	2018: 749; 2019: 844; 2020: 841
Mercy LIFE West Philadelphia H-3908	Mercy LIFE West Philadelphia H-3908	Mercy LIFE West Philadelphia H- 3908	Philadelphia County	not reported	not reported	not reported	not reported	2018: 512; 2019: 503; 2020: 385
Senior LIFE Altonna H-5902	Senior LIFE	Senior LIFE	Blair, Cambria and Indiana Counties	not reported	not reported	not reported	not reported	2018: 301
Senior LIFE Altoona H- 5902	Senior LIFE	Senior LIFE	Blair, Cambria and Indiana Counties	not reported	not reported	not reported	not reported	2019: 364; 2020: 378
Senior LIFE Greensburg H-2937	Senior LIFE	Senior LIFE	Westmoreland County	not reported	not reported	not reported	not reported	2018: 201; 2019: 231; 2020: 212
Senior LIFE Johnstown H-3925	Senior LIFE	Senior LIFE	Cambria County, Somerset County (partial)	not reported	not reported	not reported	not reported	2018: 221; 2019: 234; 2020: 211
Senior LIFE Lehigh H- 5978	Senior LIFE	Senior LIFE	Lehigh County, Berks County and Northampton County	not reported	not reported	not reported	not reported	2019: 359; 2020: 384
Senior LIFE Lehigh H-5978	Senior LIFE	Senior LIFE	Lehigh County, Berks County and Northampton County	not reported	not reported	not reported	not reported	2018: 334
Senior LIFE Washington H-2992	Senior LIFE	Senior LIFE	Washington County, Fayette County and Greene County	not reported	not reported	not reported	not reported	2018: 607; 2019: 633; 2020: 621
Senior LIFE York H- 0819	Senior LIFE	Senior LIFE	York County and Dauphin County	not reported	not reported	not reported	not reported	2019: 269; 2020: 223
Senior LIFE York H-0819	Senior LIFE	Senior LIFE	York County and Dauphin County	not reported	not reported	not reported	not reported	2018: 222
SpiriTrust LIFE H-2537	SpiriTrust LIFE H- 2537	SpiriTrust LIFE H- 2537	Franklin County, Cumberland County and Perry County	not reported	not reported	not reported	not reported	2018: 97; 2019: 104; 2020: 89
VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	Armstrong County	not reported	not reported	not reported	not reported	2019: 77; 2020: 64
VieCare Armstrong H-6118	VieCare Armstrong H-6118	VieCare Armstrong H- 6118	Armstrong County	not reported	not reported	not reported	not reported	2018: 67
VieCare Beaver H- 7660	VieCare Beaver H- 7660	VieCare Beaver H- 7660	Beaver County and Lawrence County	not reported	not reported	not reported	not reported	2019: 489; 2020: 452
VieCare Beaver H-7660	VieCare Beaver H-7660	VieCare Beaver H- 7660	Beaver County and Lawrence County	not reported	not reported	not reported	not reported	2018: 480
VieCare Butler H-3060	VieCare Butler H-3060	VieCare Butler H-3060	Butler County	not reported	not reported	not reported	not reported	2018: 201; 2019: 205; 2020: 182

PA Living Independent for the Elderly (Program of All-inclusive Care for the Elderly (PACE))

PA Living Independent for the Elderly (Program of All-inclusive Care for the Elderly (PACE)) 19

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Albright LIFE H-9068	Albright LIFE H- 9068	Albright LIFE H- 9068	Lancaster, Lebanon, Lycoming, Clinton, Union, and Chester counties	not reported	not reported	not reported	not reported	2021: 174
Community LIFE H- 3917	Community LIFE H-3917	Community LIFE H-3917	Allegheny, Westmoreland, and Washington counties	not reported	not reported	not reported	not reported	2021: 752
Innovage LIFE H-9830	Innovage LIFE H- 9830	Innovage LIFE H-9830	Philadelphia county	not reported	not reported	not reported	not reported	2021: 687
LIFE Geisinger H-2064	Geisinger Health Plan	Geisinger Health Plan	Luzerne, Lackawanna, Columbia, Montour, Northumberland, and Schuylkill counties	not reported	not reported	not reported	not reported	2021: 350
LIFE NWPA H-4999	LIFE NWPA H- 4999	LIFE NWPA H- 4999	Erie, Mercer, Crawford, and Warren counties	not reported	not reported	not reported	not reported	2021: 532

show all 19

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
LIFE Pittsburgh H-3918	LIFE Pittsburgh H- 3918	LIFE Pittsburgh H-3918	Allegheny county	not reported	not reported	not reported	not reported	2021: 537
LIFE St. Mary H-6551	LIFE St. Mary H- 6551	LIFE St. Mary H- 6551	Bucks county	not reported	not reported	not reported	not reported	2021: 243
Mercy LIFE H-3919	Mercy LIFE H- 3919	Mercy LIFE H- 3919	Philadelphia and Delaware counties	not reported	not reported	not reported	not reported	2021: 817
Mercy LIFE West Philadelphia H-3908	Mercy LIFE West Philadelphia H- 3908	Mercy LIFE West Philadelphia H- 3908	Philadelphia county	not reported	not reported	not reported	not reported	2021: 368
Senior LIFE Altoona H- 5902	Senior LIFE	Senior LIFE	Blair, Cambria, and Indiana counties	not reported	not reported	not reported	not reported	2021: 493
Senior LIFE Greensburg H-2937	Senior LIFE	Senior LIFE	Westmoreland county	not reported	not reported	not reported	not reported	2021: 232
Senior LIFE Johnstown H-3925	Senior LIFE	Senior LIFE	Cambria county and Somerset county (partial)	not reported	not reported	not reported	not reported	2021: 233
Senior LIFE Lehigh H- 5978	Senior LIFE	Senior LIFE	Lehigh, Berks, and Northampton counties	not reported	not reported	not reported	not reported	2021: 470
Senior LIFE Washington H-2992	Senior LIFE	Senior LIFE	Washington, Fayette, and Greene counties	not reported	not reported	not reported	not reported	2021: 622
Senior LIFE York H- 0819	Senior LIFE	Senior LIFE	York county and Dauphin county	not reported	not reported	not reported	not reported	2021: 293
SpiriTrust LIFE H-2537	SpiriTrust LIFE H- 2537	SpiriTrust LIFE H- 2537	Franklin, Cumberland, and Perry counties	not reported	not reported	not reported	not reported	2021: 83
VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	VieCare Armstrong H- 6118	Armstrong county	not reported	not reported	not reported	not reported	2021: 88
VieCare Beaver H- 7660	VieCare Beaver H- 7660	VieCare Beaver H- 7660	Beaver and Lawrence counties	not reported	not reported	not reported	not reported	2021: 444
VieCare Butler H-3060	VieCare Butler H- 3060	VieCare Butler H-3060	Butler county	not reported	not reported	not reported	not reported	2021: 168

Physical Health HealthChoices (Comprehensive MCO)

Physical Health HealthChoices (Comprehensive MCO) 24

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
Aetna Better Health	Aetna	CVS/Aetna	Southeast zone, Southwest zone, Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2021: 264,289; 2022: 290,670
Aetna Better Health	Aetna	CVS/Aetna	Southeast zone, Southwest zone, Lehigh/Capital zone	not reported	not reported	not reported	not reported	2020: 224,597
AmeriHealth Caritas/AmeriHealth Caritas Northeast	Vista	Vista	Lehigh/Capital zone, Northwest zone, Northeast zone	not reported	not reported	not reported	not reported	2020: 301,180
AmeriHealth Caritas/AmeriHealth Caritas Northeast	Vista	Vista	Lehigh/Capital, Northwest, Northeast	not reported	not reported	not reported	not reported	2021: 344,458; 2022: 372,537
AmeriHealth Caritas/AmeriHealth Caritas Northeast	Vista	Vista	Northwest, Northeast, Lehigh Capital, Southwest Zones	CMS reported 353,403 (2024)	15.0%	not reported	not reported	2024: 353,403

show all 24

Plan	CMS parent	Parent	Region	2024 enrollment	2024 share	Change from prior reporting year, calculated	Share change, calculated	Trend
AmeriHealth Caritas	Vista	Vista	Northwest, Northeast, Lehigh Capital, Southwest Zones	not reported	not reported	not reported	not reported	2023: 453,596
Gateway Health	Gateway Health	Gateway Health	Southwest zone, Lehigh/Capital zone, Northwest zone	not reported	not reported	not reported	not reported	2021: 313,161; 2022: 326,965
Gateway Health	Gateway Health	Gateway Health	Southwest zone, Lehigh/Capital zone	not reported	not reported	not reported	not reported	2020: 287,346
Geisinger Health Plan	Geisinger Health Plan	Geisinger Health Plan	Northeast zone	not reported	not reported	not reported	not reported	2020: 192,777
Geisinger Health Plan	Geisinger Health Plan	Geisinger Health Plan	Northeast	not reported	not reported	not reported	not reported	2021: 217,188; 2022: 233,345
Geisinger Health Plan	Geisinger Health Plan	Geisinger Health Plan	Northwest, Northeast, Southeast, Lehigh Capital, Southwest Zones	CMS reported 428,376 (2024)	18.1%	-101,852 (-19.2%)	-0.2 pts	2023: 530,228; 2024: 428,376
Health Partners Plan	Health Partners Plan	Health Partners Plan	Northwest, Northeast, Southeast, Lehigh Capital, Southwest Zones	CMS reported 310,182 (2024)	13.1%	-53,955 (-14.8%)	+0.6 pts	2023: 364,137; 2024: 310,182
Health Partners Plan	Health Partners Plan	Health Partners Plan	Southeast zone	not reported	not reported	not reported	not reported	2020: 240,521; 2021: 262,892; 2022: 276,188
Highmark Wholecare	Gateway Health Plan	Gateway Health Plan	Southwest, Lehigh Capital Zones	CMS reported 121,751 (2024)	5.2%	-28,323 (-18.9%)	-0.0 pts	2023: 150,074; 2024: 121,751
Keystone First	Vista	Vista	Southeast Zone	not reported	not reported	not reported	not reported	2023: 568,757
Keystone First	Vista	Vista	Southeast Zones	CMS reported 468,203 (2024)	19.8%	not reported	not reported	2024: 468,203
Keystone First	Vista	Vista	Southeast zone	not reported	not reported	not reported	not reported	2020: 448,307
Keystone First	Vista	Vista	Southeast	not reported	not reported	not reported	not reported	2021: 497,009; 2022: 531,873
UPMC for You	UPMC	UPMC	Northwest, Northeast, Southeast, Lehigh Capital, Southwest Zones	CMS reported 583,460 (2024)	24.7%	-121,325 (-17.2%)	+0.4 pts	2023: 704,785; 2024: 583,460
UPMC for You	UPMC	UPMC	Southwest zone, Lehigh/Capital zone, Northwest zone	not reported	not reported	not reported	not reported	2020: 451,806; 2021: 514,204; 2022: 557,528
United Healthcare Community Plan, Inc.	United Healthcare	UnitedHealth	Southeast zone, Southwest zone, Lehigh/Capital zone	not reported	not reported	not reported	not reported	2022: 292,541
United Healthcare Community Plan, Inc.	UnitedHealthcare	UnitedHealth	Southeast Zone	not reported	not reported	not reported	not reported	2023: 124,822
United Healthcare Community Plan, Inc	United Healthcare	UnitedHealth	Southeast zone, Southwest zone, Lehigh/Capital zone	not reported	not reported	not reported	not reported	2020: 237,812; 2021: 270,413
UnitedHealthcare Community Plan, Inc.	UnitedHealthcare	UnitedHealth	Southeast Zone	CMS reported 95,611 (2024)	4.0%	not reported	not reported	2024: 95,611

Plan operations (CMS MCPAR)

Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.

National plan operations · Federal compliance deadlines

Appeals, grievances, and enrollment share (2024)

Appeals, grievances, and enrollment share (2024) 63

Plan	Parent	Program	Appeals resolved	In favor of enrollee	Appeal rate	Grievances resolved	Medicaid enrollment share	Managed care enrollment share
Keystone Autism Services (KAS)	unmatched	Adult Community Autism Program (ACAP)	0	0	not reported	0	0%	0%
Pennsylvania Health & Wellness	Centene	Office of Long Term Living - Community HealthChoices_2025	4,450	not reported	not reported	520	2.85%	2.91%
UPMC Community HealthChoices	UPMC	Office of Long Term Living - Community HealthChoices_2025	2,288	not reported	not reported	1,568	4.68%	4.81%
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Office of Long Term Living - Community HealthChoices_2025	10,073	not reported	not reported	922	5.99%	6.16%
AmeriHealth Caritas Pennsylvania	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported

show all 63

Plan	Parent	Program	Appeals resolved	In favor of enrollee	Appeal rate	Grievances resolved	Medicaid enrollment share	Managed care enrollment share
AmeriHealth Caritas Pennsylvania LC	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	4,270	not reported	not reported	1,225	7%	7%
AmeriHealth Caritas Pennsylvania NE	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	2,020	not reported	not reported	459	4%	4%
AmeriHealth Caritas Pennsylvania NW	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	458	not reported	not reported	100	0.85%	0.86%
AmeriHealth Caritas Pennsylvania SW	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	246	not reported	not reported	82	0.57%	0.59%
Geisinger Health Plan	Geisinger Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported
Geisinger Health Plan LC	Geisinger Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	183	not reported	not reported	47	0.86%	0.88%
Geisinger Health Plan NE	Geisinger Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	1,372	not reported	not reported	380	7%	7%
Geisinger Health Plan NW	Geisinger Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	31	not reported	not reported	3	0.25%	0.25%
Geisinger Health Plan SE	Geisinger Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	54	not reported	not reported	37	0.54%	0.55%
Geisinger Health Plan SW	Geisinger Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	54	not reported	not reported	10	0.41%	0.42%
Health Partners Plans	Health Partners	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported
Health Partners Plans LC	Health Partners Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	94	not reported	not reported	18	0.9%	0.92%
Health Partners Plans NE	Health Partners Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	42	not reported	not reported	9	0.42%	0.43%
Health Partners Plans NW	Health Partners Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	12	not reported	not reported	4	0.27%	0.27%
Health Partners Plans SE	Health Partners Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	1,050	not reported	not reported	316	9%	9%
Health Partners Plans SW	Health Partners Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	30	not reported	not reported	12	0.46%	0.47%
Highmark Wholecare	Gateway Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported
Highmark Wholecare LC	Gateway Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	3,470	not reported	not reported	1,084	6%	6%
Highmark Wholecare SW	Gateway Health Plan	Office of Medical Assistance Programs - Physical HealthChoices_2025	1,610	not reported	not reported	764	4%	4%
Keystone First SE	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	7,896	not reported	not reported	2,247	16%	16%
UPMC for You	UPMC	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported
UPMC for You LC	UPMC	Office of Medical Assistance Programs - Physical HealthChoices_2025	926	not reported	not reported	330	4%	4%
UPMC for You NE	UPMC	Office of Medical Assistance Programs - Physical HealthChoices_2025	80	not reported	not reported	48	0.69%	0.7%
UPMC for You NW	UPMC	Office of Medical Assistance Programs - Physical HealthChoices_2025	618	not reported	not reported	188	4%	4%
UPMC for You SE	UPMC	Office of Medical Assistance Programs - Physical HealthChoices_2025	104	not reported	not reported	74	0.79%	0.81%
UPMC for You SW	UPMC	Office of Medical Assistance Programs - Physical HealthChoices_2025	2,108	not reported	not reported	868	11%	11%
United Healthcare	UnitedHealth	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported
United Healthcare SE	UnitedHealth	Office of Medical Assistance Programs - Physical HealthChoices_2025	496	not reported	not reported	606	3%	4%
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Office of Medical Assistance Programs - Physical HealthChoices_2025	not reported	not reported	not reported	not reported	not reported	not reported
Allegheny HealthChoices, Inc.	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
BHARP (Behavioral Health Alliance of Rural Pennsylvania)	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
BHSSBC (Behavioral Health Services Somerset and Bedford Counties)	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Beaver County HealthChoices	Elevance	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Berks County	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Blair Co - Central PA Behavioral Health Collaborative	unmatched	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Bucks County	Centene	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Cambria County	Centene	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Capital Area Behavioral Health Collaborative	PerformCare	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Carbon/Monroe/Pike Joinder Board	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Carelon Health of PA (Carelon)	unmatched	The Office of Mental Health and Substance Abuse Services_2025	96	67	69.8% calculated	169	11%	11%
Chester County	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
City of Philadelphia	unmatched	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Community Behavioral Health (CBH)	unmatched	The Office of Mental Health and Substance Abuse Services_2025	46	35	76.1% calculated	759	23%	24%
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	75	31	41.3% calculated	587	43%	46%
County of Delaware	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Erie County	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Fayette County Behavioral Health Administration	unmatched	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Lehigh County	Centene	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Lycoming/Clinton Joinder	unmatched	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Magellan Behavioral Health (MBH)	unmatched	The Office of Mental Health and Substance Abuse Services_2025	194	155	79.9% calculated	151	13%	14%
Montgomery County	Centene	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
NBHCC (Northeast Behavioral Health Care Consortium)	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Northampton County	Centene	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Northwest Behavioral Health Partnership Inc	Elevance	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
PerformCare	unmatched	The Office of Mental Health and Substance Abuse Services_2025	3	3	100.0% calculated	47	10%	10%
Southwest Behavioral Health Management	Elevance	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
Tuscarora Managed Care Alliance	PerformCare	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported
York/Adams HealthChoices Joinder Governing Board	Community Care Behavioral Health	The Office of Mental Health and Substance Abuse Services_2025	not reported	not reported	not reported	not reported	not reported	not reported

Sanctions (2024)

Sanctions (2024) 78

Plan	Parent	Topic	Date	Corrective action plan	Remediation status
Keystone Autism Services (KAS)	unmatched	Performance improvement	2023-10-17	No	Yes, remediated
Keystone Autism Services (KAS)	unmatched	Performance improvement	2023-10-17	No	Yes, remediated
Keystone Autism Services (KAS)	unmatched	Performance improvement	2023-10-17	No	Yes, remediated
Keystone Autism Services (KAS)	unmatched	Performance improvement	2023-10-17	No	Yes, remediated
Pennsylvania Health & Wellness	Centene	Other, specify (Noncompliance with Network Adequacy Evaluation, CHC Agreement Exhibit T)	2024-09-18	No	Yes, remediated

show all 78

Plan	Parent	Topic	Date	Corrective action plan	Remediation status
UPMC Community HealthChoices	UPMC	Other, specify (N/A)	2024-04-09	No	No, no remediation
UPMC Community HealthChoices	UPMC	Other, specify (Noncompliance with Network Adequacy Evaluation, CHC Agreement Exhibit T)	2024-09-18	No	Yes, remediated
UPMC Community HealthChoices	UPMC	Other, specify (Noncompliance with PCSP Completeness Review; SP-1)	2024-09-18	No	No, no remediation
UPMC Community HealthChoices	UPMC	Other, specify (N/A)	2024-05-06	No	No, no remediation
UPMC Community HealthChoices	UPMC	Other, specify (N/A)	2024-06-13	No	No, no remediation
UPMC Community HealthChoices	UPMC	Other, specify (N/A)	2024-10-07	No	No, no remediation
UPMC Community HealthChoices	UPMC	Other, specify (N/A)	2024-11-06	No	No, no remediation
UPMC Community HealthChoices	UPMC	Other, specify (N/A)	2024-12-06	No	No, no remediation
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (N/A)	2025-01-07	No	No, no remediation
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Noncompliance with Pharmacy Standards within CHC Agreement)	2024-10-10	No	No, no remediation
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Improvement Plan)	2024-09-18	No	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (N/A)	2024-04-09	No	No, no remediation
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (N/A)	2024-05-06	No	No, no remediation
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (N/A)	2024-10-07	No	No, no remediation
Geisinger Health Plan	Geisinger Health Plan	Performance improvement	2022-12-19	Yes	Yes, remediated
Geisinger Health Plan	Geisinger Health Plan	Other, specify (PCMH Pediatric Nursing Care Payments)	2024-10-18	Yes	Remediation in progress
Geisinger Health Plan	Geisinger Health Plan	Other, specify (Pharmacy reporting)	2024-04-26	Yes	Yes, remediated
Geisinger Health Plan	Geisinger Health Plan	Performance improvement	2023-06-01	Yes	Yes, remediated
Geisinger Health Plan	Geisinger Health Plan	Other, specify (SNU Hotline)	2024-01-26	Yes	Yes, remediated
Geisinger Health Plan	Geisinger Health Plan	Performance improvement	2023-08-04	Yes	Yes, remediated
Geisinger Health Plan	Geisinger Health Plan	Performance improvement	2023-12-06	Yes	Yes, remediated
Geisinger Health Plan	Geisinger Health Plan	Performance improvement	2023-02-16	Yes	Yes, remediated
Health Partners Plans	Health Partners	Other, specify (Branding)	2024-07-22	Yes	Yes, remediated
Health Partners Plans	Health Partners	Other, specify (Pharmacy Reporting)	2024-04-22	Yes	Yes, remediated
Health Partners Plans	Health Partners	Other, specify (Network Access)	2023-04-13	Yes	Yes, remediated
Highmark Wholecare	Gateway Health Plan	Reporting	2023-02-06	Yes	Yes, remediated
Highmark Wholecare	Gateway Health Plan	Performance improvement	2023-07-19	Yes	Yes, remediated
UPMC for You	UPMC	Performance improvement	2023-03-27	Yes	Yes, remediated
UPMC for You	UPMC	Other, specify (Marketing and Outreach)	2024-11-25	Yes	Remediation in progress
UPMC for You	UPMC	Performance improvement	2023-02-06	Yes	Yes, remediated
United Healthcare	UnitedHealth	Other, specify (Pharmacy reporting)	2024-05-02	Yes	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Financial Sanctions - Claim Processing)	2023-10-10	Yes	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Financial Sanctions -Claims Processing)	2023-11-06	Yes	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Record Retention)	2024-07-19	Yes	Remediation in progress
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Pharmacy payments)	2024-10-10	Yes	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Provider Terminations)	2024-08-19	Yes	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (834 Member Enrollment File)	2024-05-14	Yes	Remediation in progress
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Pharmacy Reporting)	2024-04-09	Yes	Yes, remediated
Vista Healthcare DBA Keystone First and Vista Healthcare DBA AmeriHealth Caritas Pennsylvania	Vista	Other, specify (Violation of Exhibit C of the HCA, Provider Terminations/Member Notification)	2024-10-25	Yes	Yes, remediated
Carelon Health of PA (Carelon)	unmatched	Performance improvement	2024-08-29	Yes	Remediation in progress
Carelon Health of PA (Carelon)	unmatched	Performance improvement	2024-08-29	Yes	Remediation in progress
Carelon Health of PA (Carelon)	unmatched	Performance improvement	2024-08-29	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Behavioral Health (CBH)	unmatched	Performance improvement	2023-11-21	Yes	Remediation in progress
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2022-09-08	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2024-08-28	Yes	Remediation in progress
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2024-08-28	Yes	Yes, remediated
Community Care Behavioral Health Organization (CCBH)	Community Care Behavioral Health	Performance improvement	2024-08-28	Yes	Remediation in progress
County of Delaware	Community Care Behavioral Health	Other, specify (Late Submission of MCO Assessment)	2024-07-08	Yes	Yes, remediated
County of Delaware	Community Care Behavioral Health	Other, specify (Late Submission of Financial Reportst)	2022-12-19	Yes	Remediation in progress
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
Magellan Behavioral Health (MBH)	unmatched	Performance improvement	2023-11-22	Yes	Yes, remediated
PerformCare	unmatched	Performance improvement	2023-11-21	Yes	Yes, remediated

Award history

Community HealthChoices 12-15: upheld. DHS issued RFP 12-15 on March 1, 2016 and on August 30, 2016 selected three offerors for Community HealthChoices negotiations in all five zones. The Commonwealth Court affirmed the denial of the UnitedHealthcare protest on October 4, 2017. The opinion does not print numeric scores.
Community HealthChoices 31-22: cancelled. DHS issued RFA 31-22 on January 30, 2024. The application deadline was extended to April 1, 2024 (past). DHS notified a non-selected applicant on August 21, 2024. On April 2, 2026 the Commonwealth Court reversed the denials of the bid protests and cancelled the award. The opinion prints the same technical score for each applicant in all five zones.
HealthChoices physical health: not published by state.

Retrieved 2026-11-03. Sources and scores

Early procurement signals

rfi 26-RFI-20476: posted. 2026-11-20. The stored eMarketplace advertisement for 26-RFI-20476 is titled HealthChoices for Physical Health Services. It lists solicitation start 10/06/26 and due date 11/20/26 at 12:00 PM. Those fields do not print a time zone and do not mention a later solicitation. This is an RFI, not an RFP. Pennsylvania. No plan is named on the record. A solicitation or early procurement signal is on the record. Next date is 2026-11-20.

Coverage: not_collected. Source receipts: 1 unchanged at 2026-11-15T10:15:08+00:00. Sources and dates

Contract amendments

No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments

Medicaid policy

Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.

Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.

Coverage not_collected.

No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy

Federal Register SPA disapproval hearing notices (2015 or later): 0

Plan financials

No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.

Federal compliance deadlines

Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.

Subscriber analysis

Subscriber analysis is available to signed-in readers. This public page keeps the evidence and leaves out the interpretation.