README DOCUMENTATION for Health Care Plan by Month Files


The attached Pivot Table has counts of eligibles by county,
aid code, plan, and month for the months January 1997 through
August 2003 for all Medi-Cal medical (not dental) managed care plans.
(FFS eligibles are indicated with a plan = 'FFS.')  

Generally, the methodology for deriving these data was to use the Medi-Cal
Eligibility File that was created six months after each of the months
for which eligiblity data was created. (This allowed for all retroactive
eligibles to be posted to our files, especially those for the COHS'.) 
For the months of eligibility for CY96, however, the files used were ones
created from seven to twelve months later (since the monthly archived 
files had expired).  Please note that the counts shown in these files may
vary slightly from counts in the report put out by the Medi-Cal Managed Care
Division entitled "Monthly Enrollment Report -- Enrollment Summary."
This is due to slight changes in the methodology used to gather and report
these counts.  Basically, the Enrollment Report is the one used for making
capitation payments to the plans, whereby counts shown on the attached
files were obtained from the automated system on an extended, retrospective basis.

Also please note that counts are not included here for the Placer and Sonoma
FFS-MCN plans inasmuch as these cannot be obtained from the automated system.
For these counts, please contact the Medi-Cal Managed Care Division at
(916) 654-8076.  In addition, the HCP plans for medical/FFS and dental/managed 
care (i.e., the 400 series) were converted to the designation 'FFS.'

A list of the most recent health care plan codes and their names is available
on our Website, at www.dhs.ca.gov/MCSS, under General Information.
Other information about Medi-Cal managed care can be obtained from the
Managed Care Annual Statistical Report, available on our Website under
Publications.

The file is compressed (or zipped) into a self-extracting file. 
To decompress (or unzip) simply double-click (using your mouse)
on the ".exe" filename, the "WinZip Self-Extractor" dialog box will appear,
select the location of where to decompress (unzip) the file to (where you want 
the Excel file to reside), and select the Unzip button. Once the file is 
decompressed (unzipped) a confirmation dialog box will appear, at this point,
select the "OK" button and then close the "WinZip Self-Extractor" dialog box.

 Any questions regarding this file can be directed to:
 Medical Care Statistics Section
 California Department of Health Services
 Phone:  (916) 552-8550
 Email:  mcssweb@dhs.ca.gov