                    README FILE for the GEOGRAPHIC MONTHLY REPORT               		
                   (This Readme file is best read in COURIER NEW FONT)		
                  ==============================================              		

QUESTIONS ABOUT THE GEO or READ ME FILE SHOULD BE ADDRESSED To
--------------------------------------------------------------
Russell.Hendel@Cms.hhs.gov
--------------------------------------------------------------


NEW -- ADDED TO FILE -- COMMENTS		
===============================		
---------------- IMPORTANT DISCLAIMER -------------------		
For a variety of reasons Dec and Jan data may		
not be 100% accurate. Therefore those who wish		
to compare year to year figures are advised		
to use Nov-Feb or Oct-Mar (Or Sept March)		
---------------- IMPORTANT DISCLAIMER -------------------	

09-05		NEW DEMC PLAN TYPE
		==================
		Effective Sep 2005, the 4 Bipa Disease management DEMOs
		will be classified as belonging to type DEMC which stands
		for COST DEMO. These DEMOs are paid like COST plans--hence
		the classification. This new classification will also appear	
		on the MONTHLY and 13-MONTH report.

09-05		RE: 1% DISCREPANCY IN PLAN DATA BETWEEN DIFFERENT CMS SOURCES
		=============================================================
		The CMS has one data system. However that one data system has
		several components. Plans, CMS Staff, and the system components
		communicate with each other at different points in time. The
		different points of time for communication can result in minor
		data differences in reports of plan enrollment. Typically the
		differences are at most 1%. There is now a new report which
		compares two CMS data components. As shown the GROWTH INDICATORS,
		per month, and per year, are about the same for each data
		component. Consqeuently the data is reliable and may be used
		for projections. The new report--13-MONTH.ZIP--is located at
		http://www.cms.hhs.gov/HealthPlans/Statistics/Monthly.
	
06-05           1% DISCREPANCY IN JUNE 2005 PLAN ENROLLMENT
                ===========================================
		There is a 1% discrepancy in aggregate plan
		enrollment for June 2005 among the following
		CMS files
		- MONTHLY REPORT
		- GEOGRAPHIC SERVICE AREA REPORT
		Both these reports are linked to
		http://www.cms.hhs.gov/HealthPlans/ReportFilesData
		The 2 MARKET PENETRATION REPORTS, 13-MONTH REPORT
		and BY RO TYPE report follow the geographic service
		area report.

		This difference in enrollment is due to the different
		times when these two reports were run. CMS plans to
		correct this difference in run times in the future.

		JUNE ENROLLEES appearing on the GEO report but not
		on the MONTHLY JUNE REPORT will appear in the JULY
		MONTHLY report (with retroactive payments to June)

05-05           13000 DISCREPANCY IN MAY 2005 PLAN ENROLLMENT
                =============================================
                There is about a 13000 enrollment discrepancy between
                - the Geo-0505.xls file, check sheet
                - the Monthly May 2005 file.
                A primary contribution to this discrepancy was the
                lack of a timely update of 10000 (dis)enrollments
                in mid April. We expect the monthly and geo file
                to agree in future months.


03-05		Competition Macro Updated
		=========================
		The original competition macro omitted from the menu
		- massachusetts
		- vermont
		- mississippi
		This has been corrected

		Additionally the original competition macro did not
		display in its plan menu all plans. This has been
		corrected.

02-05		Feb Geo-0205.xls report will not be posted
		==========================================
		Due to the implementation of the new MMCS system
		the February Enrollment numbers cannot be posted.

01-05           CONSISTENCY OF Monthly Summary Report & Geo in TYPE
                ===================================================
                A customer alerted me to differences in PLAN TYPE
                - between this Geographic Service area file
                - The Monthly report
                - The Monthly Summary Report

                This minor discrepancy, which affected under 6 plans,
                has been removed Effective Jan 2005. The discrepancy
                did NOT
                - affect enrollment counts
                - service areas
                It only affected the classification of the plan.
                Needless to say it would also affect subtotal
                of enrollees by plan type.

                Very roughly certain demonstrations were for
                all practical purposes being treated(Payment
                wise etc) like regular plans of certain types
                and vice versa. I intend to coordinate with
                the author of the monthly report so that this
                consistency is maintained.

                If there are further questions on the details
                of which plans (there were only about 6) that
                this affected please contact RHendel@cms.hhs.gov.




12-04           16 plans(40000 enr) TERMINATING or CONVERTING
                =============================================
                There are 16 plans 

                H0350 H0619 H9049 H4556 H6141
                H6142 H0316 H0357 H0662 H1083
                H1151 H2155 H2259 H3911 H5105 H5104

                that are either
                - terminating or
                - converting
                effective December 31 2004.

                The service area for these plans can not be
                found on the Geo-1204 sheet, even though they
                are still active during December. (This is due
                to a quirk in the CMS Mainframe databases). The
                enrollment for these plans may be found on the
                CHECK sheet. For further information contact
                RHendel@Cms.hhs.gov.

11-04           OCT-04 and NOV-04 FILES REPLACED
                ================================
                A minor data error was found in the Geo-1004 
 		and geo-1104 files. The data error was in the
		ELIGIBLE counts. The average error per state was
		roughly 1/2 %. Therefore on 12-01-2004 both the
		Oct and Nov 2004 geographic service area files
		were replaced. ALL OTHER ITEMS AND FILES ARE OK.
		The Sep-2004 file is OK. The ENROLLEE and H# counts
		are also ok. For further information on this contact
		RHendel@cms.hhs.gov

10-04           COMPETITION BY COUNTIES MACRO ADDED
                ===================================
                Last month we introduced a macro that gives competition
                in the Service area of a selected plan. This month we
                present a macro that gives competition by a set of counties
                that you select. We allow several counties in nearby states.

                We have also begun polishing the code. The CLEANUP module
                use to delete all sheets (possibly including sheets a user
                placed in). We have remedied this so that the CLEANUP macro
                leaves all sheets that a user adds to the geographic service
                area file. The code will be further updated over the next few
                months.


09-04		SEVERAL NEW FEATURES ARE IN THE SEPTEMBER GEO FILE
		==================================================
		- THE MAIN NEW FEATURE IS THE COMPETITION MACROS
		In September we have the COMPETITION BY PLAN MACRO
		In October we will have COMPETITION BY COUNTIES
		
		The new macro is on the COMPETITION page---
		- you simply click the button
		- you then select ONE MEDICARE ADVANTAGE PLAN
		- You then obtain as output two reports
		--- You obtain ALL COMPETING PLANS which share
		some county of the service area of the plan you
		are studying
		--- You also obtain ENROLLEES, ELIGIBLES, and
		PENETRATION for each county in the service area

		- This README sheet is now a stand alone--
  		It is no longer part of the Excel workbook

		- The ORIGINAL FILE will no longer be included in the 
		excel workbook. There are two reasons for this:
		First: Starting next year we will be using a database
		vs the text only files. Second: The original file is
		taking up too much byteage which we need for the new macros
		ANYONE WHO WANTS THE ORIGINAL FILE CAN STILL CONTACT ME


08-04		REQUEST FOR INTEREST: A customer recently suggested that it might be 
		useful to add 3 columns to the geo file describing MSA penetration.
		IF YOU ARE INTERESTED IN SUCH AN ADDITION EMAIL: Rhendel@cms.hhs.gov
		The 3 columns would roll up enrollees/eligibles by MSA The 3 columns would be
		- MSA Five digit code (Metropolitan Service Area)
		- MSA Name (e.g. NewYork Metropolitan area)
		- MSA Penetration (Enrollees over eligibles expressed as a percent)
		Customers could also use these 3 columns to obtain
		- Definitions of MSAs by state county codes and names
		- Rankings of MSAs (e.g. the top 100 MSAs)
		
07-04		The Jul 2004 file was reported with a MINOR CORRECTION on Aug 18 2004
		The replaced version differed from the original version only in that
		-- Duplicate counts of eligibles were eliminated for LOS ANGELES (1) & (2)
		-- The Original Sheet was fully placed (Originally 3000 lines were lost)
		Since the above 2 corrections are minor and do not affect computations
		we made the correction silently without notifying people. If you have already
		made computations you need not repeat them since all other numbers are the same.

07-04		(MINOR HEADER CORRECTION) The CHECK sheet gives, TOTAL
		PLAN ENROLLMENT (Col C) and SERVICE AREA ENROLLMENT(Col B)
		Both these totals have always included counties with 10 or less. However
		the FEB-2004 thru JUN-2004 files incorrectly state that COLUMN B excludes
		counties with 10 or less. This Header has been corrected as of JUL-2004.
		In passing the MAIN geo sheet has a blank space in any record with under
		11 enrollees. Thus the subtotals of the main sheet BY PLAN, may 
		differ from the COLUMN B totals by a small (say one to 2-digit) number

06-04		The Jun 2004 file was first posted Jun 10, 2004. It was 
		reposted on Jun 14, 2004 due to a minor error. The ONLY
		differences in the corrected file are
		* H5006  STERLING           All MT,MN,IA Counties          212 Enrollees
		* H1804  HUMANA             All ND Counties                    368 Enrollees
		The HUMANA ND counties WERE reported in prior months.

06-04                           		Prior to June 2004, ELIGIBLES and ENROLLEES for the following counties
		were not present in the GEO file (due to coding inconsistencies between the
		United States Postal service and CMS). Effective June 2004, ELIGIBLES 
		and ENROLLEES for these counties are listed. The counties are
		---------------------------------------------------------------------------------------------
		-CLIFTON FORGE CITY, VA (SC code 49212)
		-BEDFORD CITY, VA (SC Code 49088)
		-WASHABAUGH, SD (SC Code 43650)
		-COLONIAL HEIGHTS CITY, VA (called COLONIAL HEIGHTS CIT in the SC File-SC Code 49211)
		-EMPORIA CITY, VA (Called EMPORIA in the sc file--SC Code 49270)
		-FAIRBANKS, AK (Called FAIRBANKS NORTH STAR in the SC File-SC Code 02090)
		-ALEUTIAN ISLANDS, AK (Called ALEUTIAN in the SC File-SC Code 02010)
		-----------------------------------------------------------------------------------------------
		As of June 2004 all these counties have under 6000 eligibles
		and almost all of them have negligible enrollees.
		The above counties occur in under a dozen records.
		Note that BEDFORD CITY is distinct from BEDFORD.

02-04                           		Effective Feb-2004 the GEO file is FULLY consistent with the MONTHLY
		reports with regard to plan TYPE. The three alternative pay demos are 
		no longer classified in the geo file as demos but rather by what they
		are demos for (HMO or PFFS)

02-04                           		Effective Feb-2004 the ENROLLEE column has NO DUPLICATE counts
		This effects two county classes. (A) Effective Jun 2002 if an HMOs service area
		had both LOS ANGELES (1) and LOS ANGELES (2), then enrollment and
		eligibles were listed for only one of the two counties (but partial zips are listed for
		each county as appropriate). (B) Effective Feb 2004 if an HMOs service area has 
		both SAINT LOUIS and SAINT LOUIS (CITY) then (B1) Enrollees and eligibles 
		are listed only for SAINT LOUIS and (B2) the partial zips for SAINT LOUIS (CITY)
		are listed with the partial zips for SAINT LOUIS (When partial zips exist). This
		decision is based on the fact that the CMS uses THREE names - SAINT LOUIS
		SAINT LOUIS (CITY) and SAINT LOUIS CITY while the USPS has only TWO
		counties. Since the partial zips listed for SAINT LOUIS (CITY) belong to SAINT
		LOUIS therefore SAINT LOUIS (CITY) is reclassified as SAINT LOUIS. SAINT
		LOUIS CITY is a neighboring county distinct from SAINT LOUIS or
		SAINT LOUIS (CITY). The removal of SAINT LOUIS (CITY) prevents duplicate
		enrollee counts

02-04		The Jan 2004 Geo file accidentally omitted leading zeroes from the 5 character
		SS state county code. A replacement file was posted at the end of February

01-04		IMPORTANT NOTICE ABOUT JANUARY 2004 DATA
		There was an error in the processing of enrollments for Jan 2004.
		The original GHP file was deficient in certain (dis)enrollments.
		PLANS WERE PAID CORRECTLY since an addendum file was produced.
		This addendum file however was by PLAN not by COUNTY.
		Hence PLAN TOTAL ENROLLMENT is CORRECT and ACCURATE.
		But PLAN-COUNTY enrollment is approximate since
		we redistributed the surplus for each plan by county weight.
		This error only affected 24 plans. The county enrollment is believed
		to be highly accurate and close to actual values.
		THEREFORE THE COUNTY ENROLLMENT FOR THESE 24
		PLANS WILL NOT BE WHOLE INTEGERS

12-03		As of Dec 2003 all PACE plans are PACE NATIONAL
		The type PACE now exclusively refers to PACE NATIONAL

11-03		The November Geographic Service Area report was 
		posted on November 10 2003. Due to a minor typo
                                            		a replacement file was posted Nov 19,2003. The typo
		consisted of interchanging the words PSO and PPO.
		This was corrected. ALL ENROLLMENT NUMBERS IN BOTH
		FILES WERE CORRECT AND THE SAME.The PPO DEMO 
		classification was not affected by this typo.
		The typo affected the TYPE classification of 9 H##.
                                           		Because this error was minor, did not affect
                                               		enrollment, and affected very few plans it was
		decided to post the correction file quietly with
		an explanatory note in this readme file.
		If there are any further questions on this matter
		please contact Rhendel@Cms.hhs.gov. NOTE: Both the
		CHECK sheet as well as the main sheet were corrected.

08-03		Effective Aug 2003 the CHECK sheet will use the M+C 
		plan type, DEMP (vs DEMO) to refer to the PPO DEMOS
		The DEMP plantype includes all PPO DEMOS as well as
		PPO/FFS alternative payment demos.

06-03		Effective with the Jun 2003 file a minor bug in the macro
		that converts the Service Area file (found on the Original
		Sheet) to a flat file is corrected. This fix affected the following
		* H5006  STERLING           All SD Counties          0 Enrollees
		* H1804  HUMANA             All WI Counties          350 Enrollees
		These counties were not reported in prior files
		The  enrollment figures listed on this sheet are for Jun 2003

06-03		Pace Demo enrollment figures are being excluded from BOTH
		the Main sheet and the Check sheet. Pace-Demos are not
		covered by the under the M+C program. Pace Nationals are

04-03           		Los Angeles County has 2 state county codes (05200,05210)
		These two counties normally are treated the same
		Zip matches (to 05200 vs 05210) can also be confusing and misleading
		Therefore we simply drop the SC Code, Elig and Enrollees from 05210
		If 2 Los Angeles are listed then the plan has SA in both
		The Zip codes for Partial counties may belong to either 05210 or 05200

11-02           		Employer Only Group counties           Column L

12-02           		For a variety of reasons Dec and Jan data may
		not be 100% accurate. Therefore those who wish
		to compare year to year figures are advised
		to use Nov-Feb or Oct-Mar (Or Sept March)


xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
THE FOLLOWING IS THE ORIGINAL DOCUMENTATION ABOUT THE GEO FILE
THAT WAS IN THE READ ME FILE. THIS DOCUMENTATION HAS NOW BEEN
REPLACED BY DOCUMENTATION ON THE THE MAIN GEO PAGE.
The MAIN GEO page is located at
http://www.cms.hhs.gov/
--> Research, Statistics, Data & Systems bucket
--> Statistics, Trends & Reports subbucket
--> Health Plans, Reports, Files and Data website section

In other words the following documentation describes the
original geo files from June 2001 and thereafter. This section
has been retained for historical purposes.
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

The excel workbook contains
============================================            		
* This readme file which can be 		
  found on the README IMPORTANT sheet          		

* The original Geographic Monthly report from 		
  the mainframe which can be found on the ORIGINAL data sheet           		

* A Flat file containing the same information which 				
  can be found on the FLAT FILE sheet           				

* A comparison of Total Enrollees vs Enrollees in SA per H####				
  which can be found on the CHECK sheet				


NOTES           				
=====           				
WEB LOCATION(URL)

-->http://www.cms.hhs.gov/
--> Research, Statistics, Data & Systems bucket
--> Statistics, Trends & Reports subbucket
--> Health Plans, Reports, Files and Data website section

DATE OF FILE:              The date of this Geographic report may be				
                           found on the 2nd line of the Original Report         				
                           which can be found on the ORIGINAL SHEET				
                           ---The SERVICE AREA---------is for the MONTH of the GEO FILE				
                           ---The ELIGIBLES-----are for the LAST MONTH of the most RECENT QUARTER
                           ---The ENROLLEES--------------------are for the MONTH of the GEO FILE

ELIGIBLES/ENROLLEES        Enrollees are per Plan and County
                           Enrollees for 7 H### whose SA is US, is for the Whole Country
                           Eligibles are per County
                           Eligibles are for the Most Recent quarter
                           Enrollees are for the Most Recent Month
                           EXAMPLE: Jan-2002 has Jan-2002 enrollees but Dec-2001 eligibles
                           Prior to Jan-2002 eligibles AND enrollees were by quarter
                           Records with 10 or less enrollees have the number hidden

LISTING OF ZIPS:           The Flat file only lists Zip codes when the 
                           M+C has a partial authorization of 
                           Service Area in the county           

OMISSIONS OF ZIPS:         The flat file could not list 
                           more than 250 zip codes ---          
                           Consequently in those rare instances where there are 
                           more zip codes, then the ALL ZIPS? column has an entry
                           NOT ALL ZIPS         

TYPE:                      The flat file has the M+C type 
                           (PFFS, M+C, DEMO etc). Note that 
                           PACE Organizations are included in the CMS Data
                           but are not included on this Eligible-Enrollee report
                           As of Jan-2002, 1 PACE plan joined the program
                           As of Nov-2002 all Pace plans will be in the program
                           The PACE - DEMO plans do NOT belong to the HMO program
                           The PACE - NAT plans DO belong to the program
                           The FULL plan type will be displayed for Sep-2002 & Oct-2002

UPDATES:                   This report will be updated monthly starting Jun-2001       
                           NOTE: The Jun-2001 file had no eligibles and enrollees
                           and had faulty data. It was therefore replaced
                           All other files are accurate and were not replaced

ZIP FILE:                  The zip file contains                
                           * The excel workbook (Geo-MMYY.xls)  
                           * The original Pics report in text format (Geo-MMYY.txt)             
                           * This read me file  (Readme.txt)    
                           * A comma separated file (Geo-MMYY.csv) that can be uploaded 
                             into other applications. The csv file corresponds to 
                             the FLAT FILE. NOTE: If you pull a CSV file into excel
                             then you lose leading zeroes in zip codes which begin in 0.
                           * In the above MMYY stands for MONTH (MM) and YEAR (YY)

CHECK                      The CHECK worksheet contains a check on accuracy
                           It shows for each plan, Total Enrollees vs Enrollees in SA
                           Currently the Out Of Area enrollees are about 1%
                           As of Apr 2002 we are including TYPE-HMO in the check sheet

DATA SUBTLETIES            * The State County Codes for Manassas City and Manassas City 
                             Park have been adjusted to reflect CMS usage in other files
                           * H### whose SA is US have total enrollment indicated
                           * Some H## have no TYPE, Eligibles or Enrollees listed: Either
                           --- they are New this month or
                           --- They belong to other programs (like the Pace Demos) or
                           --- They might be pending
                           * SAINT LOUS (CITY) seems to be identical with SAINT LOUIS
                             while SAINT LOUIS CITY is a different COUNTy
                           * The CMS systems seem to use LOS ANGELES (1) and 
                               LOS ANGELES (2) arbitrarily. Hence they are both coded
                               as state county code 05200. All enrollment for all
                               of Los Angeles is indicated without further breakout
                           * When a county name has 2 state county codes associated to
                             it, Eligibles and enrollees are broken out by State County
                             Code
                           * 3 Records have states listed but no counties
                           * State County codes for Alaskan county names are not reliable
                             As of June 2001 we have very few if any enrollees there.

FIELDS                     The Flat File contains the following fields
                           The .csv file also contains these fields (in this order)
                           --- H#### (E.g. H1234)
                           --- Organization Name (e.g. Pacificare of)
                           --- Type (e.g. PFFS, M+C, Risk etc)
                           --- State Name
                           --- County (Name)
                           --- Partial: An entry of "P-" indicates a Partial SA allowance
                           --- All Zips? Zips are only listed if there is a Partial SA
                               An entry of "NOT ALL ZIPS" indicates not all zips in the
                               Partial SA are listed 
                           --- # States = The number of States the H# is licensed in
                           --- State County Code (the 5 character State County code)
                           --- MMM-YYYY Eligibles: Number of Eligibles for that County 
                               for the Most recent Quarter
                           --- MMM-YYYY Enrollees: Number of Enrollees for that County
                               for the current month 
                           --- Zips: The listing of all Zips in the Partial SA begins here

FILE IMPROVEMENTS          Prior to Jan-2002, enrollees and M+C type were for the most recent
                           quarter. As of Jan-2002, enrollees & Type are for the current month.

                           Prior to Jan-2002 the CHECK sheet only counted enrollement above 10
                           As of Jan-2002 FULL enrollment per county was counted
			   The CHECK sheet now contains PLAN TYPE
                                         
