The Louisiana Department of Health has picked four companies it intends to award multi-billion dollar contracts to in exchange for managing care for 1.7 million Medicaid patients in the state.
The agency picked AmeriHealth Caritas Louisiana, Community Care Health Plan of Louisiana (Healthy Blue), Humana Health Benefit Plan of Louisiana and United Healthcare Community Plan. The terms of the deals are still being worked out but are expected to begin in January.
Managed care companies are tasked with providing Medicaid benefits and services to the 1.7 million adults and children who are covered by the state-sponsored insurance program, which was expanded by Gov. John Bel Edwards to cover nearly half a million more people.
Currently, the state contracts with five companies to manage services for most of the state Medicaid population. Those companies are Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections and United Healthcare Community Plan.
Medicaid paid $7.6 billion to those firms in the 2018 fiscal year. The health department forecast it would spend more than $8 billion in the fiscal year that ended June 30 – including $4.7 billion for regular Medicaid patients and $3 billion for expansion patients.
The existing contracts expire at the end of the year. They were negotiated by the Jindal administration and extended by the Edwards administration.
The health department began a bid process in February for the new contracts.
Former Gov. Bobby Jindal moved the state to the privatized managed care model in 2012, moving away from the old system of directly reimbursing doctors and hospitals for each service for Medicaid patients.
Now, most Medicaid enrollees receive their health care through the new managed care model, though not long-term supports and services. Medicaid pays the managed care organizations, often called MCOs, a monthly fee based on the number of enrollees.
If a current Medicaid enrollee has a plan with one of the MCOs that was not selected for the new round of contracts, the enrollee may have to select a new plan, the health department said. The open enrollment process begins in October where members can select new health plans.
The contracts are expected to be executed later this month.
Source: theadvocate.com. For story link, click here.