Pennsylvania’s Department of Human Services has granted AmeriHealth Caritas, Centene Corp., and UPMC contracts for its new Medicaid program.
Community HealthChoices, Pennsylvania’s first-ever program for providing managed long-term services and supports (MLTSS), is scheduled to go live July 1, 2017, in the state’s southwestern region. It will continue to be implemented in zone-based phases, and should be available in the state’s southeastern region in 2018 and live statewide in 2019.
As winners of the PA MLTSS contracts, AmeriHealth Caritas, Centene, and UPMC will manage the state’s Medicaid program. In return, the insurers will each receive a monthly lump-sum payment for each patient they cover.
MLTSS programs are becoming available in an increasing number of states. They attempt to help elderly and disabled individuals who qualify for both Medicare and Medicaid coordinate their care, improve their health outcomes, and receive their health care in their homes and communities instead of in facilities.
A total of 14 companies submitted bids for Pennsylvania’s MLTSS contracts, which run through 2022. Among those who did not receive contracts were Aetna, Molina Healthcare, and UnitedHealthcare.
Community HealthChoices is expected to serve approximately 420,000 people.