Three Managed Care Groups Get $4.4 Billion for Hoosier Healthwise

August 8, 2006

Approximately 535,000 Indiana residents enrolled in the Hoosier Healthwise insurance program will gain more choices for their medical care on Jan. 1, 2007 through three managed care organizations, Indiana state officials are saying.

Indianapolis-based Anthem Insurance Companies Inc. will join two existing Hoosier Healthwise providers, Managed Health Services and MDwise Inc., in offering statewide coverage of their plans, said Mitch Roob, secretary of the Family and Social Services Administration.

During a news conference with the state’s Medicaid director, Jeanne LaBrecque, Roob announced that the three providers will share $4.4 billion over four years under contracts that still are being negotiated.

“Half of the children born in Indiana will be born on this program,” Roob said.

Hoosier Healthwise is Indiana’s Medicaid insurance program for low-income families and children.

Managed Health Services and MDWise now are among five managed care organizations that provide Hoosier Healthwise coverage regionally across the state. Effective Jan. 1, those two plans and Anthem will offer coverage statewide, meaning no recipient will be more than 30 minutes away from a primary care physician, Roob said.

Impartial, third-party benefit advocates will steer recipients toward the best plan for their individual circumstances. For example, a recipient may be better served by a particular plan’s prenatal care provisions, while another plan may offer better coverage for chronic asthma, LaBrecque explained.

Recipients will be able to change plans every 30 days if they choose.

For the first time, the insurance plans will cover mental health services for Hoosier Healthwise recipients, who currently receive them separately, LaBrecque said.

The contracts will encourage the managed care organizations to work with medical care providers in schools and to use technology for electronic health information records that can follow patients as they move among medical providers.

The contracts also will encourage the managed care organizations to expand the use of midwives, nurse practitioners, physician assistants and other non-doctors.

An advocate for Hoosier Healthwise beneficiaries applauded FSSA’s efforts. David Roos of Covering Kids and Families called it “very, very good news not only for FSSA but also the Medicaid population in the state of Indiana.”

Recipients will be able to chose from among three plans _ one more than federal rules require and the contracts will help FSSA meet its goal of holding the growth of Medicaid spending to 5 percent annually. That benefits Indiana taxpayers as well, said Roos, the South Bend-based state director of a national group that tries to increase participation in government health care programs.

Seven companies bid for the contracts, and that’s a strong signal from the insurance industry, Roos said.

“It’s a sign of confidence that Mitch Roob and the current administration have a feasible business plan to constrain growth in the Medicaid program,” Roos said.

Two of the three winning bidders are Indiana companies. Anthem is part of Indianapolis-based WellPoint Inc. and MDwise, which now provides Hoosier Healthwise coverage in central and northwestern Indiana, is a partnership of Clarian Health Partners and the Health and Hospital Corp. of Marion County.

During the 1990s, Roob directed the Health and Hospital Corp. of Marion County.

Managed Health Services is operated by St. Louis-based Centene Corp.

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