DHSS ANNOUNCES HIGHMARK AND AMERIHEALTH CARITAS SELECTED TO OPERATE MEDICAID MANAGED CARE PROGRAM

NEW CASTLE (Sept. 29, 2017) - The Department of Health and Social Services announced today that it has selected two companies to operate its Medicaid Managed Care Program.

DHSS' Division of Medicaid and Medical Assistance will continue its MCO partnership with Highmark Health Options Blue Cross Blue Shield, which began in 2015. In addition, DHSS announced its intent to contract with AmeriHealth Caritas to join the Medicaid program on Jan. 1, 2018. AmeriHealth Caritas has managed care for Medicaid clients in Pennsylvania since 1983.

"We are pleased to reach agreement with Highmark and AmeriHealth to provide these vital services to the Medicaid clients we serve," DHSS Secretary Dr. Kara Odom Walker said. "Both of these companies understand Delaware's commitment to value-based care through a health care spending benchmark, a robust network and keeping down costs. Highmark and AmeriHealth also are committed to providing care and supports to our clients that will help them achieve their optimal health."

On Sept. 7, Gov. John Carney signed House Joint Resolution 7, which gave DHSS and Secretary Walker the authority to develop a health care spending benchmark that will be linked to the growth rate of Delaware's economy. Under a benchmark - or a spending target - payments are linked to paying for value and quality of care instead of the number of services provided. The benchmark will cover all health care spending, including through Medicaid, Medicare and commercial insurers.

Finally, the Division of Medicaid and Medical Assistance's MCO contract with United Healthcare will end on Dec. 31, 2017.

"We appreciate the partnership we have shared with United Healthcare and the quality services it has provided our members," Medicaid Director Steve Groff said. "We look forward to working with Highmark and AmeriHealth to smoothly transition the United Healthcare membership."

About 200,000 of the current 230,000 Medicaid clients in Delaware are served by managed care organizations. Groff said clients will receive information during the next several weeks about their options in choosing a new plan. Open enrollment will begin Nov. 1.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

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