DE DHSS Announces Medicaid Managed Care Program Operators

October 2017 ~

Delaware’s Department of Health and Social Services (DHSS) has announced the names of the companies selected to operate its Medicaid Managed Care Program (MCO) in 2018.

Beginning January 1, Delaware DHSS’ Division of Medicaid and Medical Assistance will continue its MCO partnership with Highmark Health Options Blue Cross Blue Shield and AmeriHealth Caritas will join the program. The Division of Medicaid and Medical Assistance’s MCO contract with UnitedHealthcare will end on December 31, 2017.

“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 September 7, Delaware Governor John Carney signed House Joint Resolution 7, which gave DHSS and Secretary Walker the authority to develop a health care spending under which 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.

Approximately 200,000 of the current 230,000 Medicaid clients in Delaware are served by managed care organizations. According to Medicaid Director Steve Groff, clients will receive information during the next several weeks about their options in choosing a new plan.

Source(s): Delaware.gov;