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Managed Medicaid
Medicaid-Focused MCOs Are Expanding, Entering Into MA for 2008
Reprinted from the Oct. 18, 2007, issue of MEDICARE
ADVANTAGE NEWS, biweekly news and analysis on the Medicare (and
Medicaid) managed care programs.
As of Jan. 1, 2008, several major Medicaid-focused plans, both public
and private, will enter or enlarge their presence in the Medicare Advantage
(MA) market. Among them:
- CareSource, a nonprofit Medicaid managed care organization
(MCO) based in Dayton, Ohio, will begin serving people dually eligible
for Medicare and Medicaid with a new Medicare Advantage (MA) Special
Needs Plan (SNP) in 17 counties in Ohio and six counties in Michigan.
CareSource, which is the largest Medicaid managed care plan in Ohio
with 544,000-plus members, said Oct. 3 it has entered into a definitive
agreement to acquire Community Choice Michigan (CCM). Nonprofit CCM
covers 49,000-plus Medicaid members in Michigan. CareSource has managed
CCM — which was created in 1995 — since August 2003. The
deal, expected to be completed by the end of 2007, is subject to regulatory
approvals.
"We've invested in the infrastructure to support moving care to
the higher risk, more complex population such as dual eligibles,"
Pamela Morris, CareSource president and CEO, told MAN Oct. 16. "This
is a natural evolution of our business model."
- AMERIGROUP Corp. is expanding beyond its current dual-eligible
SNPs in Texas and Maryland to offer both MA SNPs and local MA HMOs
in five additional states - Florida, New Jersey, New York, New Mexico
and Tennessee - for 2008. "It is different.but it is evolutionary,
not revolutionary, for us," says AMERIGROUP spokesman Kent Jenkins,
Jr. "We are not changing our organizational focus.just serving
a larger sample of essentially the same group" of low-income,
disabled and/or elderly beneficiaries.
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