New firms to offer managed Medicaid
Southeastern Pennsylvania will have two new companies offering managed Medicaid benefits in 2017, the Pennsylvania Department of Human Services said Wednesday.
Southeastern Pennsylvania will have two new companies offering managed Medicaid benefits in 2017, the Pennsylvania Department of Human Services said Wednesday.
Entering the market are publicly-traded Centene Corp., of St. Louis, and UPMC For You, part of the giant University of Pittsburgh Medical Center, which dominates the managed Medicaid market in western Pennsylvania.
Not selected to continue with the program in the Philadelphia region was Aetna Better Health, which had 73,852 members in March, or 9 percent of the market, according to state data.
The changes are part of a state effort negotiate new, three-year managed Medicaid contracts that set a 30-percent target for payments based on value received or outcomes, rather than on the quantity of services provided.
Pennsylvania's Medicaid system covers 2.1 million.
215-854-4651
@InqBrubaker