A dozen entities are vying for state contracts to operate the Jindal administration’s new health-care delivery system for the poor, Louisiana’s health agency announced Thursday.
Insurance companies and other private groups submitted proposals by the deadline for those interested in running “Coordinated Care Networks,” called CCNs.
The CCNs are scheduled to be operational statewide by May 1. It’s the state’s first foray into turning over part of its Medicaid program to private insurance companies with taxpayers paying premiums for those enrolled.
Also called managed care, the system would cover two-thirds of the state’s 1.2 million Medicaid recipients — mainly children. The emphasis would be on preventive and primary care. Louisiana Medicaid is a $6.7 billion taxpayer-funded program.
At least four of the companies are in the Louisiana insurance market today. Others want to come in exclusively to do Medicaid managed-care business.
“We had a good turnout,” said state Department of Health and Hospitals Undersecretary Jerry Phillips. “That should provide the coverage we were looking for.”
Phillips said: “We are encouraged by the number of providers who want to join with us in better management of Medicaid.”
Nineteen companies originally expressed interest in the contracts. Seven firms, including Blue Cross Blue Shield of Louisiana, decided not to file proposals.
Louisiana Association of Health Plans executive Gil Dupre said the number of companies submitting proposals is about what he expected.
“If there’s one negative in this, it’s that there’s going to be more qualified companies that cannot be selected because there’s a limit on the number (of companies) operating in each region,” Dupre said.
DHH is scheduled to announce its contract award recommendations July 25.
The CCN plan will be phased-in statewide a region at a time starting in January. The New Orleans area will be the first of three regions in the roll-out with the Baton Rouge area next March 1 and then the rest of the state May 1.
Under the plan, insurers, or third party entities, would develop health-care networks of physicians, hospitals and others to provide patient care under either a pre-paid or shared risk model.
Pre-paid network plans are those in which taxpayers would essentially pay the insurance premiums of Medicaid recipients who enroll in them.
Twelve entities sought that business.
Opponents said the Jindal plan puts money into insurance company profits at the expense of health care.
The shared savings network is one under which health-care providers would continue to get paid on a fee-for-service basis by the state for care delivered. The networks would be able to share in any savings generated.
Three entities submitted proposals for that system.
United Healthcare of Louisiana, Inc., filed proposals for both network models.
The financial viability of each network would depend upon the extent to which they reduce costs through better co-ordination of care leading to healthier Medicaid recipients.
The DHH evaluation team must pick no more than three of each type — pre-paid or shared-risk — to operate in each region. Each proposer can be chosen to operate in more than one region.
Those filing proposals for the pre-paid insurance-model network were: Aetna Better Health Inc., Amerigroup Louisiana Inc., AmeriHealth Mercy of Louisiana, Inc., Children’s Hospital Health Plan, Inc., Coventry Cares of Louisiana Inc., Louisiana Cares Health Plan, LLC, Louisiana Healthcare Connections Inc., a subsidiary of Centene; United Healthcare, and Wellcare Health Plans Inc.
Filing proposals for the shared-savings network were Community Health Solutions of America LLC, LA Physicians Connections LLC and United Healthcare.
LSU System Vice President Fred Cerise said LSU hospitals previously signed letters of intent to work with AmeriHealth Mercy and Children’s.
Cerise said LSU told others they would wait to see which group landed the contract.
“We told the others we were interested in working with everybody,” said Cerise.