The state health agency late Friday named the five companies to provide health insurance for some two-thirds of the state’s 1.4 million Medicaid recipients.
The lucrative contracts will go to Aetna Better Health of Louisiana, Amerigroup Louisiana Inc., AmeriHealth Caritas Louisiana Inc., Louisiana Healthcare Connections and UnitedHealthcare Community Plan. Four of the five companies participated in the past. Only Aetna Better Health is a new player.
The health insurance companies were selected through a competitive procurement process.
Each company will be paid an insurance premium and be responsible for managing the care those who choose to enroll with them.
With the new contract award, the Jindal administration went to a total insurance-based Bayou Health program. Previously, the state used two models: one prepaid, premium-based, which was offered by three companies; and the other “shared savings,” with two companies receiving a small management fee and providers being paid directly for services.
State Department of Health and Hospitals Secretary Kathy Kliebert said the change to a total premium-based plan will provide more budget predictability and increased savings while giving health plans more flexibility in services they can offer patients.
UnitedHealthcare had been a “shared savings” plan but it shifted to the pre-paid model.
The new contracts are expected to start Feb. 1. Medicaid recipients will be given the opportunity to choose the insurance plan that best fits their needs during a 60-day annual open enrolment period scheduled to start in November.
The companies — through Bayou Health — will coordinate health care services for more than 919,000 Medicaid recipients including adults with disabilities who do not receive Medicare, children under age 19, their parents and pregnant women.
According to a DHH news release, the new contracts will bring more added benefits and services, including certain vision and dental benefits for adults, coverage of certain vaccines for adults, weight management programs, benefits for over-the-counter drugs, 24-hour nurse support lines, and physician at-home visits for postpartum care.
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