HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that South Carolina's newly reformed Medicaid program is seeing new life as managed care firms are lining up to participate. According to the latest North & South Carolina Health Plan Analysis, national players and locally-based medical home networks (MHN) are vying for members in the state's Healthy Connections Choices program.
"Privatization is a key piece of the state's Medicaid reform effort, and policymakers hope that the addition of Medicaid HMOs will eventually cut state costs," states Heather Wicks, analyst for HealthLeaders-InterStudy and author of the report. "So far, eight insurers have signed on for the state's Medicaid program."
BlueCross BlueShield of South Carolina is still building the network for its BlueChoice HealthPlan, which will be offered through a partnership with WellPoint Inc. In addition, Centene Corp. initially will offer both an HMO and MHN in the state with its recent purchase of PhyTrust of South Carolina, and AMERIGROUP has its network approved in three counties.
Healthy Connections Choices, part of South Carolina's overall Medicaid reform, stresses care coordination and disease prevention that backers hope will lead to healthier Medicaid members, fewer redundant tests and fewer emergency room visits. Enrollment will occur regionally and members will receive enrollment packets with 30 days to choose a plan. After 30 days, Medicaid recipients who do not choose a plan will have one assigned to them. Many plans are counting on this automatic assignment process to give them an initial cache of members. Assignments will be made on a rolling basis, giving each Medicaid HMO or MHN an even distribution.
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