Highmark and AmeriHealth Caritas to operate Medicaid in Delaware

United Healthcare contract with Medicaid to end Dec. 31
October 3, 2017

The Delaware Department of Health and Social Services announced that it has selected two companies to operate its Medicaid managed care program.

The department's Division of Medicaid and Medical Assistance will continue its MCO partnership with Highmark Health Options Blue Cross Blue Shield, which began in 2015. The department also announced its intent to contract with AmeriHealth Caritas to join the Medicaid program Monday, Jan. 1. AmeriHealth Caritas has managed care for Medicaid clients in Pennsylvania since 1983.

"We are pleased to reach agreement with Highmark and AmeriHealth to provide these vital services to the Medicaid clients we serve," said DHSS Secretary Dr. Kara Odom Walker. "Both of these companies understand Delaware's commitment to value-based care through a healthcare spending benchmark, a robust network and keeping down costs. Highmark and AmeriHealth also are committed to providing care and supports to our clients that will help them achieve their optimal health."

On Sept. 7, Gov. John Carney signed House Joint Resolution 7, which gave DHSS and Walker the authority to develop a healthcare spending benchmark that will be linked to the growth rate of Delaware's economy. Under a benchmark - a spending target - payments are linked to paying for value and quality of care instead of the number of services provided. The benchmark will cover all healthcare spending, including through Medicaid, Medicare and commercial insurers.

Finally, the Division of Medicaid and Medical Assistance's MCO contract with United Healthcare will end Sunday, Dec. 31.

"We appreciate the partnership we have shared with United Healthcare and the quality services it has provided our members," said Medicaid Director Steve Groff. "We look forward to working with Highmark and AmeriHealth to smoothly transition the United Healthcare membership."

About 200,000 of the current 230,000 Medicaid clients in Delaware are served by managed care organizations. Groff said clients will receive information during the next several weeks about their options in choosing a new plan. Open enrollment will begin Wednesday, Nov. 1.

AmeriHealth Caritas Chairman and CEO Paul A. Tufano said, "We are excited about this opportunity to expand our mission to Delaware. Core to our mission is that every individual should have access to healthcare, and for more than 30 years we have been working in communities across the nation to make that possible. We look forward to partnering with DMMA to help continue the transformation of healthcare in the state to help ensure Delawareans most in need receive best-in-class care and support through our person-centered model of care."