While the state of Illinois will discontinue the plan Jan. 1, Centegra said it chose to drop the plan prior to that due to its low reimbursement rate. Centegra spokesperson Michelle Green told Northwest Herald Aetna Better Health paid Centegra 45 cents per dollar of its members’ healthcare costs.
“The low reimbursement of this voluntary contract resulted in significant financial loss, which was why we made the decision not to renew,” Ms. Green said. “Shortly after we provided notice to the affected individuals, the Illinois Department of Healthcare and Family Services also did not award Aetna Better Health a contract; therefore, all affected Medicaid patients in Illinois now will be transitioned to other plans.”
Centegra’s nonrenewal decision will affect approximately 3,000 Medicaid members.
More articles on payer issues:
BCBS of North Carolina to drop grandfathered health plans; 50k affected
Anthem expands discretionary ED coverage policy to Indiana
MemorialCare Health System back in-network with Anthem Blue Cross
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
