UPMC, AmeriHealth, Centene land $5B Pennsylvania managed care bid

The Pennsylvania Department of Human Services and Aging picked UPMC, AmeriHealth Caritas and Pennsylvania Health & Wellness (Centene) for its Community HealthChoices managed care initiative, which will service more than 420,000 individuals.

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CHC will coordinate physical health and long-term services and supports for Medicare and Medicaid beneficiaries. It could be valued at $5.4 billion in annual revenue, The Philadelphia Inquirer reported.

DHS selected the managed care organizations from 14 companies vying for the statewide contracts. Pittsburgh-based UPMC, Philadelphia-based AmeriHealth and St. Louis-based Centene will proceed with negotiations to offer services beginning 2017.

“The MCOs selected will provide a choice of healthcare and LTSS providers to everyone moving into CHC and allow them to receive the services they need in a coordinated manner,” DHS Secretary Ted Dallas said.

More articles about payer issues:
15 proposals from CMS’ 2018 notice of Benefit and Payment Parameters
Medicare Advantage audits reveal widespread overbilling
Aetna’s hardball negotiation tactics spread to other insurers

 

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