The three-year contracts for the Community HealthChoices managed care initiative, which will service more than 420,000 Medicaid and Medicare beneficiaries in Pennsylvania, could be valued at $5.4 billion in annual revenue. DHS selected Pittsburgh-based UPMC, Philadelphia-based AmeriHealth and St. Louis-based Centene to proceed with negotiations to offer services beginning in 2017.
The managed care organizations were chosen from 14 companies vying for contracts. Four insurers who lost out on the bid — Hartford, Conn.-based Aetna, Long Beach, Calif.-based Molina, Tampa, Fla.-based WellCare and Pittsburgh-based Gateway Health Plan — filed appeals. A fifth insurer, Philadelphia-based Health Partners Plans, is considering a protest.
Appeals have delayed negotiations with bid winners UPMC, AmeriHealth and Centene and could postpone the program. Insurers are slated to begin offering services July 2017 in Pittsburgh and southwest Pennsylvania counties.
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