Louisiana on Monday issued a request for proposals for managed-care companies hoping to serve the state’s more than 1.5 million Medicaid members under new contracts beginning in January 2020.
Louisiana will award contracts to up to four managed-care companies, down from five insurers today. Those five, whose current contracts will expire at the end of this year, are Aetna, AmeriHealth Caritas, Anthem’s Healthy Blue, Centene’s Louisiana Healthcare Connections and UnitedHealthcare.
The new contracts will last for three years with an option to extend for an additional two years. The contracts are worth a total of roughly $12 billion, Leerink Partners analyst Ana Gupte wrote in a research note.
The Louisiana Department of Health said it is looking for managed-care companies focused on improving the health of populations while also cutting costs. The department said it increased requirements on health plans to integrate physical and behavioral health services and improve access to primary care.
Taking a cue from North Carolina’s revamped Medicaid program, the request for proposals also asks health plans how they have used data to identify and address patients’ social determinants of health and how they can apply that experience to Louisiana’s Medicaid population.
The department also asks health plans for ways to implement value-based payment arrangements with providers in the state.
“Our managed care organizations are expected to demonstrate innovation. There should be an increased focus on health equity and social determinants of health,” Dr. Rebekah Gee, secretary of the Louisiana Department of Health, said in a news release. “The managed care organizations will be expected to work with each enrollee to drive behavior change and encourage health choices.”
The department said it will accept proposals until April 29 and intends to award contracts on June 28. This is Louisiana’s third procurement for its Medicaid program, known as Healthy Louisiana, since it transitioned to a managed-Medicaid model in 2012. Louisiana expanded Medicaid in 2016; more than 500,000 low-income adults have enrolled under the state’s Medicaid expansion as of Feb. 18.
Last week, Louisiana’s Health Department told 37,000 Medicaid enrollees that they may be kicked out of the program because they earn too much to qualify for coverage. The department said the notices resulted from a computer upgrade that checks for Medicaid eligibility more frequently.
Source: ModernHealthCare.com
