(Washington, DC) – Today, the District Department of Health announced the new managed care contract awardees for the District’s healthcare programs for low-income residents, Medicaid and The DC Healthcare Alliance (Alliance).
The four Managed Care Organizations (MCO’s) awarded the new contract are AMERIGROUP DC, Inc.; DC Chartered Health Plan, Inc.; Health Right, Inc.; and Unison Health Plan of the Capital Area, Inc. The MCO’s will provide comprehensive health care services to more than 135,000 of the 190,000 District residents enrolled in both programs. The total cost of the contract is $329,029,267.00.
After a review of best practices of Medicaid managed care programs around the country, the District Government developed the new contracts in association with George Washington University. The contracts now have many additional reporting requirements, and base part of the MCO’s reimbursement on health outcome indicators. The “Pay for Performance” contracts provide better oversight for the populations they serve.
“The ultimate goal of these new contracts is to ensure that District residents have the highest quality of healthcare to improve the health outcomes of all residents served by these programs,” said Dr. Carlos Cano, Interim Director of the DC Department of Health.
The new contracts also provide greater choice options, as Alliance and Medicaid participants can choose between all four awardees. Previously, Alliance participants had a choice between two MCO’s (AMERIGROUP DC, Inc. and DC Chartered Health Plan, Inc.), and Medicaid participants had a choice of three MCO’s (AMERIGROUP DC, Inc.; DC Chartered Health Plan, Inc.; and Health Right, Inc.)
Separately, the District today began legal action against DC Chartered Health Plan, Inc., to recover Medicaid funds from the company’s alleged improper billing from August 2006 to July 2007.
ABOUT THE ALLIANCE AND MEDICAID:
Medicaid is a federal-state partnership in which the District receives 70 percent reimbursement from the federal government for all spending attributed to Medicaid beneficiaries. The DC Healthcare Alliance was created as a wrap-around coverage program to offer insurance to other uninsured DC residents who do not quality for Medicaid but are still low-income and underserved. It is funded through 100 percent local dollars.