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MDHHS issues award recommendation for Michigan’s Medicaid Health Plans

Health plan coverage awarded based on state’s 10 Prosperity Regions

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) has awarded Comprehensive Health Care Program contracts for Michigan’s Medicaid health plans, which serve nearly 2 million Michigan residents receiving coverage through Medicaid and the Healthy Michigan Plan.

Nine health plans submitted proposals. The five-year contracts include three, one-year optional extensions and go into effect Tuesday, Oct. 1. Contracts were awarded based on the state’s 10 Prosperity Regions:

  • Region 1 – Upper Peninsula Prosperity Alliance: Upper Peninsula Health Plan, LLC.
  • Region 2 – Northwest Prosperity Region: Blue Cross Complete of Michigan, LLC, McLaren Health Plan, Inc., Molina Healthcare of Michigan, Inc., Priority Health Choice, Inc.
  • Region 3 – Northeast Prosperity Region: Blue Cross Complete of Michigan, LLC, McLaren Health Plan, Inc., Molina Healthcare of Michigan, Inc., Priority Health Choice, Inc.
  • Region 4 – West Michigan Prosperity Alliance: Blue Cross Complete of Michigan, LLC, McLaren Health Plan, Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan, Inc., Priority Health Choice, Inc., United Healthcare Community Plan, Inc.
  • Region 5 – East Central Michigan Prosperity Region: Blue Cross Complete of Michigan, LLC, McLaren Health Plan, Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan, Inc.
  • Region 6 – East Michigan Prosperity Region: Blue Cross Complete of Michigan, LLC, HAP CareSource, Inc., McLaren Health Plan, Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan, Inc., United Healthcare Community Plan, Inc.
  • Region 7 – South Central Prosperity Region: Aetna Better Health of Michigan, Inc., HAP CareSource, Inc., McLaren Health Plan, Inc., United Healthcare Community Plan, Inc.
  • Region 8 – Southwest Prosperity Region: Aetna Better Health of Michigan, Inc., McLaren Health Plan, Inc., Meridian Health Plan of Michigan, Inc., United Healthcare Community Plan, Inc.
  • Region 9 – Southeast Prosperity Region: Aetna Better Health of Michigan, Inc., Blue Cross Complete of Michigan, LLC, HAP CareSource, Inc., McLaren Health Plan, Inc., Meridian Health Plan of Michigan, Inc., United Healthcare Community Plan, Inc.
  • Region 10 – Detroit Metro Prosperity Region: Aetna Better Health of Michigan, Inc., Blue Cross Complete of Michigan, LLC, HAP CareSource, Inc., McLaren Health Plan, Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan, Inc., Priority Health Choice, Inc., United Healthcare Community Plan, Inc.

“MDHHS has selected Medicaid health plan contractors with the experience, capabilities and commitment to deliver equitable, coordinated and person-centered care,” said MDHHS Director Elizabeth Hertel. “This includes prioritizing health equity, addressing social determinants of health, increasing childhood immunization rates and improving access to health care providers. The overarching goal is to provide Michigan families with a healthier future.”

MDHHS embedded changes in the new health plan contracts to strengthen Medicaid services provided to enrollees. Several of these changes seek to address social determinants of health through investment in and engagement with community-based organizations. The introduction of “in lieu of services” is one of these important changes and will allow plans to pay for nutrition services that have been shown to improve health.

The rebid was part of MIHealthyLife, an initiative launched in 2022 to strengthen Medicaid services through new Medicaid health plan contracts. Input from nearly 10,000 enrollees and family members, health care providers, health plans and other community partners informed the creation of five MIHealthyLife strategic pillars:

  • Serve the Whole Person, Coordinating Health and Health-Related Needs.
  • Give All Kids a Healthy Start.
  • Promote Health Equity and Reduce Racial and Ethnic Disparities.
  • Drive Innovation and Operational Excellence.
  • Engage Members, Families and Communities.

The MIHealthyLife initiative guided design of Comprehensive Health Care Program changes embedded in the Medicaid Health Plan contract rebid. An informational webinar is available on the MIHealthyLife home page describing these priority program changes in more detail:

  • Prioritizing health equity by requiring Medicaid health plans achieve National Committee for Quality Assurance Health Equity Accreditation.
  • Addressing social determinants of health through investment in and engagement with community-based organizations.
  • Increasing childhood immunization rates, including increasing provider participation in the Vaccines for Children program.
  • Adopting a more person-centered approach to mental health coverage.
  • Ensuring access to health care providers by strengthening network requirements.
  • Increasing Medicaid Health Plan accountability and clarifying expectations to advance state priorities.

More information about Medicaid is available at Michigan.gov/Medicaid, or about Medicaid benefits at Michigan.gov/MIBridges.

 

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