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FOR IMMEDIATE RELEASE
December 22, 2017

CONTACT
Julie Naughton, Public Information Officer, Communications and Legislative Services, (office) 402-471-1695 or (cell) 402-405-7202, julie.naughton@nebraska.gov 
 
Medicaid Heritage Health Highlights Timely Payments, Enrollment

Lincoln – Heritage Health, Nebraska Medicaid’s managed care delivery system, continues successfully serving more than 230,000 of Nebraska’s most vulnerable citizens, according to Thomas “Rocky” Thompson, interim director of the Division of Medicaid and Long-Term Care in the Department of Health and Human Services.

Heritage Health performance results are public and can be found in the Heritage Health dashboard report at http://dhhs.ne.gov/medicaid/Pages/HeritageHealthPlans.aspx. It includes information about enrollment, claims and claim timeliness, grievances and appeals, and response times.

Thompson shared the most recent monthly data with state senators today. The following provides highlights:

Claims:

Enrollment:

  • Enrollment in each of the managed care organizations’ plans remained stable, with UnitedHealthcare at 76,396, Nebraska Total Care at 76,445 and WellCare at 75,714.
  • 13,433 Heritage Health recipients are enrolled in Case Management to actively manage potentially high-expense conditions.
  • Open enrollment for the 2018 Heritage Health plan year began on Nov.1 and concluded on Dec.15. Those happy with their 2017 plan were automatically re-enrolled.
  • A comparison of the plans, including a list of value-added services, is available at https://www.neheritagehealth.com/healthplan/search

Provider Calls:

  • Call abandonment for providers in October was 1.2 percent for UnitedHealthcare, 0.7 percent for Nebraska Total Care, and 4.3 percent for WellCare.
  • Average answer speed for providers in October was 71 seconds for WellCare, 12 seconds for Nebraska Total Care, and 8 seconds for UnitedHealthcare.
  • Average call length for providers in October was 9.9 minutes for Nebraska Total Care, 9.9 minutes for WellCare and 7.8 minutes for United Healthcare.
  • Average hold time for providers in October was 71 seconds for WellCare, 47 seconds for Nebraska Total Care and 45 seconds for United Healthcare.

Member Calls:

  • Call abandonment for members in October was 1.2 percent for UnitedHealthcare, 0.9 percent for Nebraska Total Care, and 1.4 percent for WellCare.
  • Average answer speed for members in October was 14 seconds for WellCare, 10 seconds for Nebraska Total Care, and 14 seconds for UnitedHealthcare.
  • Average call length for members in October was 7.8 minutes for Nebraska Total Care, 8.5 minutes for WellCare and 9 minutes for United Healthcare.
  • Average hold time for members in October was 14 seconds for WellCare, 32 seconds for Nebraska Total Care and 91 seconds for United Healthcare.

Heritage Health continues to provide tangible and important differences in members’ lives.  Jaden, a 2-year-old WellCare of Nebraska member with Doose Syndrome, which is a rare form of epilepsy, was experiencing eight to 10 seizures a day. Doctors were finally able to prescribe a medication that effectively decreased his seizures to one or two times daily. Then in June 2017, Jaden’s mother received a letter stating that her son’s Medicaid coverage was being terminated. She had received the initial paperwork but she had been delayed in responding to it because of her caregiving responsibilities.

With Jaden’s mother’s permission, WellCare of Nebraska case manager Deborah Otto immediately reached out to DHHS regarding the impending Medicaid termination. She was able to successfully arrange for a phone interview between his mother and a DHHS specialist in order to maintain Jaden’s Medicaid eligibility. Thanks to this support, Jaden’s Medicaid coverage was approved before it could be terminated. Jaden was able to continue to take the seizure medication and his seizures have decreased to about one per day.

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