Newsroom > DHHS News Release
For Immediate Release
February 5, 2016
Kathie Osterman, Communications and Legislative Services, (office) 402-471-9313 or email@example.com
DHHS Announces Contract Recommendations
for Heritage Health
Three Health Plans Selected to Manage Integrated Health Program
Lincoln – The Nebraska Department of Health and Human Services’ Division of Medicaid and Long-Term Care (MLTC) today announced the recommendation of three managed care organizations (MCOs) to administer the upcoming Heritage Health program. Heritage Health is a new health care delivery system that combines Nebraska’s current physical health, behavioral health, and pharmacy programs into a single comprehensive and coordinated system for 230,000 Medicaid and Children’s Health Insurance Program (CHIP) enrollees. All of the health plans selected will operate statewide.
“Through Heritage Health, Medicaid recipients will receive a full array of services through one health plan, resulting in coordinated care and better outcomes,” said Courtney Phillips, CEO of the Nebraska Department of Health and Human Services. “It will help people live better lives as well as provide efficiencies to state government.”
Currently, Nebraska contracts with three health plans for physical health services like doctor visits and hospital care, a separate entity for behavioral health services, and a separate contractor to manage pharmacy services on behalf of the state. Under Heritage Health, Medicaid and CHIP enrollees will choose one health plan that will be responsible for this full array of services.
The recommended Heritage Health plans are:
- Aetna Better Health of Nebraska
- Nebraska Total Care (Centene)
- UnitedHealthcare Community Plan
The health plans were selected through a competitive Request for Proposals (RFP) to solicit qualified providers. The RFP provided the department with the discretion to award between two and three MCOs contracts. In total, the department received six bids for Heritage Health. The other plans that submitted bids are:
- Arbor Health Plan (Amerihealth Caritas)
- Meridian Health
- WellCare of Nebraska
Aetna Better Health and UnitedHealthcare Community Plan both have current contracts with Nebraska Medicaid, while Nebraska Total Care will be a new entrant into the market. Arbor Health Plan is also a current incumbent health plan.
The proposals collectively include dozens of added benefits and services for Nebraska recipients. Examples include programs to help pregnant women access the recommended prenatal visits or receive pregnancy care management, rewards for healthy behaviors and prevention activities, additional inhalers for children with asthma for use at school, community programs for children, peer support for behavioral health needs, and crisis support services. The health plans have also committed to employing hundreds of Nebraska-based staff, including care managers, social workers, billing specialists, plan leadership, and others.
“We are thrilled to have received six proposals and for the opportunity to choose the best among them to deliver high quality services to our enrollees,” said Calder Lynch, Director of the DHHS Division of Medicaid and Long-Term Care. “Our new health plan contracts provide a strong foundation to improve health outcomes through robust care management programs, payment reform, provider engagement, and an increased focus on the social determinants of health.”
Several steps remain before MCO contracts are final and their networks begin operations. DHHS will work with the Division of Administrative Services (DAS) to execute final contracts with the chosen MCOs. Once contracts are signed, MCOs will undergo a thorough readiness review before any network can begin providing services to Medicaid recipients. The new contracts are expected to start on January 1, 2017. Recipients will be given the opportunity to choose the MCO that best meets their needs during an open enrollment period scheduled to start this fall. All members will have the opportunity to select a health plan, and all members will retain the option to change health plans for ninety (90) days after enrollment.
For more information on Heritage Health, including procurement materials, a fact sheet, and frequently asked questions, please visit www.dhhs.ne.gov/HeritageHealth