The State of Michigan on Tuesday rejected a appeal by Henry Ford Health System’s health policy to permit it to keep 2 regions, involving Detroit, to its approved contract for the Medicaid program of state.
The contract would have permitted Health Alliance Policy’s Midwest Health Plan to sustain to serve 88,000 Medicaid beneficiaries, HAP Midwest Board Chair James Connelly and Mary Ann Tournoux, interim President and CEO, stated in a Monday letter to the Michigan Administrative Board.
If the state does not reverse its order and decision, HAP Midwest will sell its Medicaid membership in the rejected places to another health insurer, it stated.
“In the event that the decision of state is not reversed, MHP integrated on selling its Medicaid membership for influenced regions to another health policy,” it stated in an economical report.
In the month of October, the state granted managed care contracts and notified HAP Midwest that effective 1st January, 2016, it would not be an engaging Medicaid policy for the 2 key regions that depicted the majority of its membership.
The health policy appealed reconsideration, as did 6 other contractors. The state on the day of Tuesday rejected all but one appeal, that of Molina Healthcare of Michigan.
Losing request of a 6-year, $42 billion state contract were HAP Midwest Health Plan, Meridian Health Plan of Michigan, Sparrow PHP, Fidelis SecureCare of Michigan and Total Health Care, in accordance to a published report.
Since Medicaid expansion in Michigan went into action in the month of April 2014, bidding for the contracts has become more ruthless and competitive.
Henry Ford Health System President Wright Lassiter stated the state granted no points for purposed care.
“It is ironic, provided that one of the ‘pillars’ recognized by the state as significant in the bidding procedure was integration,” Lassiter stated in a statement. “In other words, health policies owned by integrated health networks like ours were not provided any points for giving coordinated care to members that cannot be released by insurance industries alone.”
Henry Ford takes issue with the procurement procedure itself and the initial RFP by design, which did not permit for the inclusion of data relating integration.
“We brought this entire up on request, but clearly were not victorious,” Lassiter claimed. “We are immensely disappointed in the decision of state. We consider this is a large disservice to the 88,000 HAP Midwest members whose healthcare will soon be disturbed with no considerable reason. HAP Midwest has had an exemplary record of facility to its members for the last thirty-five years. We are thinking about every present option because we sustained devoted to serving this population.”
The refusal of state means the loss of $500 million of HAP Midwest revenue, in accordance to CFO Ed Chadwick.
While the decision of state will clearly have an effect, he stated, Henry Ford Health System has been having a powerful financial year and is well-positioned moving forward.
“The latest announcements relating to Allegiance Health joining our health network and previous week’s definitive settlement between HAP and Flint-based HealthPlus to merge are significant strategic measures,” Chadwick stated. “The inclusion of HealthPlus with $410 million of revenue and Allegiance with $500 million of revenue, coupled with the loss of $500 million of HAP Midwest revenue, means Henry Ford Health System will increase from being a $5 billion purposed health network to a $5.5 billion system in the year 2016.”
Henry Ford bought HAP Midwest in the year 2011. HAP Midwest will not close. There is yet a contract for Region Six and an agreement with the state and the Centers for Medicare and Medicaid Services (CMS) to insure dual-eligibles, in accordance to the health network.
Although the 88,000 HAP Midwest Medicaid members will have very minor time to discover a new policy by the state’s fast-approaching January 1 target-time.
“We are working on various chances to reduce the affect on our members as well as our 150 HAP Midwest workers,” in accordance to a statement from Henry Ford.
Henry Ford Health System has a huge integrated contributor network, involving 5 hospitals and 1,200 employed physicians.
2 mergers will grow the network’s geographic reach for both contributor and insurance operations.
Henry Ford declared policies to establish a $110 million cancer center as part of a longer term $500 million expansion and neighborhood improvement initial step on 300 acres in Detroit, pointing a key establishment in the city’s revitalization and progress, it stated.
The planned 5-story, 144,000 square-foot cancer center is hoped to open in the season of summer 2018.
On the month of November 9, the Board of the Allegiance Health System voted to go into a non-binding letter of intent to amalgamate into the Henry Ford system. AHS is a 480-bed health network in south central Michigan. The merger, anticipated to be effective January 1, 2016, is hoped to grow HAP’s Medicare Advantage population from over 50,000 to 67,000.
The post HAP Midwest Health Policy may sell rejected places of Medicaid membership appeared first on Healthcare Insurance News.
The post HAP Midwest Health Policy may sell rejected places of Medicaid membership appeared first on Claims Med.