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HealthBeat

Managed care companies begin enrolling New Hampshire Medicaid clients

New Hampshire’s move to managed care for Medicaid has been years in the making, and today, officials with the program will begin mailing information to tens of thousands of clients, outlining their choices.

Medicaid clients have until Nov. 10 to choose one of three companies – Well Sense, Centene or Meridian. The new plans will be effective Dec. 1.

The state will pay each company a certain amount for each member on their plans, which means the next two months are a crucial marketing time.

But there are strict federal limits on what the companies can and can’t do to attract customers. No cold-calling, to start, and no give-aways, unless they’re tied to wellness initiatives for which clients can be eligible, said Patrick McGowan, an account manager with the Department of Health and Human Services.

“It’s not an incentive for selecting them, but it can be part of a plan they offer, a support for a wellness initiative that a person can be eligible for,” he said. “It can’t be, ‘Here’s your enrollment package and your cell phone and your ticket to Jamaica.’ ”

Some initiatives he’s seen have included infant car seats and cell phones for people with no other way to contact their doctor’s office, he said.

New Hampshire Healthy Families, the plan offered by Centene, offers some members a debit card for which they can earn money for health care needs like over-the-counter drugs through healthy behaviors like going to a check-up, said plan President Jay Gonzalez.

There won’t be any major TV ad purchases, but plan representatives will attend community events and potential members might receive information in the mail, Gonzalez said. Representatives from Well Sense and Meridian didn’t return requests for comment.

Some people on Medicaid can opt out of managed care: children in foster care, children with special health care needs, home care for children with severe disabilities, children who receive supplemental security income (SSI) from the Social Security system, or people who are eligible for both Medicaid and Medicare, said Carol Sideris, director for the state Division of Client Services.

If they don’t tell the department they want to opt out of managed care, and if the roughly 130,000 clients in other categories don’t choose a plan by the deadline, Nov. 10, they’ll be assigned to a plan by a computer algorithm that will consider whether their family members have signed up for a particular plan, or which plan network includes their current provider, McGowan said.

McGowan is also the typist behind Health and Human Services’ newest Twitter account, @NHMedicaidCM. He tweeted daily all of last week.

The department has also set up a website, dhhs.nh.gov/ombp/caremgt/index.htm, where clients can view the three companies’ plans side-by-side, or search a provider directory to find out which plan will include their current doctor or doctors in their region.

Clients who receive email updates instead of paper forms were notified of the enrollment period last Wednesday, and by the end of the day Thursday, nearly 400 people had chosen a new plan, said Health and Human Services Commissioner Nick Toumpas.

New Hampshire is the 48th state to enact a managed care program for Medicaid. Alaska and Wyoming are the only states that have not moved any of their Medicaid programs to managed care, but New Hampshire’s program, when fully enacted in 2015, is expected to be one of the most sweeping.

Last year, state officials agreed to pay the three companies $2.2 billion over three years to run the managed care system, anticipating savings of more than $45 million in the current biennial budget.

(Sarah Palermo can be reached at 369-3322 or
spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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