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My Turn: For Medicaid patients, a transition is under way

The New Hampshire Department of Health and Human Services recently launched the start of open enrollment for the state’s new Medicaid Care Management program. By now, we expect that all Medicaid beneficiaries have been notified about their status for managed care – be it mandatory, voluntary or exempt – and open enrollment is be fully under way.

If mandatory or voluntary, beneficiaries will receive information about each health plan and how to make a decision about which one to choose. Most important, people do not need to rush into a decision! Everyone will have at least 60 days to decide.

Health plan provider networks are very fluid at this time, as more providers who complete credentialing are added to networks on a daily basis. Some hospitals and their affiliated physicians have completed the necessary steps to be listed on the provider directory, but others have not. The process can be time-consuming, especially for large institutions. No one should conclude that the network is inadequate or that the health plans aren’t ready to “go live” simply because a provider isn’t listed on the directory yet. It is being updated daily.

We are happy to see the tremendous interest in the current status of the networks and the enrollment traffic that has already occurred. That said, there is a 60-day open enrollment period and no need to rush to enroll. For those who wish to enroll now, there is the option of calling each plan for the most up-to-the-minute status of a certain provider. The other option is to call our call center to review the health plan provider directories and make a plan selection. That toll free number is: 888-901-4999. We will also post a table of all New Hampshire hospitals with their status on our Care Management web page. This will be updated weekly. That information may be found at dhhs.nh.gov/ombp/caremgt/index.htm.

Over the past year and a half we have come to know the health plans well, and this has buoyed our confidence that the move to Medicaid Care Management is an excellent choice. Through our partnership with the health plans, the Department of Health and Human Services expands its ability to coordinate care across the spectrum, increases its focus on quality care and quality improvement, and increases its ability to ensure Medicaid beneficiaries receive the right care, at the right time, in the right place. The immediate transition period will feel disruptive to some since even positive change can prove stressful. We remain committed to making the transition as easy and smooth as possible for Medicaid beneficiaries and their families and providers.

(Nick Toumpas is commissioner of the New Hampshire Department of Health and Human Services.)

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