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It has awarded nearly $5 billion in contracts to health plans that pay for and manage the medical needs of about 600,000 people in Minnesota.
The contract awards announced this week by the state Department of Human Services cover primary health insurance programs for low-income state residents outside the metro area.
Minnetonka-based UnitedHealthcare, which became last year The first for-profit HMO To win a contract in public programs, he was among the winners, picking up business in two districts.
Under the deal, Eagan-based Blue Cross and Blue Shield of Minnesota and Minnetonka-based Medica will see even bigger expansions. Bloomington-based HealthPartners, meanwhile, won’t be an option in 22 counties in central and northern Minnesota.
For decades, Minnesota has hired HMOs and county-based purchasing organizations to manage care for enrollees in public programs funded jointly by the state and federal governments. While health plans may make money on the contract, the money is primarily paid for health care services.
Before 2017, State law For-profit HMOs are barred from bidding on contracts.
The latest acquisition covers MinnesotaCare for Families and Children and Prepaid Medical Assistance (PMAP), Minnesota’s largest program for Medicaid beneficiaries, for Minnesota’s 80 counties. Insurance programs provide coverage for low-income Minnesotans.
“These terms were expanded to improve timely and equitable care,” said Human Services Commissioner Jody Harpstead. News release.
The state has awarded contracts to three small public programs to manage care for eligible seniors and adults with disabilities in all states.
Contracts are paid on a county-by-county basis, meaning residents choose from different health plan options depending on which county they live in. Under the new contracts, about 31,000 people in public programs will have to choose a new health plan. Or have one assigned to them.
Other contract winners include: Hennepin Health, Itasca Medical Care, PrimeWest Health, South Country Health Alliance and UCare. All health plans that currently have managed care contracts in public programs will be reinstated in at least one county by 2023.
HealthPartners remains an option in 12 states, but has decided to drop its coverage due to “the uncertainty the pandemic and federal public health emergency have created for the market,” the insurer said in a statement to the Star Tribune.
The Department of Human Services has partnered with county officials to solicit bids, prioritizing how the health plans will be addressed “to address equity, eliminate disparities in health outcomes and meet the needs of rural Minnesotans,” DHS said in a news release.
“For older Minnesotans and adults with disabilities, DHS has prioritized stability and continuity of care by allowing these enrollees to continue with their current health plans,” the department said.
Last year, UnitedHealthcare was among the winning bidders for a contract to manage care for about 700,000 people in the seven-county Twin Cities metro.
In total, managed care contracts in the state’s public programs account for about $8.7 billion in annual spending, providing coverage to 1.3 million residents.
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