Introduction
Michigan has made a significant move in healthcare by awarding contracts to nine health plans for managing Medicaid programs specifically aimed at individuals who are dually eligible for both Medicare and Medicaid. These plans, part of the state’s newly developed MI Coordinated Health benefit, are set to provide improved, coordinated care for some of Michigan’s most vulnerable residents. In this article, we will explore the details of these contracts, the involved payers, and the expected benefits of the MI Coordinated Health plan.
Overview of Michigan’s New Medicaid-Medicare Contracts
On October 9, 2024, the Michigan Department of Health and Human Services (MDHHS) announced the awarding of contracts to nine major health insurers to manage the state’s Medicaid-Medicare program. This marks a significant shift toward more integrated and efficient care for those eligible for both Medicaid and Medicare benefits. Known as the MI Coordinated Health program, this initiative aims to simplify access to healthcare services for dual-eligible beneficiaries while offering comprehensive care management.
The selected health plans will help facilitate care for individuals who often face more complex healthcare needs and have historically dealt with fragmented services between the Medicaid and Medicare programs.
The Launch of MI Coordinated Health
The MI Coordinated Health program is scheduled to launch in January 2026, initially in select counties. Following the initial rollout, the program will expand statewide by 2027, providing dual-eligible beneficiaries across Michigan with a new, more streamlined healthcare experience. The program is designed to provide seamless coverage and coordinated care by aligning Medicaid and Medicare benefits under one unified plan. This ensures that beneficiaries no longer need to navigate two separate systems, making it easier for them to receive the care they need.
The new model is expected to offer several advantages, such as improved access to medical services, reduced paperwork, and better communication between healthcare providers, leading to more personalized care for each patient.
The Nine Health Plans Awarded Contracts
Here is a detailed overview of the nine payers that have been awarded contracts to manage the MI Coordinated Health benefit program:
Upper Peninsula Health Plan
Serving the Upper Peninsula, this health plan focuses on providing high-quality, locally managed care for Michigan residents. The Upper Peninsula Health Plan will play a crucial role in ensuring that individuals in this region receive accessible and coordinated healthcare.
Aetna Better Health of Michigan
Aetna, a well-known insurer, brings its experience in managing Medicare and Medicaid programs to the MI Coordinated Health plan. Aetna Better Health of Michigan aims to offer a comprehensive approach to care management, focusing on preventive care, chronic disease management, and improved outcomes for dually eligible individuals.
Meridian Health Plan of Michigan (Centene)
Meridian Health Plan, a subsidiary of Centene, is one of the largest Medicaid health plans in Michigan. Known for its integrated approach to healthcare, Meridian will work to offer dual-eligible beneficiaries a seamless care experience by aligning Medicaid and Medicare services under one roof.
Molina Healthcare of Michigan
Molina Healthcare has a strong history of managing Medicaid and Medicare programs across the United States. Molina Healthcare of Michigan will provide the MI Coordinated Health plan with a wide range of services, including preventive care, specialty care, and support services for dual-eligible beneficiaries.
UnitedHealthcare Community Plan
As one of the largest healthcare providers in the U.S., UnitedHealthcare Community Plan will contribute its vast resources and experience to Michigan’s new program. UnitedHealthcare is well-positioned to ensure that dually eligible individuals receive quality care, with an emphasis on personalized care coordination.
HAP CareSource
HAP CareSource is a trusted name in the Michigan healthcare market, providing managed care solutions for Medicaid recipients. Their involvement in the MI Coordinated Health program will help ensure that dual-eligible individuals have access to a comprehensive range of healthcare services.
AmeriHealth Michigan
AmeriHealth Michigan, a leading Medicaid managed care organization, will use its expertise to provide high-quality care for dual-eligible beneficiaries. AmeriHealth is committed to enhancing care coordination and ensuring better health outcomes through the MI Coordinated Health program.
Priority Health Choice
Priority Health Choice, based in Michigan, is a major player in the state’s health insurance market. With its focus on care coordination and innovative health solutions, Priority Health Choice will play a key role in delivering seamless services to dual-eligible beneficiaries.
Humana Medical Plan of Michigan
Humana, a national leader in Medicare services, will bring its robust expertise to Michigan’s MI Coordinated Health program. Humana Medical Plan of Michigan will focus on integrating Medicare and Medicaid services to offer a streamlined healthcare experience for dual-eligible beneficiaries.
Impact on Medicaid and Medicare Beneficiaries
The MI Coordinated Health program is expected to have a transformative impact on Michigan’s dual-eligible population. By unifying Medicaid and Medicare services, beneficiaries will experience improved access to healthcare, better care coordination, and fewer administrative hurdles. This initiative is particularly beneficial for individuals with chronic health conditions, who often require multiple services from different providers. With MI Coordinated Health, patients can expect a more holistic approach to their care, leading to improved outcomes and quality of life.
Additionally, the program’s focus on preventive care will help reduce avoidable hospitalizations and emergency room visits, further enhancing its value to the healthcare system.
Future Expansion and Statewide Implementation
While the MI Coordinated Health program will start in select counties in January 2026, its full statewide rollout is planned for 2027. This phased approach allows for a more controlled implementation, ensuring that potential challenges are addressed early on. The expansion will allow dual-eligible beneficiaries across the state to benefit from the new program, regardless of where they live.
The MDHHS has stated its commitment to working closely with health plans to ensure the program’s success and to make any necessary adjustments during the initial rollout phase.
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FAQs
1. What is the MI Coordinated Health program?
A. The MI Coordinated Health program is a new Medicaid-Medicare benefit designed to provide integrated and coordinated care to Michigan residents who are dually eligible for both Medicaid and Medicare.
2. When will MI Coordinated Health launch?
A. The program will begin in select counties in January 2026, with statewide expansion planned for 2027.
3. Which insurers have been awarded contracts for the program?
A. Nine insurers, including Upper Peninsula Health Plan, Aetna Better Health of Michigan, Meridian Health Plan (Centene), Molina Healthcare, and others, have been awarded contracts.
4. How will this program benefit Medicaid-Medicare beneficiaries?
A. The MI Coordinated Health program will streamline access to healthcare, improve care coordination, and offer comprehensive medical services for dual-eligible individuals.