Unitedhealthcare Takes Over Mississippi Chip

UnitedHealthcare kicked off the New Year with a new contract.

The Mississippi Department of Finance and Administration (DFA) contracted with UnitedHealthcare—the nation’s largest managed healthcare company serving low-income individuals in the public sector—to manage the Mississippi Division of Medicaid (DOM)-administered Mississippi Children’s Health Insurance Program (CHIP) for four years, with an option by the state to renew for a fifth year.

On Jan. 1, some 67,000 children enrolled in the program transferred to UnitedHealthcare of Mississippi, which has a healthcare provider network of 133 hospitals and nearly 10,000 healthcare professionals, including Federally Qualified Health Centers and rural health clinics. Blue Cross Blue Shield of Mississippi had serviced the program for nearly a decade.

“We won the contract in an open bid process,” said Joseph W. Blackston, MD, JD, medical director for UnitedHealthcare of Mississippi. “We proposed a plan to the State with a proactive approach involving disease management programs for children with conditions such as asthma and diabetes, risk management, a large array of inpatient and outpatient services, and patient and physician outreach.”

UnitedHealthcare, a Minnesota-based company affiliated with AmeriChoice—serving nearly 3 million beneficiaries of government healthcare programs in 25 states, will also emphasize wellness and health promotion programs.

“We’re pleased to have been awarded the opportunity and responsibility to help enhance the health and well-being of Mississippi’s children,” said AmeriChoice CEO Rick Jelinek. “Our wellness programs in other states have not only enhanced individuals’ health, but also conserved public healthcare resources, a record we hope to duplicate in Mississippi.”

Jelinek pointed to UnitedHealth Group’s UnitedHealth HEROES, a grant program initiated in 2008 to address childhood obesity in schools and youth-focused community organizations. Mississippi is one of 34 states with programs that recently received grants for demonstrating a clear understanding of the health risks associated with childhood obesity; proposing creative solutions to combating obesity in their schools and communities; and easily implementing, scaling and measuring them.

“With UnitedHealth HEROES, we’re helping young people take action to improve their overall health and quality of life in a way that’s not only educational, but beneficial for their communities,” said Daniel Johnson, vice president of UnitedHealth Group. “We believe that as people become more aware of health issues through health literacy and advocacy initiatives, they’ll make positive changes to live better lives.”

According to the Centers for Disease Control and Prevention, one of three young people is obese, and two of the three have at least one avoidable risk for heart disease.

“Childhood obesity is one of the greatest health issues facing children and youth in the U.S.,” said Steve Culbertson, CEO of Youth Services of America (YSA), which is collaborating with UnitedHealth HEROES for the grant program’s second year. “UnitedHealth HEROES provides young people the rare, but important, responsibility to seek solutions to this epidemic, and I’m thrilled to see the innovative ideas used to educate and engage their peers.”

The new contract came a year after the Legislature’s Performance Evaluation and Expenditure Review (PEER) Committee suggested the DFA shop around for a less expensive plan. Depending on CHIP usage, the new contract may not cost less.

“The whole purpose is not necessarily to do things more cheaply, but to provide all the services needed,” said Blackston. “Through health education and case management, we believe we can promote the concept of a medical home and thereby reduce unnecessary emergency room and hospital use.” Blackston emphasized that Mississippi CHIP benefits haven’t changed. “It’s more about who’s administering the program, and what services might require prior authorization,” he said. “An example is that DME items under $500 no longer require prior authorization. If there will be more than six visits, prior authorization isn’t required for physical therapy, occupational therapy, or speech therapy.”  

Blackston was selected to lead the Mississippi program based on his deep roots in the state. An Oxford native, he graduated from Ole Miss and the University of Mississippi School of Medicine, and completed his internship at the Baptist Memorial Hospital-Memphis and residency at Tulane Medical Center in New Orleans. A board-certified internist on staff at Central Mississippi Medical Center in the Emergency Department, Blackston is also an attorney. He earned a law degree from the University of Mississippi, and teaches at the University of Mississippi Medical Center and the Mississippi College School of Law. He also serves on the Disability Appeals Committee of the Mississippi Public Employees Retirement System (PERS).

“Mississippians are handling every component of CHIP,” said Blackston, “plus we have the support of a large organization, technology at our fingertips, and Mississippians dedicated to our state’s CHIP members.”

Source by Health Insurance

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