Healthcare for Pennsylvanians when it's needed
A Look At the Numbers provides information on how managed care organizations (MCOs) partner with Pennsylvania to serve the healthcare needs of the clinically and most economically challenged Pennsylvanians.
Medicaid managed care enables Pennsylvania to deliver a higher standard of healthcare, improve health outcomes of Medicaid recipients, and manage healthcare costs.
The care people need, when they need it. That is the model of managed care.
Medicaid in Pennsylvania
HealthChoices is the name of Pennsylvania’s managed care program, which serves the healthcare needs of the clinically and most economically challenged Pennsylvanians.
Program history
Serving Pennsylvania since 1972
MCOs have worked with the commonwealth of Pennsylvania for decades, helping to deliver a higher standard of healthcare to millions of Pennsylvanians.
Improved population health
MCOs in Pennsylvania integrate behavioral and physical health services to address the holistic needs of a person to ensure they are healthy.
In Pennsylvania, MCOs are addressing the opioid crisis by coordinating care and working with providers on prescribing practices as well as introducing safety measures to curb the abuse of opioids among Medicaid enrollees.8
Citations
1 https://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/managed-care/downloads/pennsylvania-mcp.pdf
2 https://www.kff.org/medicaid/fact-sheet/medicaid-expansion-in-pennsylvania/
3 https://www.dhs.pa.gov/providers/Providers/Documents/Managed Care Enrollment Information/2019 Dec Enrollment Report.pdf
4 http://files.kff.org/attachment/fact-sheet-medicaid-state-PA
5 http://www.lewin.com/content/dam/Lewin/Resources/Site_Sections/Publications/MedicaidSavingsPAHealthChoices.pdf
6 https://data.pa.gov/stories/s/c523-smgb
7 HEDIS, 2012 & 2018
8 ttps://www.governor.pa.gov/newsroom/pennsylvania-tightens-medication-rules-to-help-combat-opioid-crisis/
9 http://www.healthchoices.pa.gov/cs/groups/webcontent/documents/document/c_273530.pdf
A Look At The Numbers is an educational resource about Medicaid managed care, hosted and supported by Medicaid Health Plans of America, in collaboration with other Medicaid managed care organizations and state health plan associations.