Approximately 67,000 Mississippi children currently enrolled in the Children’s Health Insurance Program (CHIP) administered by the state division of Medicaid will transfer to coverage provided by UnitedHealthcare of Mississippi. Blue Cross Blue Shield held the contract for nearly a decade before it was awarded to UHC earlier this year.
The state Legislature’s Performance Evaluation and Expenditure Review Committee recommended the administration shop the CHIP program around in an effort to find cost savings.
According to a PEER report, CHIP cost about $605 million, most of which was paid for with federal money. From January 2004 to June 2008, the program cost the state about $100 million.
Norine Yukon, executive director for UHC of Mississippi, said taxpayers won’t pay more for the program despite the switch.
“This particular contract is the largest CHIP contract in the country,” she said. “We offer quality care that is cost effective and we have fully credentialed physicians who have undergone rigorous background checks.”
The contract with UHC is for four years with an option by the state to renew for a fifth year. It also calls for increases in premiums paid by the state to be capped at 4 percent for the first two years, although the state does have an early termination clause in the contract if the board determines the premium increases are excessive.
The company will offer all eligible children access to a healthcare provider network that includes 133 hospitals and more than 9,600 healthcare professionals, including federally qualified health centers and rural health clinics. In addition to health promotion, services under the CHIP program will include medical and dental care, prescription medications and a 24-hour nurse line.
UHC officials say the program will be proactive in the community.
“We are reaching out to members, physicians and healthcare professionals and community-based organizations to promote well-child checks, vaccinations and dental and vision screening,” said Joseph Blackston, M.D., medical director of UHC of Mississippi. “In addition, we will have disease management programs for children with conditions such as asthma and diabetes.”
Children ages 18 years and younger qualify for CHIP coverage based on annual family income and age. Enrollment is through the Division of Medicaid, which determines eligibility. Once a child is determined to be eligible for CHIP, coverage is effective for a 12-month period or until a child attains age 19, moves out of state or acquires other creditable coverage.
There are no exclusions for pre-existing conditions.
UHC of Mississippi is affiliated with AmeriChoice, the nation’s largest managed health care company serving low-income individuals in the public sector. AmeriChoice currently serves more than 2.8 million beneficiaries of government healthcare programs in 25 states and the District of Columbia.
“We are pleased to have been awarded the opportunity and responsibility to help enhance the health and well-being of Mississippi’s children,” said Rick Jelinek, CEO of AmeriChoice. “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.”