Gettysburg, Pa, May 20, 2019 (GLOBE NEWSWIRE) -- OPEN MINDS has released an updated suite of Medicaid market intelligence resources on the state of South Carolina. The resources include analysis of the South Carolina’s Medicaid system, Medicaid managed care vendor contracts, and additional state-specific information.
South Carolina’s Medicaid managed care program is called Healthy Connections Choices. Five health plans deliver physical health and behavioral health benefits to most populations, including families and children, as well as aged and disabled adults. The five health plans are available statewide, and individuals have a choice of plan.
Contracts for the five health plans are available for download:
- Absolute Total Care – Cenpatico
- First Choice by Select Health
- Healthy Blue – BlueChoice HealthPlan of SC, Inc.
- Molina Healthcare of South Carolina
- WellCare
The state withholds 1.5% of the health plan’s capitation rate, which is returned if performance on a subset of HEDIS measures is met. The state is exploring adding behavioral health measures to the measures effected by the withhold. These measures include seven-day follow-up after hospitalization for mental illness, antidepressant medication management, initiation of drug and alcohol treatment, metabolic monitoring for children on antipsychotics, and follow-up care for children prescribed ADHD medication.
30% of payments each year of the contract from 2018-2021 must be made through alternative payment models such as pay-for-performance, episodes of care, gainsharing arrangements, and capitation. Failure to meet these thresholds will result in loss of 25% of the withhold amount.
The South Carolina Medicaid Managed Care Contracts are available now for all Elite OPEN MINDS Circle members. Individual contracts may be purchased in the OPEN MINDS shop for $1,500 each.
Additionally, the OPEN MINDS team has four in-depth profiles of the South Carolina state health system:
- South Carolina Health Care System Landscape: An OPEN MINDS State Profile, which provides information on each state’s largest health plans, Medicaid expansion policy, health insurance marketplace plans, demographics, population health insurance coverage by payer, and more.
- South Carolina Medicaid System: An OPEN MINDS State Profile, which provides a detailed exploration of each state’s Medicaid financing system, including a review of the managed care financing systems, largest health plans by enrollment, key players in the state Medicaid department, and plans for future system changes and contract reprocurements.
- South Carolina Behavioral Health System State Profile Report, which provides a comprehensive listing of behavioral health benefits in the state, care coordination programs related to behavioral health, and behavioral health subcontractors for health plans.
- South Carolina Medicaid/Medicare Dual Eligible System: An OPEN MINDS State Profile, which provides an overview of each state’s dual eligible financing system, as well as the largest Medicare health plans serving dual eligibles and details on new initiatives involving the dual eligible population.
The South Carolina suite of state profiles is now available now for the Elite OPEN MINDS Circle members. In addition, the OPEN MINDS team has a wealth of additional South Carolina-specific resources. A monthly OPEN MINDS market intelligence update is available to all health and human services executives. To sign up, OPEN MINDS Circle members should set their email preferences under the My Account Settings.
All of these resources, and more, are available as part of an OPEN MINDS Circle Elite membership. Membership includes unlimited organizational access to all OPEN MINDS content and databases, plus executive education events, and other exclusive Elite member benefits. Learn more about becoming an Elite OPEN MINDS Circle member online at www.openminds.com/elite.
ABOUT OPEN MINDS
OPEN MINDS is an award-winning information source, executive education provider, and business solutions firm specializing in the domains of health and human services serving consumers with chronic conditions and complex support needs. For thirty years, we’ve been pioneers for change – helping organizations implement the transformational business practices they need to succeed in an evolving market with new reimbursement, competition, policies and regulations.
OPEN MINDS is powered by a national team of experienced executives and subject matter experts with specific expertise and experience in nine key market areas – mental health, addictions, chronic conditions, autism and intellectual/developmental disabilities, long-term care, children’s services, social services, juvenile justice, and corrections health care. Our mission is to improve the quality of care for consumers with complex support needs by improving the effectiveness of those serving them – provider organizations, payer and insurance organizations, government agencies, pharmaceutical organizations, and technology firms. Learn more at www.openminds.com