Managed Care

New Hampshire is switching from a fee-for-service Medicaid system to managed care, which emphasizes preventive care and is expected to save the state money.

Managed care will be introduced in two stages:

    • The first will cover most Medicaid enrollees and
    • The second, a year later, will cover long-term care services.

Three companies received contracts worth $2.2 billion over three years to run the managed care system.

    • Well Sense Health Plan
    • NH Healthy Families
    • Meridian Health Plan

The first stage was delayed in part because providers balked at signing up, citing concerns including reimbursement rates.

    • Under the state budget, a hospital can only receive uncompensated care payments (to defray the cost of providing charity care to uninsured and low-income residents) from the state if it participates in the Medicaid managed care system.
    • As of 7/2/13 all of the state’s hospitals had either signed up for the program or agreed to do so.

The state budget assumes managed care will save the state $47.5 million over the next two years, with $24.4 million coming in the second year of the biennium from the second stage of managed care, which will cover long-term care services.

Enrollment Call Center: 1-800-901-4999

Key Questions to Consider in Implementing Medicaid Managed Care in New Hampshire (NH Fiscal Policy Institute)

Know Your Rights: NH Disabilities Rights Center

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