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Great Lakes Wire

Wednesday, December 11, 2024

Michigan updates health plan contracts for new dual eligible benefit program

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Jean Ingersoll Chief Administrative Officer | Michigan Department of Health & Human Services Website

Jean Ingersoll Chief Administrative Officer | Michigan Department of Health & Human Services Website

The Michigan Department of Health and Human Services (MDHHS) has revised contract awards for nine health plans to implement a new benefit plan, MI Coordinated Health. This program is set to begin on January 1, 2026.

The updated award recommendations reflect changes in regional assignments for the health plans. The announcement follows the reopening of the original Request for Proposal (RFP), allowing bidders to amend their initial proposals based on updated guidelines. These modified proposals were submitted by November 21.

MI Coordinated Health will initially be available in select counties to individuals enrolled in both Medicare and Medicaid, with a statewide expansion planned for 2027. It succeeds the MI Health Link program, which concludes on December 31, 2025. Current enrollees of MI Health Link can transition to MI Coordinated Health without any coverage interruption.

Nine health plans have been chosen to manage the benefits under this program for seven-year contracts that include three optional one-year extensions. Contracts are awarded based on Michigan's ten Prosperity Regions, with specific adjustments made for regions like Detroit Metro and Barry County due to historical service areas.

Regions included in the January 1, 2026 launch are:

- Region 1 – Upper Peninsula Prosperity Alliance: Upper Peninsula Health Plan, LLC.

- Region 8 – Southwest Prosperity Region: Aetna Better Health of Michigan Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan, Inc., Priority Health Choice, Inc., UnitedHealthcare Community Plan, Inc.

- Region 10 – Detroit Metro Prosperity Region– Macomb and Wayne: Aetna Better Health of Michigan Inc., AmeriHealth Michigan, Inc., HAP CareSource, Humana Medical Plan of Michigan, Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan, Inc., Priority Health Choice, Inc., UnitedHealthcare Community Plan, Inc.

Regions scheduled for inclusion from January 1, 2027 are:

- Region 2 – Northwest Prosperity Region: Humana Medical Plan of Michigan, Inc.; Meridian Health Plan of Michigan; Molina Healthcare; Priority Health Choice; UnitedHealthcare Community Plan.

- Region 3 – Northeast Prosperity Region: Humana Medical Plan; Meridian Health Plan; Molina Healthcare; Priority Health Choice; UnitedHealthcare Community Plan.

- Other regions follow similar assignments involving combinations of Aetna Better Health and other providers.

MI Coordinated Health stems from insights gained from the MI Health Link program combined with comprehensive stakeholder feedback since 2022. This process involved surveys and input from beneficiaries as well as advocates and providers.

The program focuses on five main pillars: fostering integration and continuity; reducing racial disparities; improving care delivery; promoting self-determination; and building a culture of quality.

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