OPEN MINDS Releases Updated Suite Of West Virginia Medicaid Market Intelligence Resources

Gettysburg, Pa. (May 12, 2019) – OPEN MINDS has released an updated suite of Medicaid market intelligence resources on the state of West Virginia. The resources include analysis of the West Virginia’s Medicaid system, Medicaid managed care vendor contracts, and additional state-specific information.

West Virginia’s Medicaid managed care program is called Mountain Health Trust. Four health plans deliver physical health and behavioral health benefits for most populations including families and children, Medicaid expansion adults, and disabled adults. There are four health plans that provide benefits statewide. Enrollees have their choice of plans.

For each of the health plans, the same model contract document is used to govern the four plans. Model contracts, as well as the signature documentation, for the four health plans are available for download:

• Aetna Better Health of West Virginia
• Health Plan of the Upper Ohio Valley
• UniCare Health Plan
• West Virginia Family Health – Beacon

West Virginia awarded a fifth health plan in 2016—CareSource—a Medicaid contract. However, it is not currently operating.

The managed care contract includes a requirement for the health plans to have at least 10% of members in alternative payment arrangements in state fiscal year 2019. The state plans to increase that percentage in the future. Alternative payment arrangements include: primary care incentives; payment for performance; shared savings arrangements; risk sharing arrangements; episodes of care/bundled payments; and capitation payments with performance and quality requirements.

The West Virginia 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 West Virginia state health system:

• West Virginia 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.
• West Virginia 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.
• West Virginia 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.
• West Virginia 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 West Virginia 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 West Virginia-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.

For additional questions and inquiries, please contact Sarah C. Threnhauser, Executive Vice President, OPEN MINDS at 717-334-1329 or events@openminds.com.

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