Optima Health Announces One Year Results Regarding Medicaid Expansion

VIRGINIA BEACH, Va., Feb. 20, 2020 /PRNewswire/ -- Optima Health anticipated enrolling low-income individuals and families as they became newly eligible for health coverage when Medicaid expansion went into effect at the start of 2019. Now, one year after Medicaid expansion's launch, Optima Health reports a direct increase in membership, as well as other positive member and economic impacts including more in-network providers for Medicaid customers and Optima Health hiring nearly 200 new local employees.

Since Medicaid expansion, Optima Health reports the following for 2019:

• Expanded service into all six regions of Virginia.
• Increased in-network provider base by 15% for Medicaid members.
• Hired 197 new employees in Hampton Roads to accommodate the needs of additional members.
• Enrolled 63,384 newly eligible Medicaid members.
• Referred 1,506 members through the Unite Us platform in Hampton Roads to receive assistance based on social determinants of health screenings. Of those screened, 40% received services, and 38% are in the process of receiving services.

"What these numbers tell us is that Medicaid expansion is working. We're getting quality Optima Health coverage to those who need it, and we're providing economic opportunity to people who are interested in working in healthcare, whether they are skilled clinicians or excel in customer service," said Randy Ricker, vice president for Virginia Medicaid at Optima Health.

Beyond health coverage and job creation, Medicaid expansion provided Optima Health an opportunity to address social determinants of health – the social and behavioral health issues that can impact a Medicaid member's life and health status. Medicaid expansion has empowered caseworkers at Optima Health to better identify these determinants, which encompass conditions in which people are born, grow, live, learn, work, and age – and often impact a wide range of health risks and outcomes.

"Our caseworkers have always seen the greater needs in many of our Medicaid patients lives. We now have the opportunity to provide solutions for them," Traci Massie, Director of Government Programs at Optima Health, said. "By using new screening questions, provided to us by the Department of Medical Assistance Services, we are able to offer a new level of personal attention to members." 

Optima Health also recently partnered with the United Way of South Hampton Roads and Unite Us to tap technology to connect Medicaid members at Optima Health with social service providers for a coordinated care effort.

Massie explained how high-touch care and high-tech solutions can work together for an improved experience for Medicaid members, stating, "When a care manager discovers an Optima Health member is diabetic, for example, and learns that food insecurity is preventing them from getting good nutrition, that has severe consequences for controlling their diabetes. We can use the Unite Us technology to connect the member to a social worker for help getting nutritious food." Massie is quick to add, "All of this, of course, maintains privacy. We only use Unite Us to make these referrals with patient permission."

Optima Health Medicaid options are tailored to address the needs of the community. The plan provides access to:

• Doctor, hospital, and emergency care
• Dental and vision
• Prescription drugs
• Transportation to medical care and pharmacies
• Lab work and X-rays
• Pregnancy and newborn care, including baby showers and incentives up to $75
• Family planning and birth control
• Preventive and wellness services, including immunizations, smoking cessation, and nutrition counseling
• Home health services
• Behavioral health services, including addiction and recovery treatment

For more information about Optima Health Medicaid plans, visit optimahealth.com/Medicaid.

About Optima Health
Optima Health, based in Virginia, provides health insurance coverage to more than 510,000 members. With more than 30 years of experience, Optima Health offers a suite of commercial products including consumer-directed, employee-owned and employer-sponsored plans, individual health plans, employee assistance programs and plans serving Medicare and Medicaid enrollees. Its provider network features approximately 30,000 providers including specialists, primary care physicians and hospitals across Virginia. Optima Health also offers programs to support members with chronic illnesses, customized wellness programs and integrated clinical and behavioral health services, as well as pharmacy management—all to help members improve their health every day. The company's goals are to provide better health, be easy to use and offer services that are a great value. Optima Health is a service of Sentara Healthcare. To learn more about Optima Health, visit www.optimahealth.com

SOURCE Optima Health

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