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Gateway Health Awarded Bids To Provide Medicaid Managed Care In All Pennsylvania Counties

Millions of Pennsylvanians may have easy access to healthcare coverage through Gateway's services and network


News provided by

Gateway Health

Jan 06, 2017, 01:18 ET

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PITTSBURGH, Jan. 6, 2017 /PRNewswire/ -- The Pennsylvania Department of Human Services (DHS) recently announced the results of their evaluation of proposals for the 2017 HealthChoices Medicaid managed care contracts.  As a result, Gateway Health was selected to proceed to contract negotiations in all five HealthChoices zones, which include the Southeast, the Southwest, the Northeast, the Northwest and the Lehigh Capital zones.  The new HealthChoices contract is slated to be effective June 2017 and may give Medicaid eligible residents in all Pennsylvania counties the opportunity to select Gateway Health as their managed care organization (MCO).

In the fall of 2015, DHS originally issued bids for the new HealthChoices contracts with the intent for the new contact year to begin on January 1, 2017.  After a rebid was issued in the fall of 2016, health plans that resubmitted proposals were notified of the rescoring results and bids were awarded late last year. Pending readiness review and agreement negotiations, the new contracts will expand Gateway's footprint to serve residents Commonwealth-wide, which total approximately 1,600,000 Medicaid recipients. Formerly, Gateway provided healthcare coverage in the Southwest, Northwest and Lehigh Capital zones.  The Pennsylvania HealthChoices zones are comprised of the following counties:

  • Southeast Zone - Bucks, Chester, Delaware, Montgomery and Philadelphia counties
  • Southwest Zone - Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Green, Indiana, Lawrence, Somerset, Washington and Westmoreland counties
  • Lehigh/Capital Zone - Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York counties
  • Northwest Zone - Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango and Warren counties
  • Northeast Zone - Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne and Wyoming counties

"Gateway Health is overwhelmingly pleased with the decision by DHS to grant us the potential to provide services to Medicaid eligible consumers in all HealthChoices zones. We intend to work diligently with DHS through the agreement negotiation and readiness review phases to show how our organization and our provider network can provide unrivaled access and quality healthcare to all Medicaid recipients, said Patti Darnley, President and CEO, Gateway Health. "As one of the State's original Medicaid MCOs, we feel particularly well-equipped to provide outstanding and responsive care to this vulnerable and deserving population.  Our belief is that the health and wellness of Pennsylvania is directly tied to the health and wellness of its residents and our mission is to see that both remain as healthy as possible."

In addition to being scored on quality, community outreach and clinical outcomes, Gateway's proposal also included their plans for utilizing Small Diverse Businesses (SDBs) in their operations.  As a Pennsylvania based not-for-profit business, Gateway Health is proud to support Pennsylvania SDBs as an indication of their commitment to the responsible stewardship of state tax dollars.   Without the need to answer to shareholders, Gateway places a strong emphasis on reinvesting this money back into the Commonwealth and its residents.

About Gateway Health 
Gateway Health is a nationally ranked managed care organization that focuses on providing the best possible healthcare to a growing number of Medicaid and Medicare Advantage consumers. A not-for-profit organization, Gateway Health serves the needs of at risk and vulnerable citizens with not only healthcare coverage, but services such as disease management, health and wellness programs and preventive care. The organization provides Medicaid services in Pennsylvania, Delaware and West Virginia and Medicare coverage in Pennsylvania, Kentucky, Ohio and North Carolina. Our commitment to helping our members and their communities get and stay healthy is what keeps members, providers, communities and partners "Good with Gateway." To learn more about Gateway Health, visit us online at www.gatewayhealthplan.com.

SOURCE Gateway Health

Related Links

http://www.gatewayhealthplan.com

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