UPMC for You Expands Its Service Area as HealthChoices Grows

PITTSBURGH, July 2, 2012 /PRNewswire/ -- UPMC for You will be available in six additional counties beginning July 1, 2012, and then in 10 more counties beginning Sept. 1, 2012, as part of an expansion of HealthChoices, Pennsylvania's innovative Medical Assistance managed care program.

UPMC for You – the award-winning Medical Assistance program of Pittsburgh-based UPMC Health Plan – has been approved by Pennsylvania's Department of Public Welfare (DPW) to provide coverage for quality medical care services to Medical Assistance recipients living in those counties.  UPMC for You is currently a DPW-approved managed care organization (MCO) provider for HealthChoices in 24 counties throughout the state.  

"We at UPMC for You are honored to be chosen as a mandatory managed care program in these counties," said John G. Lovelace, President of UPMC for You.  "Our record of quality and service makes us well qualified to help meet the state's intended goal with HealthChoices – to improve access and quality for Medical Assistance recipients, while also controlling costs."

Beginning July 1, UPMC for You will be available in these six additional counties: Blair, Cambria, Franklin, Fulton, Huntington, and Somerset counties.  At that time, Bedford County, where UPMC for You is already available as a voluntary option, will become a mandatory HealthChoices county as well.

Beginning Sept. 1, UPMC for You will be available in these 10 counties in northwest Pennsylvania: Cameron, Clarion, Elk, Erie, Forest, Jefferson, McKean, Potter, Venango, and Warren.  At that time, three northwest counties where UPMC for You is already available as a voluntary option – Clearfield, Crawford, and Mercer – will become mandatory HealthChoices counties as well.  

UPMC for You has been the top-ranked Medical Assistance program in Pennsylvania by the National Committee for Quality Assurance (NCQA) for seven of the past eight years. It is both the largest and the fastest-growing Medical Assistance program in Southwest Pennsylvania.

HealthChoices was developed by DPW to help Medical Assistance recipients receive health care in Pennsylvania.  The program mandates that all recipients receive health care coverage through MCOs. Recipients are free to pick their own MCO and primary care practitioner from the group of MCOs selected to participate in HealthChoices in the county where they live. HealthChoices replaces Pennsylvania's ACCESS Plus program. 

By the end of 2012, HealthChoices will be available to Medical Assistance recipients throughout the state.  It has been estimated that this expansion will save the state $375 million in health care costs over the next four years. According to a study by the Lewin Group, over the last 11 years, HealthChoices has saved the state and federal government $5.9 billion in Medicaid funds.   

UPMC for You is currently a HealthChoices MCO in the following southwest Pennsylvania counties: Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence, Washington, and Westmoreland.  UPMC for You is currently a HealthChoices MCO in the following counties in the Lehigh Capital region: Adams, Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton, Perry, and York.  

About UPMC Health Plan

UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, one of the nation's top-ranked health systems. The integrated partner companies of the UPMC Insurance Services Division – which includes UPMC Health Plan, UPMC WorkPartners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health – offer a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to nearly 1.8 million members. Our local provider network includes UPMC as well as community providers, totaling more than 125 hospitals and more than 11,500 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland. For more information, visit www.upmchealthplan.com.

SOURCE UPMC Health Plan