UPMC for You Scores Impressive Membership Gains in Northwest Pa.

Beginning Oct. 1, 2012, Medical Assistance recipients in 13 northwest Pennsylvania counties were able to select from four available managed care organizations (MCOs) as part of an expansion of HealthChoices, Pennsylvania's mandatory Medical Assistance program. Of the more than 37,000 new eligible recipients who actively selected among the four MCOs, 71 percent chose UPMC for You.  

In addition, over 99 percent of UPMC for You's existing members in northwest Pennsylvania chose to stay with UPMC for You during this open enrollment period. The 13-county region is now known as the "New West" region.    

"UPMC for You is a name that is becoming increasingly familiar to people in northwest Pennsylvania," said John Lovelace, President of UPMC for You, the Medical Assistance MCO of Pittsburgh-based UPMC Health Plan. "They know our outstanding record for quality and for service in this region."

UPMC for You is the highest ranked Medical Assistance health plan in Pennsylvania for 2012, as rated by the National Committee on Quality Assurance (NCQA).  UPMC for You has been No. 1 in Pennsylvania for eight of the nine years that the NCQA has ranked Medicaid plans.

In October, UPMC for You's service area in northwest Pennsylvania grew from three to 13 counties, as part of an expansion of HealthChoices. The New West region consists of Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango and Warren counties. 

HealthChoices mandates that most Medical Assistance recipients receive health care coverage through MCOs.  Recipients are free to pick their own MCO and primary care practitioner (PCP) from the group of MCOs selected to participate in HealthChoices in the county where they live.  If recipients do not choose a MCO, one is automatically assigned to them.

UPMC for You was one of four MCOs approved by Pennsylvania's Department of Public Welfare (DPW) to provide coverage for quality medical care and all appropriate physical health services to Medical Assistance recipients living in New West counties.

The total number of UPMC for You members in northwest Pennsylvania (including those who were automatically assigned), exceeds 54,000, which represents more than 40 percent of the total market share in the New West region.

"Our record of quality and service makes us well qualified to help meet the state's intended goal with HealthChoices – to improve access and improve quality for Medical Assistance recipients, while also controlling costs," said Lovelace.

UPMC for You is now available in 40 counties across Pennsylvania, including northwest Pennsylvania, southwest Pennsylvania and the Lehigh/Capital region. Persons interested in enrolling in UPMC for You may call 1-800-440-3989. Providers interested in participating with UPMC for You may call 1-866-918-1595.

About UPMC Health Plan
UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, an integrated global health enterprise. 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 more than 1.9 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