HHSC Chooses Medicaid HMOs

The Texas Health and Human Services Commission (HHSC) has tentatively selected health plans for the HHSC Medicaid STAR, STAR+PLUS, and Children's Health Insurance Program (CHIP) managed care program for current and new HMO service areas. HHSC is negotiating contracts with the plans. The new contracts take effect in March 2012.  

The service areas [PDF] and health plans are:

Bexar: STAR-Aetna, Community First, Superior Healthplan Network; STAR+PLUS-Amerigroup, Molina Healthcare of Texas, Superior Healthplan Network; CHIP-Aetna, Superior Healthplan Network, Community First. 

Dallas: STAR-Parkland Community Health Plans, Amerigroup, Molina Healthcare of Texas; STAR+PLUS; CHIP-Amerigroup, Parkland Community Health Plans, Molina Healthcare of Texas. 

El Paso: STAR-El Paso First, Superior Healthplan Network, Molina Healthcare of Texas; STAR+PLUS-Molina Healthcare of Texas, Amerigroup, CHIP-El Paso First, Superior Healthplan Network. (STAR+PLUS model will begin March 2012).

Harris: STAR-Amerigroup, Texas Children's, Community Health, Molina Healthcare of Texas, United Healthcare Community Plan; STAR+PLUS-Molina Healthcare of Texas, Amerigroup, United Healthcare Community Plan; CHIP-Amerigroup, Community Health, Molina Healthcare of Texas, Texas Children's, United Healthcare Community Plan. 

Jefferson (new service area effective Sept. 1, 2011): STAR-Amerigroup, Texas Children's, Community Health, Molina Healthcare of Texas, United Healthcare Community Plan; STAR+PLUS- Amerigroup, Molina Healthcare of Texas, United Healthcare Community Plan; CHIP-Amerigroup, Community Health, Molina Healthcare of Texas, Texas Children's, United Healthcare Community Plan. 

Lubbock: STAR-Superior Healthplan Network, FirstCare, Amerigroup; STAR+PLUS, Amerigroup, Superior Healthplan Network; CHIP-FirstCare, Superior Healthplan Network (STAR+PLUS model to begin March 2012).

Nueces: STAR-Superior Healthplan Network, Driscoll Children's, Christus; STAR+PLUS-Superior Healthplan Network, United Healthcare Community Plan; CHIP-Driscoll Children's, Superior Healthplan Network, Christus. 

Tarrant: STAR-Amerigroup, Aetna, Cook Children's; STAR+PLUS; CHIP-Aetna, Amerigroup, Cook Children's.  

Travis: STAR-Amerigroup, Superior Healthplan Network, Seton; STAR+PLUS-Amerigroup, United Healthcare Community Plan; CHIP-Seton, Superior Healthplan Network, Amerigroup.

New Medicaid HMO Service Areas
Beginning in March 2012, HHSC will eliminate the Primary Care Case Management (PCCM) model in favor of the HMO model. HHSC is responding to cost-containment recommendations approved by the Texas Legislature. TMA is developing a webinar on the Medicaid HMO changes. It is tentatively planned for October.

Hidalgo: STAR-United Healthcare Community Plan, Superior Healthplan Network, Molina Healthcare of Texas, Driscoll Children's; STAR+PLUS-Molina Healthcare of Texas, Superior Healthplan Network, Health Spring; CHIP. 

Medicaid Rural Service Areas 

  • West Texas: STAR-Amerigroup, Superior Healthplan Network, First Care; STAR+PLUS; CHIP.  
  • Central Texas: STAR-Amerigroup, Superior Healthplan Network, Scott & White; STAR+PLUS; CHIP.
  • Northeast Texas:  STAR-Amerigroup, Superior Healthplan Network; STAR+PLUS; CHIP. 

Timeline:

  • Sept. 1, 2011: Expansion of HMO model to counties contiguous to current service areas.
  • March 1, 2012: Conversion of PCCM to HMO model in all remaining rural and South Texas counties.
  • March 1, 2012: Expansion of STAR+PLUS HMO model to Lubbock and El Paso.

Action, Aug. 15, 2011


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