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A map from the Wash. Health Care Authority shows the ten different managed care regions. Lewis County is part of the Great Rivers region.

County changed health plan providers in 2020

By Jake Morgan, staff writer

    Lewis County residents who are enrolled in Washington Apple Health (Medicaid) will no longer have the Community Health Plan of Washington (CHPW) or Coordinated Care of Washington (CCW) as options for managed care beginning in January 2020.

    The move is part of a years-long campaign by Washington Apple Health and the state legislature to create an integrated managed care model that combines physical and behavioral health care and payment into one system.

    "We are trying to approach this from a whole-person perspective," said Amy Blondin, chief communications officer for the Washington State Health Care Authority. "This is about combining treatment for mind and body."

    Blondin said the traditional system can be cumbersome to navigate and integrated managed care brings these systems together to remove barriers for clients.

    The state is divided into ten geographical, managed care regions. Lewis County is part of the Great Rivers region, which includes Cowlitz, Pacific, Wahkiakum and Grays Harbor counties.

    Clark and Skamania counties in Southwest Washington were the first to implement the integrated care plan in April 2016, followed by Chelan, Douglas and Grant counties in the North Central region in January 2018. Beginning in January of 2019, the Greater Columbia region began using the integrated system, along with King, Pierce and Spokane regions. The North Sound region implemented the new system in July 2019 and the final three regions of Great Rivers, Salish and Thurston-Mason will adopt the integrated system on Jan. 1, 2020.

    Apple Health uses five managed care organizations: Amerigroup, Community Health Plan, Coordinated Care, Molina Healthcare and United Healthcare. All five plans are not available in every region.

    Melissa Stevens, Vice President of Community Engagement and Growth at Community Health Plan of Washington, said there should be no changes from the clinic level.

    "We are maintaining our relationships with providers in Lewis County and hope to come back next year," Stevens said. She said Lewis County's Apple Health patients enrolled with CHPW can ask their provider to switch them into an eligible plan by mid-December or contact the Health Plan Finder at Open enrollment is from Nov. 1 to Dec. 15.

    Apple Health clients in Lewis County can choose between Amerigroup, Molina and United Healthcare for 2020.

    According to the Health Care Authority, Apple Health clients enrolled in CHPW who do not change to a different managed care organization will be automatically enrolled into one of the available plans. Clients should get an official letter in late November or early December notifying them of their new plan, Blondin said, and they can stick with that plan or chose one of the other available options.

    "No one is going to lose insurance," Blondin said about the state and federal entitlement program. "If you qualify for Medicaid, you qualify for Medicaid."

    Blondin said there are approximately 27,000 people in Lewis County enrolled in Apple Health. Of those, 5,200 are enrolled in CHPW and 820 are enrolled in Coordinated Care. She said the Health Care Authority conducted a competitive procurement among the five existing Apple Health managed care plans, and selected at least three plans in each region based on several factors, including provider networks.

    Blondin said children in foster care are in one statewide managed plan, Coordinated Care of Washington, and will see no changes. She said the change does not affect Medicare recipients.


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