May 1997

SE Michigan Medicaid Managed-Care Plans Announced

by Lisa D. Baragar

The State of Michigan recently announced that 13 qualified health plans (QHPs) will deliver comprehensive health services under capitated, managed-care arrangements to Medicaid populations in Wayne, Oakland, Macomb, Genesee, and Washtenaw counties. The QHPs currently are undergoing readiness reviews, to assure that they can meet the conditions of their contract with the state, including on-site evaluations and validation of their bid information.

The table lists the 13 QHPs, indicates whether each is a clinic plan (CP) or HMO, lists its counties of operation, its hospital network, and the monthly capitation rate accepted by the state.

The state was expected to release the request for proposal (RFP) for the balance of the state on May 15, but it has been temporarily delayed. Bidders will have 120 days to prepare their proposals. This RFP will differ from the one for SE Michigan in that it will (1) allow health plans to define their service area and (2) include incentives for plans to expand into areas previously without managed care.