Pittsburgh Business Times

Pennsylvania's managed health plan for the needy is saving taxpayer money while providing prompt, effective medical care to a vulnerable population, according to a report to be released Tuesday.

Pennsylvania's seven managed care providers saved the state $2.7 billion over the past five years in providing medical care for some 1.1 million people, according to a report by The Lewin Group, a Falls Church, Va.-based health and human services consulting company. What's more, the providers held annual medical cost increases to 7.4 percent over the past several years, which compares to 10.4 percent hikes in fee-for-service programs.

"We're doing the job we hoped that we were doing," said Michael Rosenstein, spokesman for the Harrisburg-based Pennsylvania Coalition of Medical Assistance Managed Care Organizations, which commissioned the study. "We're very proud of the outcomes."

The Lewin Group report was the first of its kind done in Pennsylvania. The 3-year-old Pennsylvania Coalition represents the seven carriers that contract with the state to provide medical care for the needy. These carriers include Gateway, Three Rivers, and UPMC Health plans in Western Pennsylvania.

Mr. Rosenstein said the state has been slowly shifting the medically needy into managed care programs over the past 10 years. Some 1.1 million of the 1.7 million people receiving the medical benefits are already in a managed care plan, he said.

In a prepared statement, Karen Ignagni, president and CEO of Washington D.C.-based America's Health Insurance Plans, said Pennsylvania's record in managed care should "serve as a national model." Pennsylvania's managed care program is called HealthChoices, which private providers bid on to provide coverage.