Pennsylvania’s Medicaid Managed Care Organizations (MCOs) are working in communities across the Commonwealth
Medicaid health plans provide access to health care coverage to more than two million Medicaid recipients across the entire state of Pennsylvania. PAMCO and its member MCOs share a common goal of ensuring timely access to a wide range of high quality healthcare providers and services.
PAMCO works with the Department of Human Services, consumers, the PA General Assembly, providers, and other stakeholders to promote the value proposition for Medicaid Managed Care, the necessity for continued support and viability of the HealthChoices model, and the efficient allocation of limited taxpayer resources.
The Value of Managed Care
The partnership between Pennsylvania’s Department of Human Services (DHS) and the seven MCOs participating in the Physical HealthChoices program has been highly effective in delivering:
Strong cost management, shown by per capita cost increases lower than national Medicare trends and those of neighboring states
Excellent quality scores on a large enrollment scale
Programmatic innovations and community invest-ments that exceed DHS’ strong set of MCO con-tract requirements
Robust provider networks that exceed those built under traditional Medicaid structures
A financial model focused on optimally serving HealthChoices enrollees, rather than selling to them—the MCOs are operating viably with a modest operating margin.
Learn more about the value of managed care.
