NEW CASTLE (July 12, 2022) – The Department of Health and Social Services (DHSS) announced today that it has selected three companies to operate its Medicaid Managed Care Program.

DHSS’ Division of Medicaid and Medical Assistance (DMMA) will continue its MCO partnership with Highmark Health Options Blue Cross Blue Shield, which began in 2015, and with AmeriHealth Caritas, which began in 2018. In addition, DHSS announced its intent to contract with Centene’s Delaware First Health.

“We are pleased to reach agreement with Highmark, AmeriHealth and Centene to provide these vital services to the Medicaid members we serve,” DHSS Secretary Molly Magarik said. “These companies not only will offer more choice to our Medicaid members, but they also understand Delaware’s commitment to value-based care, and to the critical services that our Medicaid members need and deserve. We appreciate the commitment of Highmark, AmeriHealth and Centene to providing a connection to care and support that will help our Medicaid members achieve their optimal health.”

In 2017, Gov. John Carney signed House Joint Resolution 7, which gave DHSS the authority to develop health care spending and quality benchmarks. The spending benchmark – a spending target – is linked to the growth rate of Delaware’s economy and includes all health care spending, including through Medicaid, Medicare and commercial insurers. The quality benchmarks are established periodically to offer strategic goals to improve the health of Delawareans and the care they receive.

Delaware’s Medicaid program serves about 300,000 members. Division of Medicaid and Medical Assistance Director Steve Groff said members will receive information during the next several weeks about their options in choosing a new plan for 2023. Open enrollment will begin Oct. 1.

NEW CASTLE (Julio 12, 2022) – El Departamento de Salud y Servicios Sociales (DHSS) anunció hoy que ha seleccionado tres compañias para operar su Programa de Atención Administrada de Medicaid.

La División de Medicaid y Asistencia Médica (DMMA) del DHSS continuará su asociación de MCO con Highmark Health Options Blue Cross Blue Shield, que empezó en el 2015, y con AmeriHealth Caritas, que empezó en el 2018. Además, DHSS anunció su intención de contratar con Delaware First Health de Centene.

“Nos complace llegar a un acuerdo con Highmark, AmeriHealth y Centene para brindar estos servicios vitales a los miembros de Medicaid a los que servimos,” dijo la Secretaria del DHSS, Molly Magarik. “Estas compañías no solo ofrecerán más opciones a nuestros miembros de Medicaid, pero también entienden el compromiso de Delaware con la atención de salud basada en valor y con los servicios críticos que nuestros miembros de Medicaid necesitan y merecen. Agradecemos el compromiso de Highmark, AmeriHealth y Centene de brindar una conexión con la atención y apoyo que ayudarán a nuestros miembros de Medicaid a lograr una salud óptima.”

En 2017, el Gobernador John Carney firmó la Resolución Conjunta 7 de la Cámara de Representantes, que otorgó al DHSS la autoridad para desarrollar indicadores de calidad y gasto en atención médica. El punto de referencia de gastos – un objetivo de gastos – está vinculado a la tasa de crecimiento de la economía de Delaware e incluye todos los gastos de atención médica, incluso a través de Medicaid, Medicare y aseguradoras comerciales. Los puntos de referencia de calidad se establecen periódicamente para ofrecer objetivos estratégicos para mejorar la salud de los habitantes de Delaware y la atención que reciben.

El programa Medicaid de Delaware atiende cerca de 300.000 miembros. El Director de la División de Medicaid y Asistencia Médica Steve Groff, dijo que los miembros recibirán información durante las próximas semanas sobre sus opciones al elegir un nuevo plan para el 2023. La inscripción abierta comenzará el 1 de Octubre.

NEW CASTLE (Aug. 1, 2019) – As a way to improve the health of Delawareans who are covered by Medicaid, while potentially reducing overall health care spending, the Department of Health and Social Services’ two Medicaid managed care organizations are making the YMCA’s Diabetes Prevention Program available to their members who meet eligibility criteria.

The program is available at no cost to adult members of DHSS’ Division of Medicaid and Medical Assistance two managed care organizations (MCOs) – Highmark Health Options and AmeriHealth Caritas Delaware – who meet the program’s eligibility criteria. To participate, MCO members must be 18 or older, overweight with a body mass index (BMI) over 25 and be diagnosed with prediabetes or have a previous diagnosis of prediabetes. YMCA of Delaware membership is not required.

“Unfortunately, obesity and diabetes are twin epidemics in our state,” said DHSS Secretary Dr. Kara Odom Walker, a practicing family physician. “I thank Highmark and AmeriHealth Caritas for making the YMCA Diabetes Prevention Program available at no cost to Medicaid MCO clients who meet the eligibility criteria. This is an important step forward in reducing the impact of obesity and diabetes, while helping us to build a healthier Delaware.”

Across the state, about two-thirds of Delaware adults are at an unhealthy weight, either overweight or obese. In 2017, 11.3 percent of Delaware residents age 18 and older reported they had been diagnosed with diabetes and an additional 12.2 percent reported being told they have pre-diabetes.

“Highmark Health Options is proud to partner with DHSS and the YMCA Diabetes Prevention Program as we work together to reduce obesity and chronic disease,” said Todd Graham, President and CEO for Highmark Health Options. “We look forward to this partnership that will lead to a healthier lifestyle for our members while supporting the My Healthy Weight pledge.”

“We are very pleased to be a part of the YMCA’s Diabetes Prevention Program, alongside the Department of Health and Social Services, Highmark Health Options, and our valued community partner, the YMCA of Delaware, to help reduce the life-threatening chronic conditions caused by diabetes,” said Emmilyn Lawson, CEO of AmeriHealth Caritas Delaware. “Through this complimentary community-based program, we hope to nurture healthy citizens and healthier communities by increasing access to the support and services that Delawareans need to achieve their wellness goals.”

The YMCA’s Diabetes Prevention Program is a yearlong, evidence-based health behavior change program consisting of 25 one-hour group sessions. A trained lifestyle coach helps participants learn skills and strategies to eat healthier, increase physical activity, lose weight, overcome stress, stay motivated and more. The goals of the program are to reduce participants’ body weight by 7 percent and increase physical activity by 150 minutes per week.

“We have offered the YMCA’s Diabetes Prevention Program about 10 years, we’ve seen tremendous results, and will now be able to reach even more people in need,” said Tricia Jefferson, RD, LDN, Director of Program Development and Partnerships for the YMCA of Delaware. “Partnering with both Managed Care Organizations to serve our Medicaid-eligible participants will not only help us further prevent diabetes in a population that is at great risk, but it will help shape the future of how prevention programs are delivered and paid for across the nation.”

“We are grateful to Highmark, AmeriHealth Caritas, and the YMCA for their partnership in offering an evidence-based program to address obesity and related chronic disease for eligible Medicaid enrollees,” said Steve Groff, Director of DHSS’ Division of Medicaid and Medical Assistance. “DHSS was one of nine founding members of My Healthy Weight, a national collective initiative offering obesity prevention and treatment. The Diabetes Prevention Program will fulfill our pledge to provide access to community-based programs.”

To learn more about your eligibility for the YMCA’s Diabetes Prevention Program, contact your managed care organization.

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The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.