NEW CASTLE (July 13, 2021) – The Department of Health and Social Services’ Division of Medicaid and Medical Assistance (DMMA) is beginning the process of identifying Managed Care Organizations (MCOs) to operate its Medicaid Managed Care Program beginning Jan. 1, 2023.

DMMA currently contracts with two MCOs, AmeriHealth Caritas Delaware and Highmark Health Options. to provide physical health, behavioral health, and long-term services and supports to individuals, families, children, and seniors enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) in Delaware. Those contracts expire at the end of 2022.

Delaware’s Medicaid managed care program provides comprehensive health coverage to more than 240,000 eligible Delawareans, or almost 25% of the state’s population.

This procurement process is an opportunity for DMMA to reexamine and improve the program and expectations for the MCOs. Strategic principles for the 2023 procurement include:
• Member focus: Medicaid innovation should improve quality and outcomes for members and advance health equity.
• Accountability: MCOs will have increased accountability to the Delaware Department of Health and Social Services (DHSS) for program costs, performance, and creativity.
• Lead by example: Medicaid, in partnership with the MCOs, will lead by example when it comes to innovation across Delaware’s health care system.
• Promote program evolution: DMMA will use the procurement process as an opportunity to build upon the existing contract and our successes in Medicaid and CHIP.
• Cross-agency collaboration: DMMA will look for ways to align with other DHSS programs and state initiatives.

DMMA will host four virtual town hall meetings to get input on goals and procurement priorities for the managed care delivery system. Meetings are open to the public; however, each meeting will focus on getting feedback from either members or providers. Closed captioning and an ASL interpreter will be available for all meetings.

“Medicaid managed care offers flexibility to implement innovative programs that support health care providers and enhance health outcomes for our members,” said Steve Groff, Director of DMMA. “We hope the Town Halls will give interested parties the opportunity to share best practices and provide input with regard to program improvements.”

To register for a meeting, click on the link for the date you would like to attend.
• Monday, July 19, 2021, from 3-4 p.m. – Provider-focused https://mmc.zoom.us/webinar/register/WN_x4PIhdgtTWKxFObwPlG5ww
• Wednesday, July 21, 2021, from 3-4 p.m. – Provider-focused https://mmc.zoom.us/webinar/register/WN_3YqTuXCwQNeU6QcBV2inhw
• Thursday, July 29, 2021, from 5:30-6:30 p.m. – Member-focused https://mmc.zoom.us/webinar/register/WN_h_x3l5fYSwCuxqtECP75qg
• Friday, July 30, 2021, from Noon-1 p.m. – Member-focused https://mmc.zoom.us/webinar/register/WN_-REq4Q4nRMmnVQLpeKQh1Q

You also can provide written feedback to DMMA by emailing your comments and recommendations to: DMMA_RFP@delaware.gov

Feedback received through Aug. 15, 2021, will be considered for the procurement.

If you have questions or need additional accommodations, please contact Cindi Powell at Cynthia.Powell@delaware.gov.

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.

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.