DHS Announces Community HealthChoices Plan Selections
On August 22, 2024, the Pennsylvania Department of Human Services (DHS) announced the selection of five Community HealthChoices (CHC) plans following a competitive procurement process. These plans will administer the CHC program, which covers dual eligibles (people with both Medicare and Medicaid) as well as older adults and people with physical disabilities who get Medicaid Home and Community-Based Services (HCBS) or nursing facility care. As of June 2024, over 383,000 people were enrolled in CHC across the state, with 34% receiving HCBS and 11% receiving care in a nursing home.
The chosen plans include three existing CHC plans and two plans new to CHC:
- Aetna Better Health of Pennsylvania
- Health Partners Plans
- PA Health and Wellness
- UPMC For You
- Vista Health Plan (AmeriHealth Caritas/Keystone First
Aetna and Health Partners are the two plans that are new to CHC. Aetna has past experiene with Pennsylvania’s Medicaid program, as it was a HealthChoices (Medicaid) managed care plan until 2022. Health Partners was a HealthChoices managed care plan in Southeast Pennsylvania for many years and expanded statewide in 2022. Although these plans have experience providing Medicaid managed care coverage in Pennsylvania, neither have covered long-term services and supports in Pennsylvania.
The selected plans will now undergo a readiness review period to assess if they can meet the CHC requirements. The expected start date for the new plans is January 1, 2025. This date may be adjusted based on the plans' progress during readiness review, or if there are legal challenges from plans who were not selected, as was the case when the original CHC plans were procured before CHC started in 2018.
Stay tuned to future newsletters for updates.
