Molina adds S.C. to its Medicaid managed-care portfolio

Molina Healthcare is entering the South Carolina Medicaid managed-care market by acquiring the medical-home membership in the state from Community Health Solutions of America—assuming the state phases out its medical homes program and transfers those enrollees into full-risk managed care.

St. Petersburg, Fla.-based Community Health Solutions' South Carolina Solutions, which serves about 150,000 Medicaid enrollees, is one of three medical-home networks doing business with the state's Medicaid program. Molina CFO John Molina said in an interview that South Carolina officials and lawmakers have assured the company they are on track to transition the approximately 200,000 residents in its medical homes program into managed-care organizations.

Molina said the company is purchasing South Carolina Solutions assets in order to keep its provider network together, and that the transition should be “seamless to the members.”

Molina Healthcare now counts about 1.8 million low-income members in California, Florida, Michigan, New Mexico, Ohio, Texas, Utah, Washington and Wisconsin. The company is one of several Medicaid managed-care players planning to also sell coverage next year in the health insurance exchanges established under the Patient Protection and Affordable Care Act. Molina said his company hoped to do so in South Carolina beginning in 2015.

The acquisition is contingent upon Molina Healthcare getting an HMO license from the South Carolina Insurance Department, as well as a full-risk Medicaid managed-care contract from the South Carolina Health and Human Services Department. The company expects all of the conditions to be met by January 2014.

“We look forward to partnering with both the state of South Carolina and the local provider community to continue providing quality patient-focused healthcare,” Dr. J. Mario Molina, president and CEO of Molina Healthcare, said in a news release.