Indiana awarded new managed Medicaid contracts to four out of five bidding private health insurers. UnitedHealthcare was the lone company to miss the cut because its proposed costs were too high.
For-profit insurers Anthem and Centene Corp. and not-for-profits CareSource and MDwise won Indiana's Medicaid contracts, which cumulatively cost the state $3.3 billion a year and cover 1 million poor adults and children. The contracts for Anthem, Centene and CareSource, which begin Jan. 1, are valued at $822 million. MDwise has a slightly larger share of Medicaid enrollees, and its annual contract is worth $831 million.
Anthem, Centene and MDwise are the incumbent Medicaid contractors and will share the business with CareSource.
Indiana, led by Republican Gov. Mike Pence, has implemented a conservative-based Medicaid expansion under the Affordable Care Act that imposes cost-sharing on low-income beneficiaries.
UnitedHealthcare, the insurance division of healthcare giant UnitedHealth Group that serves as a Medicaid contractor in numerous states, had the highest overall scores for its “technical and business” proposal. Those elements included an insurer's experience, provider networks and customer service. However, UnitedHealthcare flunked with its cost proposal, scoring zero points. By comparison, MDwise received 15 points for its cost estimates, and the other three bidders scored the maximum 20 points.
In a statement, UnitedHealthcare said it was “disappointed” by Indiana's decision but “proud of the services” provided throughout the state. The insurer did not say if it will appeal Indiana's decision.
