Harrisburg, PA - Department of Human Services (DHS) Secretary Teresa Miller and Department of Aging Deputy Secretary Steve Horner today reminded Pennsylvania residents about the upcoming final rollout of the Community HealthChoices (CHC) program. CHC was rolled out in three phases: the Southwest in January 2018, the Southeast in January 2019, and the third and final rollout will be launched across 48 counties throughout across the Northwest, Northeast and Lehigh/Capital regions of Pennsylvania on January 1, 2020. When fully implemented, CHC will cover approximately 400,000 Pennsylvanians.
CHC is Pennsylvania’s managed care program for individuals who are dually eligible for Medicaid and Medicare, and for eligible individuals who are 21 or older who have physical disabilities requiring long-term services and supports either in a nursing facility or in their home. CHC was developed to improve access to and coordination of medical services and person-centered long-term services and supports. CHC gives people choice, control, and access to a full array of quality services that help them live independent, healthy lives in their home or another setting of their choice.
“Our goal is always to enhance the quality, efficiency, and effectiveness of the supports and services available to Pennsylvanians,” said DHS Secretary Miller. “We want to allow more people to live in their community among their family and friends, giving them the opportunity to live in their own home, work, and experience an overall better quality of life. CHC demonstrates our commitment to supporting elderly Pennsylvanians and individuals needing long-term services and supports by improving the long-term care service delivery model, and I am grateful that this program will finally be available across Pennsylvania.”
Pennsylvania residents who are eligible for CHC were notified and reminded of this transition, what it means for them, and important deadlines beginning about six months prior to implementation and continuing regularly over the last few months. Participants are able to select from one of three participating managed care organizations (MCOs), including AmeriHealth Caritas Pennsylvania, PA Health and Wellness, and UPMC Community HealthChoices.
If participants have not yet selected an MCO, they were automatically enrolled in one of the three MCOs providing services. Participants have until December 20 to make a change to their MCO in order for it to be effective January 1, 2020. After that point, if a participant would like to change their MCO, they are able to do so at any time, but the MCO changes will take effect beginning later in 2020.
“Pennsylvanians who are eligible for Community HealthChoices are able to choose the plan that allows them to live and age comfortably in their community, best meets their health needs, and allows them to see their current health care providers,” said Aging Secretary Torres. “It’s important to us that each participant is engaged in the process and enrolls in the plan that best meets their needs. I strongly encourage participants to consider all plans available, ask questions, and make sure they are enrolled in a plan they are confident will meet their individual needs.”
As of September 2019, enrollment was over 80,000 in the Southwest and 130,000 in the Southeast totaling over 210,000 participants thus far in the CHC program. The rollout through the rest of the state will include approximately 143,000 individuals. Ninety-three percent of the statewide CHC population are dually eligible for both Medicare and Medicaid.
As each phase of CHC was rolled out, best practices were informed and implemented making CHC one of the most successful managed long-term services and supports rollouts in the country. This success is attributed to limited numbers of interruptions in participant services or provider payments, record numbers of advanced plan selections, and broadly engaged stakeholders that were part of every step of the implementation. In the nearly two years since CHC first began implementation, the rate of Pennsylvanians using long-term services and supports in the community has increase from 58.5 percent in December 2017 to 65.3 percent in October 2019.
“Because of the phased rollout process of CHC, we have had time to listen to patients, providers, and MCOs and hear their experience with the program so that by 2020, we will be delivering the best care possible to hundreds of thousands of participants across the commonwealth,” said Secretary Miller. “I am grateful to the staff at DHS and Aging that made this excellent work possible, and look forward to building on CHC’s progress as it is fully implemented.”
This program’s success delivers opportunities to support improved care coordination with the participant’s Medicare and Medicare services as well as long-term care, physical health and behavioral health. CHC is also huge step forward in creating predictability and quality management for the growing long-term services population.
For more information on plan selection, call 1-844-824-3655 (TTY 1-833-254-0690) or visit www.enrollchc.com.
For more information on the CHC program, visit www.healthchoices.pa.gov/info/about/community/
MEDIA CONTACT: Erin James - 717-425-7606
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