AP NEWS

Managed-care contracts for Medicaid expansion approved

March 27, 2019

CONCORD, N.H. (AP) — New Hampshire officials approved contracts on Wednesday totaling nearly $1 billion for three companies to manage health care for about 180,000 Medicaid recipients.

The Executive Council voted 4-1 to approve the five-year contracts for the state’s two current managed-care companies — Well Sense and New Hampshire Healthy Families — and a newcomer, AmeriHealth Caritas.

Republican councilor Ted Gatsas, of Manchester, was the lone vote against the contract, saying he was concerned that no one had asked the companies if they could fulfill the contract’s provisions for less money.

“It’s a pretty big number,” he told Jeffrey Meyers, commissioner of the Department of Health and Human Services. “I’m shocked that that’s not a big concern of the department.”

Gatsas also questioned whether the companies would pocket profits that could otherwise be returned to the state.

Meyers said the contracts are cost effective and will improve the Medicaid program significantly.

Lisabritt Solsky, executive director at Well Sense, noted that it is a not-for-profit company.

“That is 100 percent invested back into the organization to support our mission,” she told reporters after the vote. “So there are no shareholders who are enriched by us having a good year.”

Solsky also defended the contracting process.

“Purchasing insurance, particularly for people on Medicaid, is not like buying 50,000 widgets at a fixed unit price. It’s a really complicated business, and it’s highly regulated,” she said. “So I’m confident that the department ran a very appropriate negotiation.”

New Hampshire expanded its Medicaid program under the Affordable Care Act in 2014 to include adults whose income is up to 138 percent of the poverty level. The state initially used federal money to put participants on private insurance but changed to a managed-care model in reauthorizing the program last year.

Republican Gov. Chris Sununu said Gatsas raised important questions but ultimately called the contracts a good thing for the state and consumers.

“It’s competition for the expanded population we’re now serving. We’re asking a bit more of these contractors, we’re bringing in another contractor in,” he said. “The whole dynamic will change a bit but the system that’s in place is a good one and we feel very confident going forward now that the contracts are approved.”