Hospital makes changes to Managed Medicaid contracts


In a cost-saving measure, Grays Harbor Community Hospital and Harbor Medical Group will soon cancel contracts with three local Managed Medicaid providers: United Health Care, Coordinated Care and Community Health Plan of Washington.

The hospital has, however, finalized contracts with two other Managed Medicaid providers —Amerigroup and Molina — and patients served under the cancelled contracts will be allowed to transfer their coverage. About 50 percent of Managed Medicaid patients in Grays Harbor County already use Molina.

“We appreciate the relationships we have had with each health plan,” said Grays Harbor Community Hospital CEO Tom Jensen. “However, we have chosen to continue a relationship solely with Amerigroup and Molina, the two plans we believe will best support our patients and the providers who treat them at our hospitals and clinics.”

The changes won’t impact patients covered by traditional Medicaid, or patients with private United Health Care, Coordinated Care and Community Health Plan of Washington policies, said hospital spokesman David Quigg.

“We’ve had some confusion about what is going to be cut, but it’s not going to do anything to regular-old Medicaid,” Quigg said.

Managed Medicaid patients are typically low-income or have chronic illnesses, Quigg explained. The state pays some private companies to manage these patients and make sure that they have access to the care they need.

Hospital staff are attempting to reach out to any patients who might be affected, sending letters to 12,500 patients who have used Managed Medicaid at Grays Harbor Community Hospital in the past three months, Quigg said.

The letters will contain instructions for transferring to new plans, but patients can also change plans in-person at the hospital’s patient support center, located on the first floor of the East Campus building, 1006 North H St. in Aberdeen. The center is open from 9 a.m. to noon and 1 to 3 p.m. Monday through Friday. Patients can also learn more at www.ghcares.org.

In the mean time, patients will still be able to use the emergency room at Grays Harbor Community Hospital, and hospital staff will work with patients who have upcoming surgeries or other medical treatment to make sure that they are covered, Quigg said.

The contracts with United Health Care and Coordinated Care will officially lapse August 15, while the Community Health Plan of Washington contracts will end November 1.

Hospital administrators have been working with the Managed Medicaid providers since December to renew contracts, with the goal of increasing reimbursement rates.

“Some providers offer better services, and some give us higher reimbursement,” Quigg said. “There were a few things we looked at.”

It’s still too early to tell how much money the new contracts will save the hospital — but it won’t be enough to entirely fill Grays Harbor Community Hospital’s budget gaps. Administrators will continue to advocate for voters to approve a measure creating a new public hospital district, which will appear on the August 5 ballot.

“There’s not one silver bullet that will help solve the problem, this is a smaller step in the right direction,” Quigg said.

 

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