Hoosier Healthwise
In the managed care entity (MCE) delivery system, the Office of
Medicaid Policy and Planning (OMPP) pays contracted MCEs a
capitated monthly premium for each Indiana Health Coverage Programs
(IHCP) member enrolled with the MCEs. The capitated premium covers
the cost of the care for services covered under the MCE program and
incurred by IHCP members enrolled with the MCE. The MCE assumes
financial risk for services rendered to its members.
MCEs are lawful entities authorized to operate a prepaid
healthcare delivery plan (as a health maintenance organization -
HMO). These entities arrange, administer, and pay for the delivery
of healthcare services to members, as designated by the OMPP. The
care of Hoosier Healthwise members enrolled with the MCE is managed
by the MCE through its network of primary medical providers (PMPs),
specialists, and other providers of care who contract directly with
the MCE.
The following three MCEs are contracted with the state of
Indiana to serve the Hoosier Healthwise managed care
population:
For more information or questions about the Hoosier Healthwise
MCEs, please contact the MCEs directly.
For additional information regarding Hoosier
Healthwise
Risk-Based Managed Care (RBMC) Pharmacy
Information