Hoosier Healthwise
In the managed care organization (MCO) delivery system, the
Office of Medicaid Policy and Planning (OMPP) pays contracted
managed care organizations a capitated monthly premium for each
IHCP enrollee in the MCO's plan. The capitated premium covers the
cost of the care for services covered under the MCO program and
incurred by IHCP enrollees in the MCO plan. The MCO assumes
financial risk for services rendered to members in its plan.
Managed care organizations (MCOs) 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 in the MCO is managed by the MCO through its
network of primary medical providers (PMPs), specialists, and other
providers of care that contract directly with the MCO.
The three MCOs listed below are currently contracted with the
State of Indiana to serve the Hoosier Healthwise managed care
population:
For more information or questions about the Hoosier Healthwise
MCO plans, please contact the MCOs directly. Contact information
for each of the IHCP-contracted MCOs can be found on the Health Plan
Contacts.
For additional information regarding Hoosier
Healthwise
Risk-Based Managed Care (RBMC) Pharmacy
Information