The state chose four health care providers Monday as potential contractors with the BadgerCare Plus Basic Plan.
UnitedHealthCare, Abri Health Plan, Children’s Community Health Plan and Community Connect Health Plan were chosen as the providers that could best suit the needs of southeastern Wisconsin BadgerCare Plus Basic members, Wisconsin Department of Health spokesperson Stephanie Smiley said. However, no official contract has been signed.
They have only been informed BadgerCare Plus Basic has an intent to award a contract to cover approximately 240,000 members in Milwaukee, Racine, Waukesha, Ozaukee, Kenosha and Washington counties, Smiley said.
Alhtough they may offer different perks and discounts to their members, each provider’s health coverage is very similar.
There is no guarantee each member’s current doctor and plan will be included in the four providers, but it is likely many current members of BadgerCare Plus Basic would have an easy experience transitioning Smiley said.
The providers would have to prove they are able to provide health care before the contracts are officially signed on July 1. If the contracts were approved, they would be providers for three and a half years and could apply for an extension.
There would be an enrollment package available once the contracts are officially approved which would help BadgerCare Plus Basic members decide which provider would be best for them and give them all the information they need to make a transition.
A Department of Health committee selected the providers because they had the potential to administer childhood vaccinations, facilitate healthy births and address other health needs of the community, Smiley said.
Health care providers were evaluated not only on how many BadgerCare Plus Basic members in the six counties they could provide for, but also on their specific healthcare practices.
Smiley said last year, the Department of Health solicited bids from potential providers for BadgerCare Plus Basic in order to create a competitive healthcare service for members. The competitive bid was a way to improve healthcare outcomes.
She said members of BadgerCare Plus Basic in the six counties have paid some of the highest administrative costs in the country and the quality of healthcare provided has not matched up to what was paid.
“It is imperative we get good quality care for the members which are enrolled in HMOs,” Smiley said.
Rep. Jeff Fitzgerald, R-Horicon, spokesperson Jim Bender said some questions still remain on the specifics of BadgerCare Plus Basic.
Members of BadgerCare Plus Basic would pay the state for the services from a provider; however, Bender said there are no checks in the Legislature to make sure taxpayers do not foot the bill if the estimated costs of using a provider increase.
He added there are no checks in Legislature against premiums increasing for a BadgerCare Plus Basic member if the costs of using the provider were over what were expected.
