State certifies HMOs for Medicaid recipients

Maryland Watch

March 04, 1997

The state Department of Health and Mental Hygiene certified its first three Medicaid "managed care organizations" yesterday. Two health maintenance organizations that have been serving Medicaid recipients, FreeState and Prudential, were approved, along with a new group called Maryland Physicians Care, a joint venture involving four smaller hospitals.

Maryland Physicians Care thus becomes the first hospital-sponsored MCO, although other hospitals, including Johns Hopkins, have begun the application process.

The MCOs will function like HMOs in providing all care for a subscriber in return for a fixed monthly fee. Beginning in June, about 300,000 Medicaid recipients, mostly welfare mothers and their children, will be required to enroll in a managed-care plan. The switch is designed to provide better preventive care and to reduce costs.

Maryland Physicians Care is a joint venture including Maryland General Hospital, Washington County Hospital and Western Maryland Health System (made up of Memorial Hospital of Cumberland and Sacred Heart Hospital).

Pub Date: 3/04/97

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