Blue Cross Blue Shield of Montana gears up to pilot state's Medicaid expansion

Now that Blue Cross and Blue Shield of Montana (BCBSMT) has won the contract to be the third-party administrator of Montana's Medicaid expansion program, the company is getting ready to step into its new role, according to an article from HealthcareDive. 

Earlier this month, Montana became the first state to partner with a major insurance provider to oversee the state's Medicaid expansion plan. The road ahead is not going to be an easy one for BCBSMT, but the state's largest and longest-standing health insurer has already created two teams to tackle the task, the article notes.

One team will focus on project structure and the other will focus on program governance, and both will have a lot of interaction with each other. The project structure team will build the technology platform and develop processes for accurately processing the premiums, co-pays and maximum out-of-pocket costs participants will pay. The governance group will be focused on ensuring compliance with all state and federal regulations through the contract, waivers and administrative rules, the article says.

With 5,550 people signing up for coverage in the first week under the state's new Health and Economic Livelihood Partnership (HELP) Act, BCBSMT has been focused on building the network with HELP specifically in mind. "We have made great progress in a short amount of time to contract with physicians, behavioral health specialists, facilities and all other providers needed to give HELP participants broad access to the healthcare they need," BCBSMT Director of Public Relations John Dora told HealthcareDive.

Four healthcare firms bid on the opportunity to manage Montana's expanded Medicaid program, FierceHealthPayer previously reported. Montana's decision to expand Medicaid made it the 30th state to do so, despite concerns that the federal government would not approve its plan to require beneficiaries to pay monthly premiums. 

To learn more:
- read the article