Children

1
Childrens Community Health PlanA member of
Childrens Hospital and Health System
2
What is CCHP?

• an HMO for Medicaid and BadgerCare eligible
  children and adults
• Milwaukee, Waukesha, Racine and Kenosha
  Counties.
• CCHP does not participate in SSI

3
What benefits does CCHP offer?

• Doctor Visits
• Hospital Services
• Dental Services
• Vision Services
• Behavioral Health

• Medical Equipment
• Emergency Care
• Prescription Drugs
• Transportation for Milwaukee County Residents

4
Why has Childrens entered the Medicaid HMO
market?

• Childrens entered the Medicaid HMO market
• for many reasons
• To maintain local ownership and management
• To increase member access to needed services
  (especially dental and mental health)
• To integrate delivery and management of care

5
Why has Childrens entered the Medicaid HMO
market? (contd.)

• CCHP has the ability to integrate health care and
  social services (Childrens Service Society of
  Wisconsin)
• CCHP is committed to re-distributing funds back
  to providers and into the community

6
Who is in our Provider Network?

• Aurora Health Care (special rules apply)
• Childrens Hospital Childrens Medical Group
• Columbia / St. Marys
• Wheaton Franciscan HealthCare
• Medical Associates

• Froedtert Community Health
• Medical College of Wisconsin
• United Hospitals System
• Waukesha Elmbrook Health Care
• Waukesha Memorial and Oconomowoc Memorial
  Hospitals

7
Who is in our Provider Network?(contd)

• Dental services coordinated by SEDA
• Vision services coordinated by Herslof

8
Medicaid BadgerCare Statistics as of
February 2007

• Wisconsin
• 487,465 pregnant women, children and their
  caretakers in Family Medicaid
• Of this number, 97,294 are enrolled in BadgerCare

9
Medicaid BadgerCare Statistics as of February
2007

• Milwaukee County
• 144,432 pregnant women, children and their
  caretakers in Family Medicaid (approx. 30 of
  the states total)
• Of this number, 18,570 are enrolled in BadgerCare

10
CCHP Enrollment

• As of 4/1/07 Milw Wauk Racine Kenosha Total 2/1/0
  6 Change
• CCHP/Dean SE 4,367 622 1,777 1,495 8,261
  38 8,223
• United/AC 63,700 5,650 8,566 5,855 83,771
  69,362 14,409
• MHS/NHP 63,313 2,984 5,035 7,711 79,043 100,661
  (21,618)
• Abri 5,056 206 2,111 264
  7,637 6,444 1,193
• Other 0 0 3
  0 3 12 (9)
  _________________________________________________
  ______________________________
• 136,436 9,462 17,492 15,325 178,715
  176,517 2,198

11
Dean Health Plan Southeast

• Dean Health Plan has subcontracted with CCHP to
  expand their Medicaid service area to Milwaukee,
  Racine, Kenosha and Waukesha counties.
• Through the subcontract with CCHP, Dean Health
  Plan members will access the CCHP provider
  network and follow all CCHP policies and
  procedures.

12
How will Dean Health Plan impact you as a
provider?

• Dean Health Plan Medicaid members, living in
  Southeastern Wisconsin will access the CCHP
  provider network.
• From an operational perspective, this addition
  will be seamless to CCHP providers.

13
How will Dean Health Plan impact you as a
provider? (Contd)

• Members that select or are auto assigned to Dean
  Health Plan in Milwaukee, Kenosha, Racine and
  Waukesha counties will have the Forward Card.
• When a provider office swipes the Forward Card or
  calls EDS eligibility, the HMO identifier of Dean
  Health Plan Southeast will appear HMO 18.
• As a result, members will be able to access
  services at your clinic. If you are a provider
  for CCHP, you will also be a provider for Dean
  Health Plan Medicaid in Southeastern Wisconsin.

14
Contact Information

• Mark Rakowski, Executive Director
• 414-266-6328 MRakowski_at_chw.org
• Teri Frederickson, Dir. Of Clinical Services
• 414-266-6120 TFrederickson_at_chw.org
• Sue Gorecki, Operations Manager
• 414-266-2445 SGorecki_at_chw.org

15
Contact Information (contd)

• Julie Antholine, Provider Relations Contracting
  Rep
• 414-266-3898 JAntholine_at_chw.org
• Laura Kerecman, Member Advocate
• 414-266-2747 or 877-900-2247
• LKerecman_at_chw.org
• Childrens Community Health Plan Member Services
• 1-800-482-8010
• Medicaid BadgerCare Enrollment Specialist
• 1-800-291-2002