South Florida Hospital News
Saturday November 17, 2018

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November 2018 - Volume 15 - Issue 5



Lee Health Affiliate Wins State Award to Launch and Operate New Provider-Sponsored Medicaid Plan in Southwest Florida

Lee Health, a non-profit, community-owned integrated health care services organization and health care leader in southwest Florida, and Evolent Health, a company providing an integrated value-based care platform to the nation's leading health systems and physician organizations, today announced that Lee Health has been notified by the Florida Agency for Health Care Administration (AHCA) of its intent to award a contract to a Lee Health affiliate, Best Care Assurance, LLC, to provide physical and behavioral health care services through Florida’s Statewide Medicaid Managed Care (SMMC) Program. 

In collaboration with Evolent, Best Care Assurance, LLC will launch and operate a Managed Medical Assistance (MMA) plan to serve Medicaid beneficiaries in Region 8, which includes Lee, Collier, Charlotte, DeSoto, Glades, Hendry and Sarasota counties. The region covers more than 200,000 eligible beneficiaries in the Managed Medical Assistance program. Pending regulatory approval and successful completion of readiness review, the five-year agreement is expected to commence between October 1, 2018 and January 1, 2019.
Most of Florida’s Medicaid recipients receive their Medicaid services through Florida’s Statewide Medicaid Managed Care (SMMC) program, which includes the Managed Medical Assistance (MMA) program. Best Care Assurance’s plan will serve eligible adult and other Medicaid beneficiaries through its Managed Medical Assistance plan. 
“By launching a Medicaid health plan, we have a tremendous opportunity to comprehensively meet the health care needs of the most underserved and vulnerable members of our community,” said Lee Health Chief Population Health Officer John Chomeau. “The combination of Evolent’s deep Medicaid and operational expertise and market-leading clinical programs, technology and health plan services will be critical to helping us deliver on our mission to improve the health of the communities we serve.”
Evolent will provide health plan administration and operational services for Best Care Assurance’s plan, including claims management, member and call center services and other critical services. In addition, Evolent will collaborate with the plan to deploy physician-led, evidence-based clinical programs and market-leading technology to drive high quality care, reduce cost and enhance the care experience for the plan’s Medicaid beneficiaries.  
“We are proud to work with Lee Health to help transform health care in southwest Florida and support the region’s Medicaid beneficiaries,” said Evolent Health Chief Executive Officer Frank Williams. “Lee Health is a market-leading health system in Florida nationally recognized for their clinical care. Lee Health also serves as a national example of a health system boldly driving the transition to value-based care to improve outcomes while lowering health care costs.”
Lee Health is also a participant in the Center for Medicare and Medicaid Services’ Next Generation ACO program for the 2018 performance year. Evolent supports Lee Health’s Next Generation ACO, Best Care Collaborative, by delivering technology, analytics, clinical programs and shared learnings to drive higher quality, lower cost health care for Medicare beneficiaries.
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