Pennsylvania Medicaid Managed Care Contracts & Winning Proposals

Pennsylvania has two managed care programs:

Physical HealthChoices - Provides physical health and pharmacy services to low-income adults, children, parent/caretaker relatives, and the aged, blind, and disabled population that does not need long-term services and supports (LTSS). Physical HealthChoices is available statewide, and health plans are available by region. In calendar year 2019, 30% of the medical portion of the capitation and maternity revenue rate must be in value-based arrangements. At least 50% of the 30% must incorporate shared savings contractual arrangements, bundled or global payment arrangements, and full-risk or accountable care organization arrangements.

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