Highmark supports Medicaid decision

PARKERSBURG – The governor’s decision to expand Medicaid has been endorsed by Highmark Blue Cross Blue Shield West Virginia.

The plan to cover 91,500 uninsured residents under Medicaid could significantly reduce the overall health care costs offered to its citizens, Highmark West Virginia on Thursday said.

“As a company, our vision is to ensure that all members of the communities we serve have access to affordable, quality health care,” Fred Earley, president of Highmark West Virginia, said.

Gov. Earl Ray Tomblin on May 2 announced the expansion, cautioning, however, action would be taken if the program becomes unsustainable after three years or the federal government pulls funding.

“We’ve been diligent in our decision-making process-analyzing the Supreme Court ruling, asking the tough questions, and obtaining as much information as possible,” Tomblin said on Thursday. “We’ve weighed the options and believe expanding Medicaid is the best choice for West Virginia.”

The expansion will significantly reduce the number of uninsured West Virginians, Tomblin said.

“As we move forward, we will continue to ask questions, obtain information, and make sure we are doing what is right for the people of West Virginia,” he said.

Tomblin has in the past supported reorganization and expansion of Medicaid in West Virginia, Highmark West Virginia said.

In 2012, the governor signed House Bill 4438 into law for the development of Provider Sponsored Networks. As a result, Highmark West Virginia has successfully collaborated with West Virginia Family Health Plan to develop a network to provide managed care services to the Medicaid population in West Virginia.

The network, which is operated by Family Health Plan, is owned and governed by Highmark West Virginia and 25 provider shareholders, including 22 federally qualified health centers and the West Virginia Primary Care Association.

The purpose of the collaboration, announced in March 2013, was for Highmark West Virginia and Family Health Plan to create a new care delivery model that would bring a more cost-effective approach to Medicaid managed care while also enhancing quality and health outcomes for the state’s citizens.

As a result, Family Health Plan is seeking approval from the West Virginia Department of Health and Human Resources Bureau of Medical Services to operate as a Medicaid Managed Care Organization for West Virginia.

“Through the pursuit of this endeavor, we, along with WVFHP, are fulfilling this vision and are looking forward to working with state officials to serve the new and existing Medicaid population starting this fall,” Earley said.

Highmark West Virginia is responsible for managing the overall operations and administration of Family Health Plan.

The company said Keith Peifer will be the president of Family Health Plan. Peifer is vice president of sales and client management for small group and individual markets for Highmark in Pennsylvania.

Peifer will assume the position on May 28 in Parkersburg. Plans are the full operation of Family Health Plan will begin in October.

Highmark West Virginia serves about 300,000 customers and employs 800 people in Parkersburg, Charleston and Wheeling.