Molina Healthcare of Puerto Rico Contracted for Island-Wide Medicaid Managed Care Program

Molina Healthcare, Inc. of Long Beach, California has disclosed that its subsidiary, Molina Healthcare of Puerto Rico, Inc., has been selected by the Puerto Rico Health Insurance Administration to be one of the organizations to administer the Commonwealth’s new Medicaid Managed Care contract.

Under the current contract, Molina serves approximately 316,000 members in the East and Southwest regions of Puerto Rico. Services under the new contract, currently expected to begin on November 1, 2018, would cover the entire island.

Contracts will be executed pending the assessment and agreement to the contract terms by Molina and ASES. The base contract runs for a period of three years with an optional one year extension.

“Being awarded an island-wide contract in Puerto Rico represents an exciting opportunity for Molina to serve even more Puerto Rico citizens with improved access to high quality care,” said Joe Zubretsky, president and chief executive officer of Molina Healthcare, Inc. “We are honored to have the chance to be one of the health plans tasked with playing a role in the transformation of the Island’s managed care program in partnership with ASES.”

“Molina is thrilled to be selected to coordinate and offer integrated managed care to Medicaid beneficiaries in all municipalities,” said Carlos A. Carrero, president of Molina Healthcare of Puerto Rico. “Molina has been able to achieve cost savings while improving health outcomes through care coordination, commitment to quality, and a focus on preventive care, and we are excited to build upon that success with this new contract.”

The new Medicaid Managed Care model will establish a single, island-wide region including all municipalities. This model was designed to provide Medicaid beneficiaries with the option to select the insurer and the network of providers of their choice while improving overall access to care.

In addition, the program will introduce a High-Cost High Needs model and emphasize both preventive health care and education while strengthening the oversight and audit process.

Molina Healthcare, Inc., a FORTUNE 500 company, provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through its locally operated health plans, Molina Healthcare served approximately 4.1 million members as of March 31, 2018.