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Meridian Health Plan (MHP) is a Medicaid HMO in the State of Illinois providing health care to beneficiaries enrolled into the AllKids, Family Care and Moms and Babies programs through a contract with the Illinois Department of HealthCare and Family Services (IDHFS). MHP is a privately owned and physician managed Medicaid health plan. Its corporate headquarters are located in Chicago, Illinois. Currently MHP operates in 8 counties. Our Mission: To continuously improve the quality of care in a low resource environment Our Vision:
Key Features:
CORPORATE INFORMATION Corporate History Meridian Health Plan (MHP) is an Illinois Medicaid health plan that began providing health services to enrollees in December of 2008. MHP has extensive experience in the Medicaid market through its sister organization, Health Plan of Michigan. Health Plan of Michigan is a Medicaid health plan contracted with the Michigan Department of Community Health (DCH) to provide health care services. Health Plan of Michigan was formed from the merger of two clinic plans, Central Michigan Health Plan (CMHP) and American Preferred Provider Plan of Michigan (APPPM). CMHP was founded by physicians at the Jackson Northwest Clinic located in Jackson, Michigan in December of 1996. In August of 1997, Dr. David B. Cotton acquired a majority position in CMHP and assumed fiscal and administrative responsibility for the plan, which had approximately 1,400 members. CMHP acquired APPPM in January of 1999 and ultimately became operational as Health Plan of Michigan in May of 1999. In January of 2000, HPM acquired the Michigan membership of Family Health Plan of Ohio. Health Plan of Michigan is now the largest Medicaid HMO in the State of Michigan with over 261,000 members. HPM currently operates in 64 counties throughout the State of Michigan and has developed one of the largest Medicaid provider networks in the state, including:
Health Plan of Michigan has operated as a full service HMO since January of 2000 and obtained NCQA accreditation in May of 2002. HPM and MHP both remain physician owned and physician managed health plans. To learn more about our sister corporation Health Plan of Michigan, visit their website at www.hpmich.com. Provider Network and Service Area Meridian Health Plan has the stated goal of offering the most full and comprehensive provider network possible to its referring physicians and members who receive care. MHP will model the same successful strategies as the Health Plan of Michigan in the development of its provider network and plans on being present in all 102 counties throughout the State of Illinois. The MHP option is currently available to eligible Medicaid recipients residing in the Plan's service area which includes the Illinois counties of Adams, Brown, Cook, Henry, Mercer, Pike, Rock Island and Scott Counties. (Click to Enlarge)
Service Description MHP provides a wide range of Medicaid covered benefits for its enrollees including preventive care, physician office visits, diagnostic tests, home health care, inpatient hospital care and emergency room treatment. All services are provided based on the State of Illinois Medicaid benefit guidelines. MHP's philosophy is to function as a care management and preventive care organization with an emphasis on disease management. The following are some of the beneficial services provided by Meridian Health Plan: Member Outreach - Each new member receives a welcome call within the first 30 days of enrollment to verify their primary care provider selection and to explain MHP's managed care processes. In addition, members receive periodic telephone calls to remind them of important preventive services such as well child visits, immunizations, prenatal care and other screenings. Health Risk Assessment (HRA) - Members are contacted via phone and are interviewed regarding their medical history. Based on the results of the HRA, the members are assigned to disease management programs or case management services, as appropriate. Members not acute enough to require case management are screened for required preventive services and are contacted through MHP's health outreach program and are actively encouraged to obtain the necessary care. Disease Management - MHP has developed disease management programs that are rolled out to the entire eligible membership. These programs include Diabetes, Asthma and Heart Disease. Members in the disease management programs are stratified based on claims data and are assigned to a level of one through three, with three being the most complex. The Disease Management department provides education and outreach to members and providers. Case Management - Members entering the health plan with multiple medical issues are identified and immediately assigned to a case manager trained to develop interventions that can result in lower hospitalization rates. The overriding philosophy of MHP is to deliver as many outpatient services as necessary to maintain member health and avoid an inpatient admission. All of the data gathered through these activities is captured in MHP's state of the art managed care system (MCS). This allows for a comprehensive approach to preventive care and health management for our members and providers. Commitment to Quality The State of Illinois uses the nationally recognized Healthcare Effectiveness Data and Information Set (HEDIS®) to compare quality among the health plans serving the Medicaid population. MHP has made HEDIS improvement a corporate priority, with a goal of becoming the Top Medicaid health plans in the State of Illinois in terms of its HEDIS performance. Throughout the year, MHP monitors its HEDIS performance and conducts improvement activities to meet its goals, including education and outreach to members and providers. |
