Centene is a leading multi-line healthcare enterprise that provides programs and related services to individuals receiving benefits under Medicaid, including the State Children's Health Insurance Program (SCHIP), as well as Aged, Blind, or Disabled (ABD), Foster Care, Long-Term Care and Medicare (Special Needs Plans).
MEDICAID
Currently, Medicaid is the third largest source of health insurance following Medicare and employment based plans. Individuals covered under Medicaid include low-income families, individuals with disabilities and the elderly. There are federal guidelines regarding Medicaid coverage, but eligibility is dependent on both income and asset requirements, as determined by the states.
SCHIP
Created in 1997 and enacted as Title XXI of the Social Security Act, the State Children’s Health Insurance Program (SCHIP) builds upon Medicaid by providing expanded coverage to uninsured children that do not meet Medicaid eligibility requirements. KCMU estimates 6 million children are covered under SCHIP as compared to 28 million covered by Medicaid.
ABD
Supplemental Security Income (SSI) is a federal entitlement program for people with disabilities who have limited income and resources. Many people on SSI receive Medicaid healthcare benefits under individual state’s Aged Blind and Disabled (ABD) programs. The KCMU calculates ABD enrollees make up approximately 25 percent of Medicaid enrollees and 70 percent of total Medicaid expenditures. This unique population requires an individualized management approach. Centene offers programs for dual (ABD members with both Medicare and Medicaid coverage) and non-dual (ABD members with Medicaid only) populations. Through these programs, consumers and caregivers are provided access to tools and resources that enable independent living.
Long-Term Care
Long-term care accounts for 37 percent of total Medicaid spending with roughly 3 million individuals relying on Medicaid for long-term care. Medicaid offers a continuum of delivery options for long-term care services ranging from nursing home care to home and community based care. Relative to the total, spending on home and community based services has grown in recent years. Growth in the aged population has increased the demand for long-term care services and the demand is expected to continue to increase. Many states are making efforts to make long-term benefits more flexible and allow consumer choice and involvement. States are challenged with ensuring access to needed services while providing cost-effective quality results. As such, more states are turning to partners like Centene who can provide solutions to meet these demands.
Centene is positioned as an effective partner and is committed to ensuring that members are involved in their care planning and offers services to support long-term care including a 24-hour nurse hotline, integrated behavioral health programs, home modifications, attendant care, emergency alert systems and equipment to assist with mobility. Centene has proactive member assessments that eliminate functional barriers to care.
Foster Care
The U.S. Children’s Bureau estimates around 800,000 children are served in the foster care system each year. The foster care population has special behavioral and medical needs. States are turning to Medicaid managed care solutions to help coordinate the unique medical, behavioral and social services for these children. On April 1, 2008, Centene began providing statewide managed care services to foster care children in the state of Texas under its subsidiary, Superior HealthPlan. With commencement of operations, Centene became the first organization in the country to serve as a state’s exclusive managed care company for the foster care population.
Uninsured Solutions
Centene is committed to offering a full range of healthcare solutions for the rising number of uninsured individuals and families. Between our innovative managed care programs throughout the country and Celtic Insurance Company, our national commercial insurer focused exclusively on individuals and families, Centene offers a range of customized coverage solutions to meet the diverse needs of each state and their respective residents. Centene is uniquely positioned to work with states to design both public and private-based solutions for all segments of the uninsured. For more information visit the website at www.celtic-net.com.
Specialty Health Solutions
Centene strives to provide specialized health solutions to the complex problems faced by state governments and patients. We offer a unique suite of programs and services which, alone or combined, deliver improved outcomes, reliable data, and cost-effective coordinated care. For more information visit the website at www.cencorphealthsolutions.com.
Medicare
Centene offers Medicare Special Needs Plan (“SNP”) coverage to ABD members who are eligible for both Medicaid and Medicare through our health plans in Arizona, Ohio, Texas and Wisconsin. By offering Medicare and Medicaid benefits, Centene is better positioned to effectively manage the care of our members. Our plans provide access to personal, local care and promote health and independence.