Case Study: Regaining a lost Medicaid contract

Case Study: Regaining a lost Medicaid contract

Case Study: Regaining a lost Medicaid contract

Challenge

Columbia United Providers is a local health plan based in Southwest Washington serving Medicaid beneficiaries and TPA clients. In 2012, they faced a tremendous challenge to their major line business: they were not renewed as a Medicaid plan with the state. In order to regain their Medicaid contract, Columbia United Providers enlisted the help of Wilson Strategic Communications.

Solution

Wilson Strategic provided a business strategy to Columbia United Providers by facilitating a partnership with Community Health Plan of Washington, another carrier who was also denied a contract in Clark County. The partnership proved successful, and together both entities were able to continue serving their members.

Wilson Strategic worked closely with Columbia United Providers to diversify their business by filing a product on the Washington Health Benefit Exchange marketplace, marking the company’s first commercial line of business. A significant part of this effort was the creation of an individual exchange product, which Wilson Strategic helped develop from scratch, guiding the health plan through federal and state regulatory hurdles: from product development and filing with the Office of the Insurance Commissioner and CMS, to ensuring network adequacy.

At the same time, Wilson Strategic successfully prepared Columbia United Providers to regain their direct Medicaid contract with the state.

Outcome

Columbia United Providers launched an individual exchange product for Open Enrollment in 2015. They were able to regain the direct contract with the state effective January 2015, thus diversifying their risk and allowing the company to not only continue, but expand, their operations.

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