Meridian Health Plan (MHP) is an Iowa Medicaid health plan that began providing health services to enrollees in March 2012. MHP has extensive experience
in its operations across the Midwest Medicaid market.
Meridian Health Plan is Michigan's largest Medicaid HMO, providing health care to over 290,000 Medicaid enrollees in 67 counties throughout the state. Meridian has developed one of Michigan's largest provider networks, including over 3,900 PCPs, 12,500 specialists and 127 hospitals. Meridian's Michigan plan holds URAC Full Health Plan Accreditation with Health Utilization Management.
In Illinois, Meridian Health Plan is a Medicaid HMO providing health care to over 10,000 beneficiaries in 20 counties. Meridian's Illinois provider network includes 16 hospitals, over 450 PCPs and over 1,000 specialists.
Provider Network and Service Area
Meridian Health Plan is continually seeking ways to improve access within our service area, as well as to expand into new service territories.
Meridian Health Plan is currently available to eligible Medicaid recipients residing in Benton, Black Hawk, Clinton, Linn, Muscataine, and Polk counties. On December 1, 2012, Meridian will also be available to eligible Medicaid recipients residing in Webster County. If you're interested in becoming a Meridian Health Plan provider, click here
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MHP's philosophy is to function as a care management and preventative care organization with an emphasis on disease management. MHP provides all Medicaid
covered benefits to our members based on the State of Iowa Medicaid benefit guidelines. These benefits include preventive care, provider office visits,
diagnostic tests, home health care, inpatient hospital care, emergency room treatment, and many other services to help our members stay healthy. The
following are some of the 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 (PCP)
selection and to explain MHP's managed care processes. In addition, members receive reminder calls to schedule important services such as well-child
visits, immunizations, prenatal and postpartum care, screenings for chronic conditions, and other preventive services. MHP Member Services also helps
schedule appointments for members who need assistance.
- Health Risk Assessment (HRA) - Members are reached by phone and asked about their medical history and current health status. Based on the
results of the HRA, the member can be enrolled in disease management programs or case management services, as appropriate. MHP's member outreach program
actively encourages these members to obtain the necessary care.
- Disease Management - MHP has developed Disease Management programs that are offered to the entire eligible membership, including diabetes,
asthma and cardiovascular disease. Members in the Disease Management programs are stratified based on claims data, and are assigned 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 enrolled with MHP who have multiple medical issues are identified and immediately assigned to a Case Manager. The Case
Manager is trained to develop self-management interventions that can result in lower hospitalization rates. MHP also helps members who select Case Management
for themselves. The overriding philosophy of MHP is to deliver as many outpatient services as necessary to maintain member health and avoid inpatient admissions.
All of the data gathered through these activities is captured in MHP's state of the art Provider Portal. This allows for a comprehensive approach to preventive care and
health management for our members and providers.
Commitment to Quality HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
The State of Iowa uses the nationally-recognized Healthcare Effectiveness Data and Information Set (HEDIS®) to compare quality among health plans
serving the Medicaid population. Meridian Health Plan has made HEDIS® improvement a corporate priority, with a goal of becoming Iowa's top Medicaid
health plan based on HEDIS® performance.
Throughout the year, Meridian Health Plan monitors its HEDIS® performance and conducts improvement activities to meet its goals, including education
and outreach to members and providers.