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- EIN 35-1931354
- (317) 822-7100
- 2955 N Meridian Street Indianapolis IN 46208-4798 USA
- www.mdwise.org
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Nonprofit Overview
Mission: Mdwise is a not-for-profit health maintenance organization contracting with healthcare providers to provide healthcare services to its indiana members for three state programs: hoosier healthwise, healthy indiana plan and hoosier care connect (hcc). Mdwise accomplished its core values through a five-fold mission:1. Delivering consistent, high quality care. 2. Focusing on families and community in a culturally competent way. 3. Shaping health policy and promoting innovation in medicaid managed care. 4. Ensuring financial viability through efficient and cost effective operations. 5. Involving providers in key decision making and nurturing local governance of the mdwise product.
Programs: Beginning january 1, 2011, mdwise was granted a four-year contract with the state of indiana (the "state"), through the family and social service administration ("fssa") and office of medicaid policy and planning ("ompp"), to arrange for and administer two risk-based managed care programs ("hoosier healthwise and "healthy indiana plan") for certain indiana medicaid enrollees. Mdwise contracts with various delivery networks including the affiliated mdwise medicaid network ("excel"). Excel and the other delivery networks accept the medical service risk for enrollees who choose a primary care provider after selecting the mdwise network. There were approximately 224,000 and 233,000 members enrolled in the hoosier healthwise product at december 31, 2017 and 2016, respectively. There were approximately 117,000 and 151,000 members enrolled in the healthy indiana product at december 31, 2017 and 2016, respectively. The increase in members is related to the expansion of the program by the state. On january 1, 2017, the contract with the state of indiana was renewed and is now scheduled to expire on december 31, 2022. The company was granted a four-year contract in january 2014 to participate in care select beginning february 1, 2014 and was to expire january 31, 2018. During 2014, the state released a request for proposal to replace the newly granted four-year contract with risk-based managed care services in the form of a new program called hoosier care connect ("hcc"). The company was selected to begin contract negotiations on the replacement program on november 26, 2014. As a part of this transition, the hcc program began april 1, 2015 while the care select contract was phrased out during 2015. The new hcc agreeement will be effective for a 4 year period ending march 30, 2019. At the discretion of the state, there may be two 1-year renewals. In no event, shall the term exceed a total of six years. The company's contract with the state was terminated on march 31, 2017. The company collaborated with the state to transitions those members to alternate managed health plans. The company was responsible for approximately 0 to 39,000 members at december 31, 2017 and 2016, respectively.