Care Wisconsin of Madison and My Choice Family Care of Wauwatosa, two of the six managed care organizations that oversee long-term care for frail elderly people and adults with disabilities in the state’s Family Care program, plan to merge, the organizations said Tuesday.
Care Wisconsin lost $36.4 million last year in Family Care, part of Medicaid, while My Choice made $5.2 million, according to a state financial report. During the first half of this year, Care Wisconsin made $6.5 million in Family Care and My Choice made $651,000.
The merger, subject to regulatory approval, “will build upon the established strengths of both organizations and enhance their ability to effectively coordinate acute, primary, community-based and long-term care services for members with a focus on quality outcomes, member satisfaction, and a robust provider network,” the organizations said in a statement.
In May, Dr. Kevin Park, then interim CEO of Care Wisconsin, told the Wisconsin State Journal that financial losses in 2018 stemmed from new members in Dane County and northeast Wisconsin, among the last parts of the state to join Family Care as required under a 2015 law.
Care Wisconsin early this year issued rate cuts for providers ranging from 5% to 60%, leading about six providers of services for adults with developmental disabilities in Dane County to terminate their contracts with Care Wisconsin. Care Wisconsin spokeswoman Karen Hitchcock said the cuts were starting points for negotiations and most providers worked out “mutually agreeable terms.”
Clients of providers that terminated contracts with Care Wisconsin had two main choices: Stay with their providers and switch to My Choice or switch providers and stay with Care Wisconsin. They could also consider an alternative called IRIS, which stands for Include, Respect, I Self Direct.
Care Wisconsin began as the first adult day care center in Madison in 1976, and My Choice started providing services as one of the original Family Care pilot operations in 2000.