COMMUNITY HEALTHCHOICES (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. CHC will use managed care organizations (MCOs) to coordinate physical health care and long-term services and supports (LTSS).
The Commonwealth of Pennsylvania is committed to improving service coordination and health outcomes for older residents and adults with disabilities. In order to meet this commitment,
Community HealthChoices (CHC) joins with Physical HealthChoices and Behavioral HealthChoices to ensure a complete system of coordinated managed care. Behavioral HealthChoices provides a range of mental health and substance use disorder treatment services.
What does CHC mean for Behavioral HealthChoices?
Behavioral health services will continue to be offered through the existing network of behavioral health managed care organizations (BH-MCOs). Behavioral health providers will not be required to contract with a CHC-MCO to provide behavioral health services. CHC-MCOs and BH-MCOs will work together to coordinate the services that each participant needs.
Will CHC increase behavioral health services recipients?
CHC will enable individuals previously excluded from the Behavioral HealthChoices program to be eligible for BH-MCO coverage. The majority of new enrollees will include individuals in the Aging Waiver and residents of nursing facilities. Behavioral health providers serving these individuals can ensure continuity of care by enrolling to provide services through Behavioral HealthChoices. Providers should continue to check the Eligibility Verification System (EVS) daily to confirm BH-MCO enrollment.
Who are the Community HealthChoices managed care organizations?
Through a request for proposals, the commonwealth has selected the following MCOs to proceed with negotiations to deliver services on a statewide basis:
- AmeriHealth Caritas
• Pennsylvania Health and Wellness (Centene)
• UPMC for You
When does the CHC program begin?
Pennsylvania is undertaking a regionally based, three phase implementation of CHC, beginning with the Southwest region. Prior to the implementation of CHC in each region, DHS will hold an in-person regional event for providers, which will include a session addressing BH-MCOs and behavioral health providers. Southwest region providers will receive an event announcement soon.