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NEW HEALTH PLAN TO PROVIDE MANAGED CARE APPROACH, IMPROVED BENEFITS TO MEDICAID RECIPIENTS

 PITTSBURGH, Jan. 25 /PRNewswire/ -- Improved access to primary care and expanded health care benefits will be made available to area Medicaid recipients through a newly formed health care organization designed specifically to serve the Medicaid population in southwestern Pennsylvania.
 The Gateway Health Plan, initiated by Blue Cross of Western Pennsylvania, Allegheny General Hospital and Mercy Health Plan of Philadelphia, will utilize a network of quality providers to enhance the level and continuity of care available to Medical Assistance patients.
 Gateway Health Plan will operate through an affiliation with Keystone Health Plan West, the HMO jointly owned by BCWP and Pennsylvania Blue Shield. A contract was signed recently with Keystone and the Pennsylvania Department of Public Welfare.
 Scheduled to be operational in April of this year, Gateway's initial service area will include Allegheny, Beaver, Butler, Washington, Westmoreland and Armstrong counties.
 "The Gateway Health Plan was developed to address a number of issues and trends now affecting the state of Pennsylvania and its Medical Assistance population, including cost and access to primary care," said David O'Brien, chief executive officer of Gateway Health Plan.
 The efficiencies of the Gateway Health Plan will allow it to provide comprehensive, high-quality care at a lower cost to the Commonwealth of Pennsylvania, thus enabling the state to provide more care to more people.
 Participants in the Gateway Health Plan will be able to select a primary care physician who will manage their care and be available for patients 24 hours a day, seven days a week. This round-the-clock access and continuity of care adds a much needed dimension to the care and treatment of the Medicaid population. Primary care physicians will also refer patients to specialists when appropriate.
 Gateway Health Plan will cover all bei?ts currently available through Medical Assistance cards, including: doctor visits, baby and child care (including regular check-ups), immunization, prenatal care, yearly physicals, family dental care, eye examinations, prescription drugs, foot care, emergency care, hospitalization, laboratory and X-ray tests, surgery and anesthesia, physical therapy, occupational therapy, skilled nursing or intermediate care (limited to first 30 days), and home health care services authorized by a doctor.
 Currently, only a portion of Medical Assistance patients receive dental benefits. Gateway Health Plan will provide dental care to all participants as well as coverage for eye glasses and vitamins.
 "Participants will now have the benefits, access and continuity of care traditionally associated with commercial HMOs and third-party payor plans," said O'Brien. The Gateway Health Plan also issues its own membership card, eliminating the need for the Medicaid "green" or "blue" card.
 The Gateway Health Plan should also assist greatly in relieving the pressures now being placed on area emergency rooms by Medicaid patients. Emergency room visits by Medicaid patients across the nation have risen by 34 percent in the last five years. The majority of these visits are non-emergency and reflect the ever-increasing lack of primary care for the Medical Assistance population.
 A select network of hospitals and physicians has been established to facilitate care in the Gateway Health Plan. These include: Allegheny General Hospital, Forbes Regional Health Center, Harmarville Rehabilitation Center, Ohio Valley General Hospital, Children's Hospital of Pittsburgh, Magee Women's Hospital, Mercy Hospital of Pittsburgh, St. Margaret Memorial Hospital, South Side Hospital, Westmoreland Hospital and Latrobe Area Hospital.
 Discussions with other hospital providers are currently underway.
 Medical Assistance recipients may enroll in the Gateway Health Plan at no cost. Participation in the program is voluntary.
 Representatives from Gateway Health Plan will be conducting a number of community outreach programs aimed at educating Medicaid recipients about the new initiative.
 Gateway Health Plan will assemble a multidisciplinary advisory committee that will provide a link to the community and can assist in communicating the plan's availability.
 Additional information on the Gateway Health Plan may be obtained by calling 800-392-1147.
 -0- 1/25/93
 /CONTACT: John McDermott, 412-255-8247, or Thomas Chakurda, 412-359-6896, both for Blue Cross of Western Pennsylvania/


CO: Blue Cross of Western Pennsylvania ST: Pennsylvania IN: INS SU:

JS-CC -- PG012 -- 8492 01/25/93 12:17 EST
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Date:Jan 25, 1993
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