Healthy Start is a free home visiting program that provides education and care coordination to pregnant women and families with children under the age of three.
The Agency for Health Care Administration (AHCA) contracts with an administrative services organization (the MomCare Network) representing all Healthy Start coalitions to provide Medicaid waiver services to Healthy Start participants.
In addition, Statewide Medicaid Managed Care health plans contract with the Healthy Start coalitions in the plans’ regions to provide care coordination services for pregnant women and infants.
Statute, state contracts, and agreements among these entities specify the required service provision and coordination efforts between the health plans and Healthy Start for serving Medicaid enrollees participating in Healthy Start. While some services specified in state contracts appear similar for both sets of entities, the agreements between the health plans and the Healthy Start coalitions clearly delineate who is to provide which services. These agreements show overlap between the entities in only two areas: care coordination and data sharing.
Healthy Start and eight of the nine health plans reported finding no service duplications. AHCA staff reported that some services included in the AHCA-MomCare Network contract are also covered under the AHCA-health plan contracts. Due to data limitations, the existence of duplication cannot be validated through AHCA’s encounter data. Both Healthy Start and the health plans reported frequent communication and coordination as part of efforts to avoid duplication of services.
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