CareCentrix Adds Aetna Medicaid Vet, Expands Service Offerings to Health Plans

CareCentrix — a care management company that focuses on home-based care — has brought on a long-time managed care veteran to expand its service offerings to Managed Medicaid health plans.

Hartford, Connecticut-based CareCentrix provides post-acute care and discharge management services, plus durable medical equipment (DME) and home-based care services.

Moving forward, Scott Markovich will serve as CareCentrix’s general manager of Medicaid, the company announced last week.

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“Historically, the company has done commercial members, Medicare members — even dual eligibles, to some degree,” Markovich told Home Health Care News. “I would say that they’re really [a] leader in keeping people at home, allowing them to heal and age at home.”

The addition of Markovich is part of CareCentrix’s larger investment in home care for Medicaid beneficiaries. It’s a space the company previously didn’t focus on, Markovich noted.

“[Before this], they’d never had programs for Medicaid, specifically,” he said. “The company is, without question, making a pivot to invest more in Medicaid.”

While joining CareCentrix is his first foray into the provider side of the business, Markovich is no stranger to working with Medicaid health plans. He has 24 years of experience under his belt, most recently serving as regional vice president for the Midwest region and vice president of business development at Aetna Medicaid.

“I understand what the health plans are going to be doing,” Markovich said. “On the CareCentrix side, there is a unique opportunity to leverage our assets — the company’s 20-plus years of experience in managing care at home, and now bringing it to one of the most vulnerable populations.”

Prior to joining CareCentrix and Aetna Medicaid, Markovich was the president of Magellan Complete Care, where he oversaw the formation of one the nation’s first Medicaid health plans for individuals with serious mental illness.

Additionally, Markovich has held executive leadership roles at Anthem and Unison Administrative Services.

One of the main reasons CareCentrix is making a bigger push toward investing in Medicaid is because of the impact that COVID-19 has had on the health care landscape, according to Markovich.

“As COVID-19 has really unfolded, the population in the country that has probably been the most impacted by the virus are the ones that are eligible for Medicaid,” he said.

As unemployment rises, there will likely be more individuals over the course of the next few months who will become eligible for Medicaid. For state governments that are already under tight budget pressures, the public health emergency has added an unprecedented level of uncertainty to these matters.

“Those members will eventually, in most states, become members of these Medicaid HMOs that the states contract,” Markovich said. “In its simplest form, the risk is going to be passed from the states to the Medicaid health plans. As Medicaid health plans look to understand how they can manage this population … better and more cost-effectively, keeping a member at home and surrounding them with all the supports and services that they need [will be a priority].”

Typically, economic downturns shift hundreds of thousands of people into the Medicaid system. Between February and April alone, New York’s Medicaid enrollment had a net gain of 136,000, for example.

Since joining CareCentrix, Markovich’s focus has been taking the company’s existing suite of programs and tailoring them for the Medicaid population.

“We do a lot of programs today for home health, for DME, for readmission management — and now they need to be tweaked a little bit for Medicaid, thus adding value to the health plans who are going to have to figure out how they’re going to manage in this COVID-19 world we live in,” he said.

One of these changes includes navigating a more “high touch” Medicaid population.

“You can’t expect to reach them via telephone calls,” Markovich said. “We had to change our programs to be a little more face-to-face. We are leveraging more community-based organizations that these members are comfortable with and are used to dealing with. It’s also about understanding all of the social determinants of health that impact the members.”

So far, CareCentrix is already seeing significant interest from Medicaid health plans, according to Markovich.

Looking ahead, Markovich wants the company to get more involved in the management of long-term support services, specifically targeting individuals that meet the criteria for nursing home care and home- and community-based waiver services.

“My long-term goal would be to build programs that CareCentrix can leverage, in cooperation with health plans, to really help these individuals, who most of the time are on the fast track to moving into a nursing home,” he said. “My goal is to keep them at home instead. We can surround them with home care, DME and make sure they have social determinants of health programs available to them.”

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