AmeriHealth Michigan to Serve Metro Detroit’s Dual Eligibles Through CMS Financial Alignment Demonstration

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Services in Wayne and Macomb Counties to Begin on May 1, 2015; Michigan Native Marcia Laleman to Lead Newest AmeriHealth Caritas Dual Eligible Product

Marcia "Marc" Laleman has been appointed to lead AmeriHealth Caritas VIP Care Plus locally.

AmeriHealth Caritas, a national leader in Medicaid managed care and other health care solutions for those most in need, announced that its Michigan affiliate, AmeriHealth Michigan, Inc., has been selected to provide integrated care to dual eligibles in Michigan’s Wayne and Macomb Counties under MI Health Link. AmeriHealth Michigan’s Medicare-Medicaid Plan, AmeriHealth Caritas VIP Care Plus, will begin caring for dual eligibles in these counties on May 1, 2015.

AmeriHealth Michigan is one of five insurers selected by Michigan’s Department of Community Health and approved by the Centers for Medicare & Medicaid Services (CMS) to participate in the demonstration. MI Health Link, which is part of CMS’ Financial Alignment Initiative, is intended to improve care coordination for dual eligibles, or individuals enrolled in both Medicare and Medicaid.

There are approximately nine million dual eligibles nationwide, including about 62,000 in Wayne and Macomb Counties. On average, more than $38,000 per person is spent each year on health care for dual eligibles, or individuals whose health care services are covered by both Medicare and Medicaid.

Medicare-Medicaid Plans include Medicare and Medicaid managed care benefits and services under one plan, fully integrating the two programs to deliver the most effective health care to dual eligibles.

“We are committed to working with CMS, the Michigan state government and other businesses to find innovative ways to improve access to health care for those most in need,” said John Baackes, president Medicare VIP Plans for AmeriHealth Caritas. “It is a privilege to collaborate with the state of Michigan to improve the quality and efficiency of health care for dual eligibles in Wayne and Macomb Counties.”

Michigan Native Marcia Laleman to Lead AmeriHealth Caritas VIP Care Plus

AmeriHealth Caritas has appointed Marcia “Marc” Laleman as vice president, Medicare-Medicaid Plans. In this role, Laleman will oversee the medical management, member and provider relations, network development, marketing and community relations for AmeriHealth Caritas VIP Care Plus (the Medicare-Medicaid Plan). She reports to John Baackes, president, Medicare VIP Plans for AmeriHealth Caritas.

A Michigan native, Laleman has over 30 years of experience as a Medicare health care executive. She began her career in health care at Blue Cross Blue Shield of Michigan, where she served in several managerial capacities in the insurer’s Medicare and managed care lines of business. She later served as director of Medicare programs for Independence Blue Cross, as well as a senior executive for RISCORP Health Plans, CorCell Inc. and TMG Health Inc. She joined AmeriHealth Caritas as vice president, Medicare Operations in January 2012.

Laleman earned her bachelor’s degree from Central Michigan University, and a Master of Social Work degree from Michigan State University.

“Laleman’s experience in Medicare health plans and knowledge of the Michigan market will serve us well as we begin enrollment and serving members,” said Baackes.

“It is great to be able to help my native state benefit from AmeriHealth Caritas’ nationally renowned approach to health care,” said Laleman. “Michigan’s financial alignment demonstration, MI Health Link, holds great potential for the health of the state’s dual eligibles, and AmeriHealth Caritas VIP Care Plus is well-positioned to make good on that potential.”

About AmeriHealth Caritas
AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. AmeriHealth Caritas operates in 16 states and the District of Columbia, and serves more than 6.6 million Medicaid, Medicare and CHIP members through its integrated managed care products, pharmaceutical benefits management services, behavioral health services and other administrative services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven company with more than 30 years of experience serving low-income and chronically ill populations. For more information, visit http://www.amerihealthcaritas.com.

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Joshua Brett
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