More Info on Beacon and Medicaid

MEDICAID TRANSITION WITHIN THE BEACON MEDICAL SYSTEM
Information received from Kreg Gruber
Beacon's CEO on October 30, 2023
FREQUENTLY ASKED QUESTIONS

Is Beacon participating in Medicaid?
Yes. Beacon cares for two-thirds of the Medicaid population in our area and will remain a Medicaid provider. Recent changes occurred at seven of our 72 physician sites for two of the managed Medicaid plans. This change does not impact the hospitals, specialist or ancillary services that Beacon provides to the community. Beacon has almost 600 providers; this change impacted 33 physicians and four mid-level providers. 
 
What office(s) does the Medicaid transition impact?
The seven sites include: Beacon Medical Group Ireland Road, Beacon Medical Group Main Street, Beacon Medical Group Cleveland Road, Beacon Medical Group La Porte, Beacon Medical Group Internal Medicine Osolo Road, Beacon Medical Group Pediatrics Bristol Street and Beacon Medical Group Elkhart East.

Does this include specialists?
No, this change only includes Family Medicine/Internal Medicine providers who are enrolled as a Primary Medical Provider (PMP). BMG specialists and Beacon hospitals will continue to participate in these Medicaid plans.
Which Medicaid plans does this affect?

This affects the Anthem and Managed Health Services Medicaid Plans that include members of the Healthy Indiana Plan, Hoosier Healthwise, and Hoosier Care Connect, also known as a managed care entity (MCE). When these members enroll in a managed care program, they choose a doctor to be their Primary Medical Provider, often called a PMP. The sites listed above will no longer be designated as PMPs with these identified plans. 
Does this mean these offices will no longer take Medicaid patients?
No, these offices will continue to care for traditional Medicaid patients, also called fee-for-service (FFS) and Ambetter (Marketplace Plan). 

Where can affected patients go for care?
Patients are encouraged to work with their insurance provider as they continue to have choices for their primary care. Beacon worked with the insurance companies and the following providers to ensure a smooth transition of care:

• , a Federally Qualified Health Clinic (FQHC), where there are multiple facilities located within three counties. HealthLinc has the capacity to accept the transfer of patients to their clinics. HealthLinc has a good reputation within our communities with achieving strong quality clinical outcomes. HealthLinc has excellent patient customer ratings and high retention with its associates and providers.
• Heart City Health, an FQHC, has facilities located in Elkhart County. They have a multifaceted approach to healthcare that allows them to provide superior care, across multiple disciplines, to treat the whole person.
• Indiana Health Centers, an FQHC that provides medical, dental and behavioral health care throughout the State of Indiana.
• Memorial Family Medicine Residency Program at Beacon Medical Group E. Blair Warner.

What is a Federally Qualified Health Center (FQHC)?
FQHC is a federal/state care model by which these licensed facilities allow for a higher reimbursement payment model than a health system or private/independent groups. FQHCs provide more covered “wraparound” services: dental, vision, mental health, substance abuse, prescription/pharmacy, and legal. Health systems/medical groups do not receive coverage for these services.

What are the benefits of a Federally Qualified Health Center (FQHC)?
The primary purpose of FQHCs is to serve as Patient-Centered Medical Homes within our communities for the underserved patient population. FQHCs have special relationships with their patients to address barriers to care, including lack of transportation or problems in navigating health systems, to access needed services. FQHCs play an important role in encouraging patients to keep appointments, attend health education activities, and self-manage their medical conditions. Numerous wraparound services are offered, including dental, behavioral health, food pantry and medical transportation services.

WHICH MEDICAID CLIENTS WILL BE AFFECTED?
Medicaid Transition: The transition did not impact the hospitals, specialist, ancillary services or any other primary care sites other than the below 7 locations.

Phase 1: 
Cleveland Rd: 2235 Cleveland Road, South Bend, IN 46628 (Phone # 574-647-4530)
La Porte: 900 I. Street, LaPorte, IN 46350 (Phone # 219-324-1700)
Bristol Family Medicine: 306 E. Vistula Street, Bristol, IN 46507  (Phone # 574-848-4427)
Phase 2:
Main Street Medical Group: 6913 N. Main Street, Suite 300, Granger, IN 46530 (Phone # 574-647-1500)
Elkhart East: 3301 CR 6 East, Elkhart, IN 46514 (Phone # 574-264-9635)
Phase 3: 
Internal Medicine Osolo Rd (Elkhart East): 3301 CR 6 East, Elkhart, IN 46514 (Phone # 574-264-9635)
Ireland Rd: 1815 E. Ireland Road, South Bend, IN 46614  (Phone # phone: 574-647-1700)
 
Medicaid Transition: The transition did not impact the hospitals, specialist, ancillary services or any other primary care sites other than the below 7 locations.