The Bureau for Medical Services (BMS), Office of Managed Care, initiated a risk-based managed care program called Mountain Health Trust (MHT) in September 1996. Mountain Health Trust provides managed care services to approximately 87% of the state’s Medicaid membership. Populations covered under managed care include most adults and children, pregnant women, and members receiving Supplemental Security Income (SSI). The Bureau contracts with three Managed Care Organizations (MCOs) for the provision of Medicaid medically necessary services. Services carved out of managed care include point of sale pharmacy, long-term care, Home and Community-Based waivers and non-emergency medical transportation services. Effective January 1, 2021, West Virginia Children's Health Insurance Program (WVCHIP) members are included in the MHT program.
In January 2021, there were 438,987 Medicaid members enrolled in Mountain Health Trust. For more information about MHT Medicaid enrollment, external quality reviews and annual reports, please click here.
Managed Care Organization Links:
Aetna Better Health of West Virginia (formerly Coventry Health Care of West Virginia)
The Health Plan of West Virginia (formerly Health Plan of the Upper Ohio Valley)
Highmark Health Options
UniCare
Bureau for Medical Services, Office of Managed Care, MHT organizational structure:
Susan L. Deel, Director, Office of Managed Care
Anita Ferguson, Managed Care Enrollment and Network Services
Mountain Health Promise Specialized Managed Care Program for Children and Youth
The Mountain Health Promise (MHP) program serves specialized managed care for children and youth. Mountain Health Promise assists children in foster care, kinship care and adoptive care. Aetna Better Health of West Virginia is the single managed care organization for MHP. Members eligible for the Children with Serious Emotional Disorder Waiver (CSEDW) are automatically enrolled with Aetna Better Health of West Virginia. For more information, please the MHP webpage.
There are approximately 23,574 children enrolled in Mountain Health Promise.