Michigan Medicaid managed care operates through the Comprehensive Health Care Program (CHCP), administered by MDHHS, first implemented in 1997 and currently under nine-plan contracts effective Oct. 1, 2024 through Sept. 30, 2029 (with three one-year renewal options), covering roughly 2.2 million beneficiaries. Michigan adopted the ACA Medicaid expansion as the Healthy Michigan Plan, covering adults 19 to 64 with incomes up to 133 percent of the federal poverty level; Healthy Michigan Plan members enroll in the same nine Medicaid Health Plans as the rest of CHCP, and federal work requirements apply to them beginning January 1, 2027. The dual-eligible population moved to a new coordinated-care model, MI Coordinated Health, on Jan. 1, 2026, replacing the outgoing MI Health Link demonstration. Specialty behavioral health remains carved out of CHCP entirely, run through a 10-region Prepaid Inpatient Health Plan (PIHP) system whose planned 2026 restructuring into 3 regions was formally withdrawn by MDHHS in early 2026 after a court ruled the restructuring RFP conflicted with the Michigan Mental Health Code; the existing 10-PIHP structure remains in place, not a pending or unsettled question.
Nine Medicaid Health Plans (MHPs) hold CHCP contracts effective Oct. 1, 2024: Aetna Better Health, Blue Cross Complete, HAP CareSource, McLaren Health Plan, Meridian Health Plan, Molina Healthcare, Priority Health Choice, UnitedHealthcare Community Plan, and Upper Peninsula Health Plan (the sole plan serving the UP). Nursing facility residents, MI Choice waiver participants, and MI Coordinated Health enrollees do not enroll in a standard MHP.
Not integrated into standard MHP managed care. The MI Choice Home and Community Based Services waiver, Michigan's primary community-based long-term-care program for older adults and adults with physical disabilities, operates as its own carved-out program outside the nine CHCP MHPs; MI Choice participants are excluded from standard MHP enrollment. Nursing facility residents are likewise excluded from standard MHP enrollment. The state's I/DD and other 1915(c) HCBS waivers similarly operate as their own carved-out programs rather than being integrated into CHCP's MHP structure.
Not integrated into managed care
Fully carved out of the nine CHCP MHPs. Specialty behavioral health, substance use disorder, and I/DD services are instead administered through a 10-region Prepaid Inpatient Health Plan (PIHP) system, with the PIHPs subcontracting to roughly 46 county-based Community Mental Health Services Programs (CMHSPs) for direct service delivery. MDHHS proposed consolidating the 10 PIHP regions into 3 under a competitive procurement model in 2025, but rescinded that proposal after a court found it conflicted with the Michigan Mental Health Code; the existing 10-region PIHP/CMHSP structure remains in place.
Carved out
Dental for members under 21 is carved out of the MHPs into Healthy Kids Dental, a statewide program serving about 955,000 children and young adults, administered by Delta Dental of Michigan under a five-year contract effective October 1, 2026. For adults, dental is an in-plan MHP benefit; adult dental benefits were expanded in 2023, and access and network adequacy vary by plan.
Pharmacy is carved in and administered per-MHP; each plan maintains its own preferred drug list, per consumer-facing plan-selection guidance directing members to check each plan's own formulary. Michigan has no single statewide PBM vendor or centrally mandated preferred drug list.
Non-emergency medical transportation (NEMT) is contracted per-MHP, not through one statewide broker. A current MDHHS document identifies Medical Transportation Management, Inc. (MTM) as Molina Healthcare of Michigan's NEMT vendor. Sources disagree on the broader picture: a third-party NEMT-industry rate guide describes ModivCare as Michigan Medicaid's statewide broker, which conflicts with MDHHS's own document naming MTM for Molina specifically. Which characterization applies to the other eight MHPs, or whether both vendors operate for different plans, is unclear.
CHAMPS (Community Health Automated Medicaid Processing System) is Michigan's Medicaid Management Information System, operated by Acentra Health, serving as the state's provider enrollment, eligibility, prior authorization, and claims platform for roughly 2.6 million residents. Michigan's MMIS runs on a multi-state cloud governance model shared with Illinois; both states use a common underlying platform to reduce costs.
75 agency updates tracked for Michigan. Available with Pro.
See them with ProBridge Michigan reports that Michigan Democrats, after winning major elections by campaigning on affordability, are considering options including wage increases, expanded tax credits, and caregiver support programs once Gov.-elect Jocelyn Benson and legislative leaders take office in January. Sen.-elect Abdul El-Sayed and fellow Democrats are also seeking to reverse or revise federal actions including spending cuts to Medicaid and food assistance. Experts cited in the piece say state options are limited and costly, and that much depends on how federal changes to Medicaid and food assistance funding affect the state budget. Benson has proposed expanding the Rx Kids cash assistance program and creating a new caregiver tax credit.
CMS will terminate Kalamazoo Behavioral Health Hospital's Medicare provider agreement effective Nov. 16, according to an Oct. 30 public notice, after finding the hospital failed to meet conditions of participation covering patients' rights, nursing services, physical environment and psychiatric hospital staffing and recordkeeping requirements. The hospital, owned by Neuropsychiatric Hospitals, is also under investigation by Michigan's Department of Licensing and Regulatory Affairs over alleged violations, with records showing patients were transferred to another hospital at least 57 times between January and May, including transfers tied to falls, assaults, unexplained injuries and unresponsive patients. CMS will not pay for inpatient services for patients admitted on or after Nov. 16, though Medicare may continue paying up to 30 days of covered services for patients admitted before that date.
Trinity Health CEO Mike Slubowski said federal changes under HR 1 will cost the Livonia, Mich.-based system about $1.6 billion over three years, with 80% of its business tied to Medicaid and Medicare. Speaking Nov. 3 at Becker's CEO + CFO Roundtable, he said the response, called "repositioning," goes beyond cost-cutting to include refining clinical service lines, expanding community-based care, and reducing administrative expense. Community-based services already make up 62% of revenue, with a goal of reaching at least 75% within three to five years. Catholic Health Association CEO Sister Mary Haddad, speaking alongside him, said hospitals will keep absorbing uncompensated care costs as patients lose coverage. Slubowski also described expansion of Trinity's PACE programs for dual-eligible older adults, AI tools for prior authorization, and said he would tell Congress it "blew it" on ACA and Medicaid cuts.
Voters in five Michigan cities, Benton Harbor, Lansing, East Lansing, Kalamazoo and Portage, approved charter amendments creating seven- or eight-member "citizens' advisory health action" committees to study healthcare costs, by margins ranging from 55% to 80%. The committees will hold public forums, track federal and state officials' votes on healthcare legislation, and must deliver a "Healthcare Action Plan" to city leaders by October 1 of each even-numbered year, with city councils holding public hearings by October 15. A liberal "dark money" nonprofit spent nearly $3 million on the campaigns, which were concentrated in two toss-up congressional districts represented by Republicans who lost reelection; funding sources and how the boards will function remain unclear. Local officials, including Kalamazoo's mayor and a city commissioner, raised concerns about ongoing costs to taxpayers and the use of undisclosed funding to drive the measures.
LiveWell Partners closed its acquisition of Detroit-based Assured Home Health and Hospice, a provider serving Southeast Michigan, according to Home Health Care News. Terms were not disclosed. Assured will continue operating under its existing name and leadership. The deal is LiveWell's fourth transaction in Michigan, following prior acquisitions of Michigan Community VNA Home Health and Hospice and John Paul Home Care and Hospice; LiveWell is backed by private equity firms Encore Management Group and Camino Partners and operates across Illinois, Kansas, Michigan, Missouri and Ohio.
16 active waivers tracked for Michigan. Available with Pro.
See them with ProNo active solicitations currently tracked for Michigan.
2 managed care contracts tracked for Michigan. Available with Pro.
See them with Pro16 bills tracked for Michigan. Available with Pro.
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