Pennsylvania’s primary Medicaid managed care program, Physical HealthChoices, contracts with seven managed care organizations (MCOs) and serves over 2.3 million individuals as of July 2025. In this report and its accompanying summary documents, we evaluate the Physical HealthChoices program’s performance across areas such as quality outcomes, cost management, collaboration between Pennsylvania’s Medicaid agency and the MCOs, community investments, provider partnerships, and initiatives addressing social determinants of health.
Our key overall observations, supported in detail in the report, include:
- HealthChoices epitomizes a successful public/private partnership. HealthChoices also epitomizes what Medicaid can be for those it serves, and the value of a well-designed, expertly implemented system of care and care coordination in the Medicaid arena.
- The program, now in place for decades, has delivered exceptional quality of care and access to care for Pennsylvania’s Medicaid population, while managing costs effectively for the Commonwealth’s taxpayers.
- The vast programmatic features each MCO has implemented above the state’s (considerable) contractual requirements made all of us involved in preparing this report grateful to have a role in its compilation.