Magellan Behavioral Health Care LLC.

What Magellan Behavioral Health Care LLC. does

Magellan Behavioral Health Care LLC, operating as Magellan of PA, is a behavioral health managed care organization (BH-MCO) that administers Pennsylvania's HealthChoices behavioral health program for Medicaid beneficiaries across seven Pennsylvania counties (Bedford, Bucks, Cambria, Lehigh, Montgomery, Northampton, and Somerset). The company manages mental health, substance use disorder, autism services, crisis intervention, and integrated whole health services under capitated contracts with the Pennsylvania Department of Human Services and partner county governments. Magellan functions as a subsidiary of Magellan Health, Inc., a diversified healthcare company, with a lean administrative footprint of approximately 24 employees and more than 20 years of operating history in Pennsylvania.

The company's product portfolio includes the HealthConnections program (physical-behavioral integration since 2009), Community HealthChoices, Intensive Behavioral Health Services (IBHS), Intensive Care Coordination, recovery and peer support services, autism support, substance use disorder resources including Medication-Assisted Treatment, and tobacco cessation support. Supporting infrastructure includes proprietary tools like SmartScreener (a behavioral health screening platform built on validated SAMHSA instruments), the PCP Toolkit for primary care integration, an Electronic Incident Reporting System, the BCM Outcomes Tool, and the Center for Recovery and Resiliency e-learning platform. Integrations include Availity for provider administration, Healthwise for health education, PA Quit Logix for tobacco cessation, and Tableau for data visualization.

Magellan operates as a B2B/B2G managed care organization with its revenue derived entirely from per-member-per-month (PMPM) capitated payments from the Pennsylvania Department of Human Services. Member services are delivered at no cost to eligible Medicaid beneficiaries through a contracted provider network spanning hospitals, clinics, therapists, and specialists. The go-to-market is exclusively through state and county procurement contracts, with member acquisition driven by Medicaid eligibility rather than direct-to-consumer marketing. The company holds NCQA Full MBHO Accreditation through 2026 and Health Equity Accreditation through 2027, and it is HIPAA-compliant with Section 1557 non-discrimination policies.

Name

Magellan Behavioral Health Care LLC.

Legal name

Magellan Health, Inc.

Website

https://magellanofpa.com

Company type

Private

Operating status

Operating

Headcount range

11–50 employees

Short description

Magellan Behavioral Health Care LLC operates as a Pennsylvania BH-MCO under the state HealthChoices program, managing behavioral health services for Medicaid beneficiaries across seven counties as a subsidiary of Magellan Health, Inc.

Ownership category

akta.pro rank

Product category

Behavioral Health Managed Care

NAICS

HMO Medical Centers (621491)

SIC

Services-Membership Organizations (8600)

akta.pro primary industry

Managed Care Entity Administration for Medicaid (MCO/PHP/PIHP/PAHP) (HLAEAEAJ)

Keywords

• Behavioral health services
• Medicaid managed care
• Mental health treatment
• Substance use disorder
• Health plan administration

Headquarters

HQ city

Columbia

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Pennsylvania HealthChoices Managed Care Contracts: Magellan generates revenue through capitated managed care contracts with the Pennsylvania Department of Human Services under the HealthChoices program. The company receives per-member-per-month (PMPM) payments to manage behavioral health services for Medicaid beneficiaries in contracted counties.

Go-to-market motion2 records

Distribution channels2 records

Marketing channels6 records

Core offering

Magellan of PA is a Behavioral Health Managed Care Organization (BH-MCO) contracted with the Pennsylvania Department of Human Services to manage behavioral health services for PA HealthChoices Medicaid beneficiaries across seven Pennsylvania counties. It administers mental health, substance use disorder, autism, and crisis intervention services through a contracted provider network, while offering integrated whole health programs, quality improvement, and cultural competency initiatives. The company holds NCQA Full MBHO Accreditation and Health Equity Accreditation and operates toll-free member and provider service lines per county.

Product overview

Magellan of PA is a behavioral health managed care organization providing PA HealthChoices funded services across seven Pennsylvania counties (Bedford, Bucks, Cambria, Lehigh, Montgomery, Northampton, and Somerset). The company operates a platform-based approach combining core behavioral health services with integrated whole health programs. Key product modules include HealthConnections (physical-behavioral integration since 2009), Community HealthChoices (long-term services and supports), Intensive Behavioral Health Services (IBHS), and Substance Use Disorder resources including MAT. Supporting infrastructure includes SmartScreener and other behavioral health screening tools, the PCP Toolkit for primary care integration, Center for Recovery and Resiliency e-learning platform, Magellan Explorer quarterly quality newsletter, and cultural competency programs. Quality improvement systems encompass HEDIS monitoring, patient safety reporting, provider performance standards, member experience surveys, and outcomes assessment tools including CANS, PHQ-9, and C-SSRS.

Differentiator

Problem solved

Functional benefit

Products and services

• PA HealthChoices Behavioral Health Management Managed care administration of behavioral health services for Medicaid beneficiaries across Bedford, Bucks, Cambria, Lehigh, Montgomery, Northampton, and Somerset counties, delivered through a contracted provider network.
• Whole Health Program Integrated care model addressing behavioral, physical, and environmental health factors with PCP toolkit, tip sheets, HealthConnections integration, and maternal health support for providers and members.
• HealthConnections Integrated healthcare program connecting physical and behavioral health services for adult Medicaid beneficiaries with serious mental illness and co-occurring physical health conditions, in operation since 2009.
• Community HealthChoices (CHC) Pennsylvania Medical Assistance managed care program providing physical health benefits and long-term services and supports (LTSS) for individuals with Medicare coverage and disabled adults aged 21 and over.
• Intensive Behavioral Health Services (IBHS) Comprehensive behavioral health services for children and adolescents, including assessment, individual treatment, and family therapy.
• Intensive Care Coordination Care coordination services for members requiring intensive behavioral health support and multi-system engagement.
• Recovery, Resiliency, Wellness & Peer Support Recovery-oriented services promoting resiliency and wellness, with peer support specialists available for members.
• Autism Resources and Services Resources and support for autism, including behavioral training, family support, and resources for caring for adults with autism.
• Substance Use Disorder (SUD) Resources Comprehensive SUD resources including ASAM alignment, Medication-Assisted Treatment (MAT), discharge planning, assessment sites, and connections to Centers of Excellence.
• Tobacco Cessation Resources & Support Tobacco cessation support including connections to 1-800-Quit-Now, PA Quit Logix, My Life My Quit for youth, and Nicotine Replacement Therapy information.
• Medication Adherence Program Program supporting members with medication adherence for behavioral health conditions.
• SmartScreener (OnToBetterHealth) Behavioral health screening tool using SAMHSA-validated brief screens for insomnia (ISI-3), depression (PHQ-2), anxiety (GAD-2), alcohol (AUDIT-1), drugs (DAST-1), and pain (PEG-3), with automatic expansion to longer versions when threshold is met.
• Behavioral Health Screening Programs (Outcome Assessment Tools) Suite of validated behavioral health screening tools including BCM Outcomes Tool, CAGE Assessments, Child and Adolescent Needs and Strengths (CANS), Columbia Suicide Severity Rating Scale (C-SSRS), GAIN-SS, Modified Family Assessment Form (MFAF), and PHQ-9.
• Cultural Competency and Health Equity Program Cultural competency program aligned with National CLAS Standards, promoting equitable treatment and health equity throughout the provider network.
• PCP Toolkit Toolkit for primary care physicians to support behavioral health screening, SUD patient care, and referral processes.

Segments2 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

Feature3 records

Partnerships

Two partnerships are on record, tiered core.

• Pennsylvania Department of Human ServicescoreStrategic or Co-development PartnerMagellan operates as a BH-MCO under contract with the Pennsylvania Department of Human Services to manage behavioral health services for PA HealthChoices members in contracted counties.
• Pennsylvania County Governments (Bedford, Bucks, Cambria, Lehigh, Montgomery, Northampton, Somerset)coreStrategic or Co-development PartnerMagellan collaborates with county customers in Bedford, Bucks, Cambria, Lehigh, Montgomery, Northampton, and Somerset counties to manage behavioral health services for PA HealthChoices members.

Scale indicators2 records

Recent moves5 records

Expansion highlights6 records

Regional players

• Health Partners Plans: Health Partners Plans is a Philadelphia-based Medicaid managed care organization operating in southeastern PA counties (e.g., Bucks, Montgomery). Regional competitor overlapping with Magellan's behavioral health carve-out footprint in the same county-level Medicaid market.
• AmeriHealth Caritas Pennsylvania: AmeriHealth Caritas operates Medicaid managed care plans in Pennsylvania, including physical-behavioral integration programs for HealthChoices-eligible populations. Regional player with overlapping member base and contract channels.
• Allegheny County HealthChoices / Allegheny County BH MCOs: Other PA HealthChoices BH-MCOs operate in Allegheny, Berks, and other non-Magellan counties. Comparable regional competitors running the same PA DHS behavioral health carve-out model in neighboring counties.

Broad incumbents

• Optum Behavioral Health (UnitedHealth Group): Optum is one of the largest U.S. behavioral health managed care platforms, serving commercial, Medicaid, and Medicare populations. Comparable as a broad incumbent BH-MCO with integrated physical-behavioral offering competing for scale-bearing government contracts.
• Molina Healthcare: Molina is a major Medicaid managed care insurer providing integrated physical and behavioral health benefits across many states. Overlaps with Magellan in serving Medicaid populations under capitated, state-contracted arrangements.
• Carelon Behavioral Health (formerly Beacon Health Options): Carelon Behavioral Health is a large, national managed behavioral health organization operating across many states. Acts as a broad incumbent in the BH-MCO space with national scale, integrated physical-behavioral capabilities, and capital resources that dwarf regional carve-outs like Magellan of PA.
• Centene Behavioral Health: Centene acquired Magellan Health, Inc. in early 2023, making Centene the ultimate parent of Magellan Behavioral Health Care LLC. Centene's managed care subsidiaries compete with Magellan indirectly for Medicaid behavioral health contracts across multiple states.

Direct peers

• PerformCare: PerformCare is a Pennsylvania-based BH-MCO serving PA HealthChoices members in multiple counties. Directly comparable as a managed care organization administering behavioral health Medicaid benefits on behalf of PA DHS and county governments.
• Community Care Behavioral Health (CCBH / UPMC): CCBH is the most direct PA HealthChoices BH-MCO competitor, operating as the UPMC-affiliated managed behavioral health carve-out serving many of the same PA counties. Competes head-to-head with Magellan for county-level Medicaid behavioral health contracts.

Others

• Wellpath (behavioral health correctional services): Wellpath provides managed behavioral health services in correctional and government-contracted settings. Not a direct competitor but operates under adjacent state and county contracts similar to Magellan's public-sector behavioral health carve-out model.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat3 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/MagellanHC
• YouTubeyoutube.com/user/MagellanHealth
• Facebookfacebook.com/Magellanhealth
• LinkedInlinkedin.com/company/magellanbehavioralhealthcare-llc

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Magellan Behavioral Health Care LLC.