Gettysburg, Pa. (July 8, 2019) – OPEN MINDS has released an updated suite of Medicaid market intelligence resources on the state of Ohio. The resources include an analysis of the Ohio’ s Medicaid system, Medicaid managed care vendor contracts, and additional state-specific information.
Ohio has a statewide managed care program with five health plans that provide care to most populations, except dual eligbles. In some counties, dual eligibles are required to enroll in the state’s dual demonstration, called MyCare Ohio. As of July 1, 2018, health plans are responsible for all physical health, behavioral health, and pharmacy benefits.
The managed care and MyCare Ohio contracts available for download include:
- Buckeye Community Health Plan
- Molina Healthcare of Ohio, Inc.
- Paramount Advantage
- United Healthcare Community Plan
- Aetna Better Health (MyCare Ohio program only)
In March 2019, the state’s community engagement and work requirements were approved. They are not expected to go into effect until 2021.
The managed care contract includes a requirement for the health plans to make 50% of aggregate net payments to provider organizations through value-oriented strategies by the year 2020. Examples of value-oriented strategies include performance-based payments, price variation reduction, and clinical guideline adherence.
The state is currently in the process of issuing a reprocurement of the health plan contracts. On June 13, 2019, the state issued a request for information and the procurement process is expected to be completed in FY 2021.
The Ohio Medicaid Managed Care Contracts are available now for all Elite OPEN MINDS Circle members. Individual contracts may be purchased in the OPEN MINDS shop for $1,500 each.
Additionally, the OPEN MINDS team has four in-depth profiles of the Ohio state health system:
- Ohio Health Care System Landscape: An OPEN MINDS State Profile, which provides information on each state’s largest health plans, Medicaid expansion policy, health insurance marketplace plans, demographics, population health insurance coverage by payer, and more.
- Ohio Medicaid System: An OPEN MINDS State Profile, which provides a detailed exploration of each state’s Medicaid financing system, including a review of the managed care financing systems, largest health plans by enrollment, key players in the state Medicaid department, and plans for future system changes and contract reprocurements.
- Ohio Behavioral Health System State Profile Report, which provides a comprehensive listing of behavioral health benefits in the state, care coordination programs related to behavioral health, and behavioral health subcontractors for health plans.
- Ohio Medicaid/Medicare Dual Eligible System: An OPEN MINDS State Profile, which provides an overview of each state’s dual eligible financing system, as well as the largest Medicare health plans serving dual eligibles and details on new initiatives involving the dual eligible population.
The Ohio suite of state profiles is now available now for the Elite OPEN MINDS Circle members. In addition, the OPEN MINDS team has a wealth of additional Ohio-specific resources. A monthly OPEN MINDS market intelligence update is available to all health and human services executives. To sign up, OPEN MINDS Circle members should set their email preferences under the My Account Settings.
All of these resources, and more, are available as part of an OPEN MINDS Circle Elite membership. Membership includes unlimited organizational access to all OPEN MINDS content and databases, plus executive education events, and other exclusive Elite member benefits. Learn more about becoming an Elite OPEN MINDS Circle member online at www.openminds.com/elite.
For additional questions and inquiries, please contact Sarah C. Threnhauser, Executive Vice President, OPEN MINDS at 717-334-1329 or firstname.lastname@example.org.
ABOUT OPEN MINDS
OPEN MINDS is an award-winning information source, executive education provider, and business solutions firm specializing in the domains of health and human services serving consumers with chronic conditions and complex support needs. For thirty years, we’ve been pioneers for change – helping organizations implement the transformational business practices they need to succeed in an evolving market with new reimbursement, competition, policies, and regulations.
OPEN MINDS is powered by a national team of experienced executives and subject matter experts with specific expertise and experience in nine key market areas – mental health, addictions, chronic conditions, autism and intellectual/developmental disabilities, long-term care, children’s services, social services, juvenile justice, and corrections health care. Our mission is to improve the quality of care for consumers with complex support needs by improving the effectiveness of those serving them – provider organizations, payer and insurance organizations, government agencies, pharmaceutical organizations, and technology firms. Learn more at www.openminds.com.