Caresource ohio group contract

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Share on Pinterest. Share on LinkedIn. Terms of the new deal were not disclosed. FOX19 spoke with two of the families impacted earlier this week. Most Read. Third Bengals game ball surfaces at OTR bar in revival of tradition. By rebidding the contracts and resetting the conditions for how the money gets spent, the DeWine administration is trying to engineer better outcomes for the different Ohioans with Medicaid.

Some examples of these changes include that providers will be able to work out one Medicaid contract, instead of having to broker deals with all the different Medicaid plans. Claims billing and prior authorizations will be processed through a single system instead of with each plan individually. Loren Anthes, who researches Ohio Medicaid for Cleveland-based Center for Community Solutions, said providers can get bogged down in all the paperwork and redundancy that can come with Medicaid payments.

Along with working more with each other, Tassie said the insurance plans will work more with community organizations. The new program will be carved up among six insurance companies with the possibility of a seventh. When the state was deciding who to award these contracts to, they gave each of the bidding insurance companies a score and CareSource scored the lowest. UnitedHealthcare scored the highest.

Some people in the Dayton-area with Medicaid are covered by one of the insurance plans that lost their bid. Members will continue to receive services with their current managed care plans until the transition in early and will not lose coverage. Members will have the opportunity to select a new plan during the open enrollment period later this summer.

If members do not select a plan, one will be automatically assigned to them. Kaitlin Schroeder is a health care and business reporter with the Dayton Daily News. She covers the local hospitals, CareSource, public health, nursing homes, caregiving, and other related topics. In addition, some of the changes include: A new separate program will help kids with lots of behavioral health needs and help their families navigate the different systems their child gets services from.

Aetna will manage this new separate program. There will also be provider advisory councils so that providers can be heard by the insurance companies.