CareSource featured in national report
Case management, nurse hotline recognized as innovative, cost-effective
DAYTON, Ohio, March 22, 2005 – CareSource, Ohio’s largest Medicaid managed care plan, is part of a new report that details how Medicaid managed care plans across the country have created programs that improve the health of their members while providing value to state governments through innovative and cost-effective programs.
The report, Innovations in Medicaid Managed Care, was released March 8 by America’s Health Insurance Plans (AHIP). It is on the group’s website at www.ahip.org.
Two CareSource initiatives were included in the report. In the first, CareSource established a case management program for members ages 6 months to 21 years with asthma, HIV, teen pregnancy, and other ongoing health care needs. In the second, CareSource established an in-house 24-hour nurse hotline for members to call with medical questions and problems.
Both programs have measurably improved the health and quality of life for CareSource members while delivering a return on investment for state Medicaid dollars.
“We are thrilled to be included in a report that highlights the best practices and truly innovative programs of Medicaid managed care plans across the country,” CareSource President and CEO Pamela B. Morris said. “These programs show that managed care works for both Medicaid consumers and the state of Ohio.”
In the past decade, state and federal lawmakers have increasingly recognized the value of managed care for Medicaid’s long-term stability and sustainability. As of June 2003, according to the federal Centers for Medicare and Medicaid Services (CMS), 59 percent of the nation’s 42 million Medicaid consumers were enrolled in a Medicaid managed care plan. However, the 41 percent enrolled in the fee-for-service system accounted for more than 80 percent of Medicaid spending.
About CareSource Management Group
CareSource Management Group offers a full spectrum of services for companies that operate Medicaid managed care plans. Among CSMG’s services are administration, including claims processing and payment, case and medical management, provider relations, quality improvement, and regulatory compliance; member services, including a member call center and 24-hour nurse hotline; and financial consultation and turnaround.
CSMG is affiliated with CareSource, a nonprofit managed care plan that serves more than 354,000 Medicaid consumers in Ohio and more than 23,000 Hoosier Healthwise consumers in Indiana. CSMG also administers Community Choice Michigan, a nonprofit managed care plan serving more than 48,000 Medicaid consumers in Michigan. Each plan covers all state-required services and offers special benefits such a member service center, 24-hour nurse hotline, and transportation to medical appointments.
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