The Ohio Department of Job and Family Services announced today that CareSource, in partnership with Humana Inc. (NYSE: HUM), will be serving people who qualify for both Medicaid and Medicare (often referred to as dual eligible) in the following three Ohio regions as part of the state’s new Integrated Care Delivery System (ICDS):
- Northeast region (Cleveland market; approximately 31,000 dual eligible; one of three plans selected)
- East Central region (Akron market; approximately 16,000 dual eligible; one of two plans selected)
- Northeast Central region (Youngstown market; approximately 9,000 dual eligible; one of two plans selected)
“People who are dually eligible for Medicaid and Medicare are among the most vulnerable populations, with multiple chronic conditions and complex health care needs,” said Pamela Morris, CareSource President and Chief Executive Officer. “Today, they face the daunting challenge of navigating two separate programs often resulting in uncoordinated and costly care.”
The CareSource Humana alliance was established earlier this year to more effectively serve Medicare and Medicaid beneficiaries. CareSource and Humana will bring their extensive experience in both programs to deliver innovative, full-service solutions to federal and state governments looking to enhance care coordination, provide long-term services and support and make the programs simpler and easier to navigate. This care coordination is expected to result in better health outcomes for members.
Together, the CareSource Humana alliance will deliver a fully integrated Medicare/Medicaid solution – one card, one point of contact and one care treatment plan – with an emphasis on preventative care and wellness.
“Members eligible for Medicaid and Medicare deserve an integrated approach designed to help them achieve and maintain independence and lifelong well-being,” said Kevin Meriwether, Division Leader for Humana’s East Region Medicare Division. “This solution from Humana and CareSource builds on the strengths of our respective core capabilities to deliver a comprehensive, quality offering to the member.”
The plans selected by Ohio Medicaid will enter into three-way agreements with Ohio and the Centers for Medicaid and Medicare Services (CMS) to serve this population.
“We applaud the state, the Office of Health Transformation and CMS for constructing a program to solve these important issues,” Morris said. “We are honored to be chosen to assist the state and look forward to working with Humana to improve the quality of care and create a cost-savings solution.”
CareSource, a community-based nonprofit health plan with more than 900,000 Medicaid members in Ohio, has 23 years of experience in Medicaid. Humana has approximately 5.3 million members enrolled in Medicare plans (both Medicare Advantage medical plans and stand-alone prescription drug plans) and brings more than 25 years of experience in Medicare.