Earlier this week, the Ohio Department of Medicaid (ODM) released a Request for Applications (RFA) inviting managed care organizations (MCO) to submit proposals for Ohio’s next generation managed care program supporting more than 90 percent of Ohioans receiving health care services through Medicaid.
This re-bid process is a major step towards advancing the state’s Medicaid program which hasn’t undergone a redesign or major structural changes since 2005.
ODM’s goals for the future of managed care include:
Improve wellness and health outcomes.
Emphasize a personalized care experience.
Support providers in better patient care.
Improve care for children and adults with complex needs.
Increase program transparency and accountability.
“We envision a managed care program in which ODM and the MCOs work together to tackle some of the toughest health challenges and disparities,” said Maureen Corcoran, director of ODM. “We can achieve health care excellence by introducing a seamless service delivery system that works for members, providers, and community partners. Bidders will be assessed based on their ability and interest in partnering with ODM to achieve the goals of the future program.”
AOF is excited for ODM to begin the process of updating their managed care system. We're hopeful this overhaul results in better care coordination and health outcomes for Ohioans--especially our kids. The Ohio Medicaid program should strive to meet the physical and behavioral health care needs of Ohio’s most vulnerable citizens through high quality, accessible services-but we know the needs of individuals go beyond physical and behavioral health care. We hope this proposal encourages Medicaid managed care to play a more significant role in addressing non-clinical factors, or social determinants of health within communities that significantly impact health outcomes.
The request for application will be posted until Nov. 20. Bidders can learn more about the managed care procurement process and goals by visiting https://managedcare.medicaid.ohio.gov/wps/portal/gov/manc/