CareSource and UnitedHealth seeing early enrollment gains in Ohio Medicaid

Private managed care plans saw enrollment grow in the first month of Ohio Medicaid’s statewide territory reorganization.

July was the first month of statewide contracts for five private insurers, replacing more fragmented territories with fewer choices in each region. A small population of children with severe disabilities also came into managed care for the first time.

The transition went smoothly for the more than 2 million existing enrollees, state Medicaid Director John McCarthy said. Official enrollment data has not been released.

Dayton-based nonprofit CareSource reported nearly 6 percent growth, adding more than 50,000 members from June. The state’s largest private Medicaid plan was the only one with a statewide presence before the switch.

“We really had more to lose than to gain quite frankly,” CEO Pamela Morris said.

Only about one-third of enrollees pick their own plan, McCarthy said. The rest go into an auto-enrollment rotation. The state asked CareSource to sit out of that rotation for the July 1 assignments to give the other four plans a chance to grow.

The others include Molina Healthcare Inc. of Long Beach, Calif., which had been Ohio Medicaid’s second-largest plan; Buckeye Community Health Plan, the Columbus subsidiary of St. Louis-based Centene Corp.; Minneapolis-based UnitedHealth Group Inc.; and Paramount Health Care, owned by Toledo hospital system ProMedica.

July 1 also saw the exit of Virginia Beach, Va.-based Amerigroup Corp. and Tampa, Fla. WellCare Health Plans Inc., which together had fewer than 200,000 members. Of those who chose a new plan instead of leaving it to auto-enrollment, 80 percent picked CareSource, Morris said. It had been the second plan in regions where the ending plans operated.

“That name recognition and brand reputation are all factors, clearly,” she said.

UnitedHealth, which expanded statewide after serving Medicaid in the eastern counties, also had added about 50,000 members, said Tracy Davidson, president of UnitedHealthcare Community Plan of Ohio.

“The market share has switched,” she said. “It’s really an exciting time for us to grow the business and be able to serve more Ohioans.”
UnitedHealth has added 200 employees to its Westerville office that’s the hub for its commercial and Medicare plans in the state. Together plans had expected to add 1,000 jobs.

It’s too early to measure how well the plans are doing to control health costs, but managed care is part of the case Medicaid officials make to lawmakers debating whether to expand eligibility under Obamacare.

“We never would have proposed expanding Medicaid coverage if we hadn’t done some of the reforms we did,” McCarthy said. “Managed care plans are doing amazing work to control costs.”

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