Ohio Medicaid Managed Care Plans Reinvest In Ohio Communities

Date: 04/11/24

Columbus, OH

Ohio’s Medicaid managed care organizations (MCO) announced the launch of a new yearly collaborative initiative designed to build healthier communities and reduce health inequities throughout the state.

The grants will empower local organizations to provide services that make healthier lives possible — from training more women of color to serve as doulas to supporting food prescriptions in rural areas to expanding mental health services in underserved communities. The grants align with Gov. DeWine’s priorities, including reduction of maternal and infant mortality and expansion of behavioral health services.

The collaborative action stems from the Ohio Department of Medicaid’s (ODM) Next Generation of Medicaid Managed Care (NextGen) program. The vision for NextGen focuses on the individual rather than on the business of managed care.

Ohio’s MCOs are Aetna OhioRISE, AmeriHealth Caritas Ohio, Inc., Anthem Blue Cross and Blue Shield, Buckeye Community Health Plan, CareSource Ohio, Inc., Humana Healthy Horizons in Ohio, Molina Healthcare of Ohio, Inc. and UnitedHealthcare Community Plan of Ohio, Inc.

Through community reinvestment, the MCOs combine resources to address social determinants of health — nonmedical factors such as income, education, and access to transportation that can affect an individual’s physical and mental health. The process targets the needs of particular populations in neighborhoods where systemic barriers can impact health outcomes.

“Our NextGen vision is to serve Ohioans better by addressing barriers that create health inequities. We also want to improve health outcomes,” ODM Director Maureen Corcoran said. “Community reinvestment is a way to address those barriers directly by working with community organizations that understand the challenges best.”

Through NextGen, Ohio is pioneering a model of collective impact: Population health and health equity teams for the eight current Medicaid MCOs consulted with community-based organizations to identify impactful potential grant projects. Each plan submitted potential projects; all plans scored them based on common criteria which included factors like:

Sustainability.
Scalability.
Alignment with ODM’s population health and quality strategies.
Ability to address health inequities and disparities.
Coordination with an organization that can leverage their trusted relationship within their community.

Based on the scoring, the health plan CEOs reached a consensus on which projects to fund.

“These investments will bring meaningful improvement to the health of Ohio communities,” said Kelly O’Reilly, president and chief executive officer of the Ohio Association of Health Plans, which helped coordinate the collective effort. “It’s a dramatic example of the power of the plans working together toward our common goal of a healthier Ohio.”

In keeping with the goal of enabling systemic health equity, most of the community reinvestment grants won’t be spent in doctor’s offices or hospitals but in places like homes, classrooms, community clinics and food pantries, in partnership with organizations that are working effectively in communities of need.

The following projects and organizations were awarded funding:

Statewide Doula Initiative ($850,000): Works with doula education and support programs in four regions of the state to provide education and support for doulas, particularly for women of color and in Appalachia. Support from a doula has been shown to provide better birth outcomes and postnatal health for mothers and babies.
Hocking-Athens-Perry Community Action Program ($1.4 million): Four separate grants support food programs in southeast Ohio including a school-based food pantry, food as medicine, outreach to seniors on SNAP (food stamps) and home delivery of healthy food to people with limited mobility.
Intensive Home-Based Treatment ($400,000): Works with local northwest Ohio groups to expand the availability of in-home treatment for substance use disorder.
Ohio State Parks Foundation ($400,000): Supports playground development across the state, including equipment accessible to people with disabilities.
Harm Reduction Ohio ($400,000): Provides comprehensive expanded access to fentanyl test strips and overdose prevention packets, including a mobile unit to serve areas with low access to harm reduction materials.
Nurse Navigators ($250,000): Ohio University’s program provides full-time nurses and a manager to help pregnant and postpartum women get medical and social services to help reduce the risk factors that influence birth outcomes.
Project ECHO ($250,000): Through teleconferencing, the Project Extension for Community Health Outcomes, in partnership with the Weitzman Institute, connects local healthcare providers, often in rural areas, with medical specialists who share their expertise to enhance the quality of care the local providers can give.
Statewide Lead Testing Initiative with Meridian Health ($250,000): Provides LeadCare II analyzers and blood testing kits to community-based organizations, day care facilities and other selected providers for point-of-service testing.
Asian Services in Action ($250,000): The agency operates two federally qualified health centers specializing in linguistically and culturally competent care as well as wraparound services for immigrants and refugees.
Birthing Beautiful Communities ($235,000): This northeast Ohio doula program focuses on improving quality of life for Black expectant mothers, babies and families.
Star House ($150,000): To expand and replicate in Toledo a Columbus-based 24/7 drop-in center for youth ages 14-24 who are experiencing homelessness. It offers stabilizing resources, an on-site medical clinic, employment and education assistance, and more. There are also a number of studio apartments for those ages 18-24, with on-site access to services and supports.
Passion Works Studio ($100,000): A one-time payment to support ongoing operations of a program that fosters social integration and economic stability for people with developmental differences and other disadvantaged groups through collaborative creation of art.
Rising Suns Pharmacy ($95,000): A free pharmacy that serves uninsured or underinsured residents of southeast Ohio.
Last Mile Food Rescue ($86,969): Using app technology, Last Mile deploys volunteers to pick up excess fresh/perishable food and deliver it within 60 minutes to nonprofit and human service agencies serving those who are food insecure.
Ghetto Therapy ($72,000): Provides mental health education and connection to licensed, culturally competent therapists for people in Cleveland’s Black community.
Greater Cleveland Food Bank ($60,000): Supports the food bank’s new Community Resource Center that provides help with legal needs, education, healthcare and housing in addition to food aid.
School-Based Health Projects with Cleveland City School and Nelsonville York School Districts — MCOs are actively collaborating with these two school districts to test interventions to improve utilization of preventative care including dental, vision and primary care along with behavioral health care in school-based clinics. These programs will include evaluating ways to address social determinants of health such as transportation, all with the goal to improve outcomes and achieve greater health literacy for students, school staff and the community. The intervention plans will be finalized by end of year and also funded through the community reinvestment program.

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About the Ohio Association of Health Plans

The Ohio Association of Health Plans is a statewide association dedicated to working with legislators, providers, nonprofits and other partners to improve the health of Ohioans through access to quality, affordable care.