09/06/2021

Ohio Medicaid Announces Go-Live for Next Generation Managed Care 

Ohio Medicaid announced that July 1, 2022 is the projected date on which managed care members will begin receiving services from one of the seven next generation managed care plans, including the Single Pharmacy Benefit Manager (SPBM), Provider Network Management (PNM) module, Centralized Credentialing, and Fiscal Intermediary. OhioRISE services through Aetna Better Health of Ohio are also projected to begin July 1, 2022. Additional updates about the OhioRISE implementation timeline will be communicated in the coming weeks. 

This timeline allows ODM to go-live with a next generation program that is focused on the individual and provides members increased choice and ability to select a plan that fits their individual needs. It also takes into consideration the complexity of the systems and operational improvements being made and allows for time to conduct significant training to support providers in utilizing new systems.

This fall, managed care members will receive annual open enrollment notices as usual and can select from ODM's current managed care plans. Members will have the opportunity to select from the next generation plans in spring 2022.

View the Press Release to learn more about the July 2022 go-live. For additional details on the next generation of Ohio Medicaid's managed care program, visit managedcare.medicaid.ohio.gov. 

Next Generation
Managed Care Organizations

The seven managed care organizations (MCOs) selected for the next generation managed care program—serving more than 3 million members and thousands of medical providers—are as follows:

• UnitedHealthcare Community Plan of Ohio, Inc.
• Humana Health Plan of Ohio, Inc.
• Molina Healthcare of Ohio, Inc.
• AmeriHealth Caritas Ohio, Inc.
• Anthem Blue Cross and Blue Shield
• CareSource Ohio, Inc.
• Buckeye Community Health Plan

Questions?

Call 614-527-6762 or email info@osma.org