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Managed MedicaidCareSource Gets Majority of ABD Members in New Northern Ohio Pacts Reprinted from the May 21, 2009, issue of MEDICARE ADVANTAGE NEWS, biweekly news and analysis on the Medicare (and Medicaid) managed care programs. By James Gutman, Managing Editor
With a protest filed by a losing bidder now resolved, new contracts for northern Ohio’s aged, blind and disabled (ABD) Medicaid population have taken effect, and CareSource has emerged with the most members in both the Northeast and Northwest region, state figures for Jan. 1 show.
Awards of the contracts — designed to invigorate Medicaid managed care in two regions where the penetration for ABD beneficiaries was only 18%, compared with more than 90% elsewhere in the state — was delayed when Molina Healthcare of Ohio appealed the award in the Northwest region to Unison Health Plan of Ohio, Inc.
But attorney Dale Lehmann, assistant bureau chief in the Ohio Department of Job and Family Services, which administers the state’s Medicaid program, told MAN Jan. 4 that ODJFS’s review of the protest concluded that “Unison was rightfully chosen to enter into a provider agreement. Molina [then] did not appeal the department’s findings or decision.”
CareSource, according to Lehmann, began serving the first ABD beneficiaries in the Northeast region on Aug. 1, 2009. As of Jan. 1, the state figures show, CareSource had 14,586 members, while Centene Corp’s Buckeye Community Health Plan tallied 9,703.
In the Northwest region, Lehmann said, Unison, part of UnitedHealth Group, began serving the first ABD beneficiaries Oct. 1. As of Jan. 1, it had 4,867 members, while CareSource had 6,621, state figures show.
By contrast, a May 30 note to investors from Oppenheimer & Co. securities analyst Carl McDonald reported, Centene had about 4,500 ABD members in the Northeast region, while CareSource had only 2,200 in the Northwest region.
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