CareSource

CareSource
Formerly called
 Dayton Area Health Plan
Non-Profit
Industry health care
Founded 1989
Founder Pam Morris
Headquarters Dayton, Ohio, United States
Area served
 Ohio, Kentucky, Indiana, West Virginia
Products Medicaid managed care plans, Health Insurance Marketplace plans, MyCare Ohio plan, Medicare Advantage plans
Revenue $5.4 Billion USD (2014)[1]
Number of employees
 2,500 [2]
Website www.caresource.com

CareSource is a nonprofit managed health care plan headquartered in Dayton, Ohio. It is the largest Medicaid plan in Ohio and second largest in the United States.[3][4] The company is contracted with the Ohio Department of Job and Family Services.[5] In 2010, CareSource had approximately 900 employees with 800 of them based in Dayton.[6]

History

CareSource was founded in Dayton, Ohio by Pamela Morris, who is still the president and chief executive officer, with the goal of expanding health care for underserved populations. The plan was originally called the Dayton Area Health Plan (DAHP) and was associated with United Health Care.[7] DAHP began with a $500,000 grant from the state of Ohio to address a growing issue with the health care problems of low income citizens.

The company dealt with several regulatory hurdles in 1987 to 1989 from the Ohio Department of Insurance. The DAHP had to raise funds, secure an HMO license and obtain a federal waiver allowing the company to operate solely as a mandatory enrollment plan. The DAHP would become the first mandatory Medicaid managed care program [7] In 1993 the federal waiver would expire and in order to allow the organization to continue (rather than maintain a mandatory 75/25 ratio of mandatory and voluntary enrollees) Congressional action would be required. This meant that at that time, 25% of the plan's members could not be on Medicaid or Medicare. It overcame these hurdles when U.S. Congressman Dave Hobson intervened on its behalf to gain an exception for the DAHP.[8]

In the year 2000, DAHP consolidated all its health plans under one name – CareSource.[7] In this year, the company had about 70,000 members and by 2003 that number exceeded 320,000. .[9]

In 2004, the organization was ranked sixth-largest Medicaid managed care plan in the United States by Interstudy.[10] Also in 2004, the company's training program-CareSource University opened to educate employees and keep service standards high.

In 2006, desiring to support surrounding non-profits, CareSource established the CareSource Foundation. The foundation collaborates with non-profits who share in the misson of serving the underserved. It has awarded a total of 693 grants to non-profit organizations so far. In this same year when the economy was down in Dayton, Ohio and major employers like National Cash Register, General Motors, and Delphi closed or left town. In 2007 employment in the area remained weak, but CareSource saw business growth and became the only Medicaid Managed Care provider to offer services in all 88 counties in Ohio. That year CareSource broke ground on its new corporate headquarters in Downtown Dayton, showing the company's commitment to the city it was founded in. The project was the largest urban building development in Ohio at the time. Building was completed in 2009 on the $55 million corporate headquarters at the corner of Main Street and Monument Avenue in downtown Dayton. The 300,000-square-foot, 9-story building is downtown's first new office tower since before 2000.[11] The building's Architect was BHDP Architecture.

By 2010, the company was the third largest Medicaid HMO in the country, with $2.5 billion in revenue and 800,000 clients across Ohio and Michigan.[12] In 2010, CareSource announced expansion of its provider network in Southeastern Ohio through a partnership with Quality Care Partners (QCP), a physician-hospital organization (PHO).[13]

In 2012, the company announced a partnership with Humana. This partnership works to serve dual-eligible populations, or individuals who qualify for both Medicare and Medicaid. In this year, the company expanded into Kentucky with Humana.

In 2013, CareSource announced that it would move some employees to a second office at 40 West Second Street in Downtown Dayton. 200 employees were relocated in that building, across from the Schuster Center in Dayton while the rest of the employees remained in the headquarters building a few blocks away.[4] CareSource worked with provider partners in 2013 to create an affordable option for Ohio in collaboration with the Affordable Care Act. They entered the Health Insurance Exchange and created Just4Me, a product which allowed the company to enter the commercial insurance market. CareSource Just4Me allows individuals the opportunity to choose either an individual or family plan that best fits his/her needs while remaining affordable.[14]

In 2014, MyCare Ohio was launched to integrate Medicare and Medicaid benefits. CareSource used this opportunity to create a plan which assimilates both Medicaid and Medicare into one CareSource health plan.[15] By the end of 2014, the company expects to exceed 2,000 employees and will occupy the offices in three buildings in downtown Dayton.[16] The company also announced plans to expand into the health insurance marketplaces of Kentucky and Indiana.[17] The constant growth that CareSource is experiencing with healthcare reform and Medicaid expansion has made it the third largest company in the Dayton area again in 2014.[18]

CareSource celebrates 25 years as one of the nation's largest Managed Medicaid Plans and the largest in Ohio in 2014. The company now serves more than 1 million consumers in Ohio and Kentucky. CareSource is living its mission to provide health care to those who need it most. CareSource understands the challenges consumers face navigating the health system and works to put health care in reach for those it serves.[19]

About CareSource

CareSource is a non-profit health plan headquartered in Dayton, Ohio. As one of the largest Medicaid Managed Care plans in the country and the largest in Ohio, CareSource understands the challenges consumers face navigating the health system. CareSource members complete a Health Risk Assessment and have access to the Nurse Advice Line. They are also given information handbooks, provider directories, continues updates and the opportunity to appeal any decision and share feedback at any time.[20] CareSource provides similar services that most medicaid companies provide.There are no co-pays for members as the company is a Managed Medicaid and Medicare Advantage company.[21]

With the implementation of the Affordable Care Act, CareSource entered the health insurance marketplace in Ohio with their plan called Just4Me.[22] With this expansion, the company now offers health insurance to all Ohioans.

Awards and recognition

CareSource has won numerous awards and recognition. The most notable recognition is that CareSource was named the sixth-largest and second-fastest-growing Medicaid managed care plan in the nation by Interstudy.[23] In 2010, CareSource was named one of Training Magazine’s Top 125 companies. CareSource made number 78 in the rankings.[6] In 2013, CareSource received two Pinnacle Awards for Best Practices from the Ohio Association of Health Plans. The two Programs awarded were Care4U Case Management Program and the Medication Therapy Program. The Pinnacle Awards recognize the efforts of health plans to improve the quality of health care for Ohioans.[24]

Other awards

CareSource is the third largest company in the Dayton Area in 2013, behind AK Steel and Speedway, ranked by total revenue. From 2011 to 2012, the company’s revenue grew 21.43 percent to $3.4 billion. CareSource’s percent growth was more than double the average revenue growth of the other 99 largest Dayton companies in that time frame.[30]

Service area

CareSource has four offices, its headquarters in Dayton is spread across three buildings while satellite offices exist in Columbus, Cleveland, and Louisville.[31]

Whistleblower case

In 2011 two nurses filed a federal lawsuit against CareScource worth $26 million, thought to be the largest settlement involving an Ohio managed care organization. The federal lawsuit alleged that CareSource defrauded the state of Ohio Medicaid program by failing to conduct health assessments of large numbers of special-needs children between 2001 and 2006. CareSource admitted no wrongdoing in the case and claimed that there were no supporting evidence to back the claims. The two nurses were allegedly told to falsify what was being submitted to the Ohio Department of Job and Family Services, which administers the state’s Medicaid program.[32]

While being interviewed, CareSource declined to answer specific questions such as, Whether CareSource executives knew if the two nurses had approached CareSource managers with their concerns; and what evidence CareSource had to show that children deemed to have special health care needs were receiving the assessments paid for by the state Medicaid program. In addition to the settlement, the company must abide by a “corporate integrity agreement” with the U.S. Department of Health and Human Services for five years.[33]

References

  1. ↑ https://www.caresource.com/documents/2015-annual-report/
  2. ↑ http://www.bizjournals.com/dayton/news/2015/12/21/caresource-ends-2015-with-1-6m-in-donations.html
  3. ↑ "Ernst & Young Entrepreneur Of The Year 2007 Magazine" (PDF). Ernst and Young. 2007-11-17: 27.
  4. 1 2 http://www.bizjournals.com/dayton/news/2013/01/30/caresource-adds-downtown-dayton-office.html
  5. ↑ "CareSource brief information". Retrieved 2009-06-04.
  6. 1 2 "Training Magazine National Ranking". 2010-02-03. Retrieved 2010-02-04.
  7. 1 2 3 4 http://www.bizjournals.com/cincinnati/stories/2007/11/26/daily32.html
  8. ↑ Navera, Tristan (Sep 27, 2013), CareSource pumps life into heart of downtown Dayton, Dayton, Ohio: Dayton Business Journal, retrieved May 13, 2014
  9. ↑ Study notes CareSource growth, Dayton, Ohio: Dayton Business Journal, Dec 2, 2003, retrieved May 13, 2014
  10. ↑ "Company History and Timeline". Archived from the original on November 20, 2008. Retrieved 2009-06-04.
  11. ↑ "CareSource Office Building". Archived from the original on November 20, 2008. Retrieved 2009-02-03.
  12. ↑ DeBrosse, Jim (Jan 9, 2010), Critics question hospitals’ CEO on CareSource board, Dayton, Ohio: Dayton Daily News, retrieved May 13, 2014
  13. ↑ "Expansion to SW Ohio" (PDF). Retrieved 2010-04-07.
  14. ↑ https://www.caresource.com/just4me/
  15. ↑ https://www.caresource.com/mycare/
  16. ↑ http://www.bizjournals.com/dayton/print-edition/2014/05/23/caresource-ceo-pam-morris-on-reshaping-dayton-amid.html?page=4
  17. ↑ http://www.bizjournals.com/dayton/news/2014/06/20/caresource-plans-expansion-into-kentucky-indiana.html
  18. ↑ http://www.bizjournals.com/dayton/subscriber-only/2014/06/06/dayton-area-top-100-companies.html
  19. ↑ https://www.caresource.com/about-us/news-room/recent-news-releases/
  20. ↑ https://www.caresource.com/about-us/health-care-plans/
  21. ↑ "CareSource Services". Archived from the original on April 14, 2009. Retrieved 2009-06-26.
  22. ↑ https://www.caresource.com/just4me/whycaresource-just4me/
  23. ↑ "CareSource Awards". Archived from the original on May 5, 2009. Retrieved 2009-06-26.
  24. ↑ http://www.daytondailynews.com/news/business/caresource-health-programs-recognized-for-best-pra/nYGxC/
  25. ↑ http://www.startwalkingnow.org/documents/FFGoldApr2013.pdf
  26. ↑ http://www.topworkplaces.com/frontend.php/regional-list/company/daytondailynews/caresource
  27. ↑ http://www.topworkplaces.com/frontend.php/national/standard
  28. 1 2 3 4 http://www.prweb.com/releases/2013/3/prweb10524618.htm
  29. ↑ (4) http://www.topworkplaces.com/frontend.php/regional-list/company/daytondailynews/caresource
  30. ↑ http://www.bizjournals.com/dayton/print-edition/2012/05/18/regions-top-100-companies-grew-sales.html?page=all
  31. ↑ CareSource: General Information, Dayton, Ohio, retrieved May 13, 2014
  32. ↑ "CareSource case sheds light on Ohio whistleblower laws". Retrieved 2011-02-06.
  33. ↑ "CareSource Whistleblower case". Retrieved 2011-02-06.

External links

This article is issued from Wikipedia - version of the Friday, April 01, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.