July 18, 2023

Statewide MyCare Promises Better Health for Ohio’s Most Vulnerable Seniors

Angela Weaver, Director of Regulatory Affairs, Ohio Association of Health Plans

MyCare Ohio is going statewide! OAHP is extremely grateful to the General Assembly and Gov. Mike DeWine for including this important policy directive in the 2024-25 state budget.

MyCare, which provides integrated care management to Ohioans eligible for both Medicare and Medicaid, has been a resounding success as a pilot program since its launch in 2014, in seven regions comprising 29 counties. Almost 150,000 people have participated and overall, they have seen significantly improved outcomes:

  • A higher number of physician visits per month
  • A greater likelihood that patients discharged from mental-health care will have a 30-day follow-up mental-health visit
  • Fewer inpatient hospital admissions
  • Less time in long-stay nursing facilities

Those served by MyCare, referred to as dual-eligibles, are among the state’s most medically frail. While they make up only 5% of the Medicaid population, their care accounts for 26% of the Medicaid budget. Improving their outcomes via integrated care means a better quality of life for them and significant savings for taxpayers.

OAHP has long advocated extending the advantages of MyCare to the entire state and we are thrilled to see the process begin.

We stand ready to work with the Ohio Department of Medicaid (ODM) as it begins to convert MyCare from pilot to permanent status and extend the benefits to all Ohioans. ODM and our member plans have learned a lot since MyCare began: for example, that older Ohioans increasingly are facing mental-health challenges and addiction, making it critical that the new model prioritizes behavioral-health care.

We also think Ohio should make it easier for Medicaid members, including those in MyCare, to have self-direction of services — for example, by allowing friends and family to be service providers without the full typical qualification process and by allowing providers who aren’t Medicaid-certified to provide nonmedical services such as cleaning or home modification.

There will be plenty of details to work out, but we’re confident that MyCare for all dual-eligible Ohioans will mean better health outcomes and a more manageable Medicaid budget. We’re excited to get to work!