2024 Pinnacle Awards Recognize AmeriHealth Caritas Ohio, CareSource for Making a Difference Through Innovation

Recognition from the Ohio Association of Health Plans honors two unique programs: a concierge-style care model for Medicaid populations and a community-based nutrition initiative

COLUMBUS, Ohio — An innovative model making pediatric direct primary care accessible to low-income families and a program to eliminate barriers to healthy nutrition among people with diabetes earned this year’s Pinnacle Awards from the Ohio Association of Health Plans (OAHP). The Pinnacle recognition is the culmination of the OAHP Annual Convention & Trade Show, held this year Sept. 10-11 in Columbus.

OAHP member plans submitted innovative initiatives for consideration. Developing novel approaches to solving persistent health care challenges and inequities is a hallmark of OAHP members. Entries were judged and winners chosen by a panel of health industry professionals.

“Every year, the Pinnacle Awards are the perfect capstone to the convention,” said Kelly O’Reilly, OAHP president and chief executive officer. “We’re all focused on ways to make health care better and more accessible, and these terrific ideas serve as an inspiration to all of us.”

AmeriHealth Caritas Ohio: Concierge-Style Pediatric Care for Medicaid Patients

AmeriHealth Caritas Ohio’s youngest members in northeast Ohio can now receive more personalized care quicker than before at no additional cost to their families. The Medicaid health plan is teaming up with Zest Pediatric Network for a new value-based payment model that utilizes concierge-style pediatric care for Medicaid members in the Cleveland area.

Transportation, work schedules, and child care arrangements are some of the factors that lead to skipped annual checkups and unaddressed chronic health conditions. The new program not only helps overcome these challenges by offering participating AmeriHealth Caritas Ohio members easier access to medical care, same-day appointments, virtual appointments, and the ability to call or text doctors directly, but also does so without the out-of-pocket fees and membership costs traditionally associated with this care model.

“We want to eliminate barriers that all too often impede preventive care or divert sick care to emergency departments,” said Mark Grippi, AmeriHealth Caritas Ohio CEO and market president. “This program is special because we are taking the concept of concierge care — that often comes with significant costs to patients — and making it available to Ohioans who need it most.”

Value-based payment (VBP) models promote a higher, more reliable level of care by holding physicians, clinicians, and care facilities accountable for quality and cost through shared financial risk. This VBP incentivizes Zest to provide more preventive, diagnostic and treatment services; injections, immunizations and medications; health education and counseling services; and routine screenings for its AmeriHealth Caritas Ohio patients. Through the arrangement, AmeriHealth Caritas Ohio aims to increase access to medical care for underserved children, increasing health outcomes in early childhood and well into the future.

CareSource Ohio: Culinary Medicine and Nutrition Program

Launched in 2023, the program targets the 12.3% of Ohio residents who have been diagnosed with diabetes. Advocates including the American Diabetes Association state that this population numbering nearly 1.6 million needs more resources to manage their disease. Healthy eating and lifestyles clearly are the key, but people face barriers: physical limitations, lack of knowledge about healthy food, and limited cooking skills or kitchen equipment.

The program’s Teaching Kitchen Model combats those barriers with partners around the state including Goodwill, YMCA, County Corp Housing, Wright State University, Mercy Health Toledo and the city of Cincinnati. As the model rolls out statewide, more partners are joining.

Its objectives are to:

• Enhance knowledge of nutrition among Ohio Medicaid members through personalized dietary counseling with registered nutritionists.
• Help members overcome barriers to good nutrition.
• Collaborate with community partners via shared programming, mutual referrals and shared decision-making.

Robin Carter-Moore, executive director of the YMCA of Greater Dayton, offered a testimonial: “The Teaching Kitchen Model is a unique setup. It teaches people in my community with high blood pressure and diabetes to eat better and cook better. It gives people the chance to gather in a comfortable atmosphere and talk about their health issues.”

So far, more than 3,000 Ohio Medicaid enrollees have received benefits through the program including free access to Weight Watchers, free six-month YMCA memberships, and in-person cooking and nutrition classes. CareSource also has created a new care coordination role for registered dietitians, who follow up with members to celebrate successes, suggest and connect with additional resources, and offer ongoing lifestyle support.

They’re already seeing results: In the months prior to joining the program, 33% of CareSource members had emergency department (ED) visits related to their diabetes. Among those enrolled in the Teaching Kitchen program, only 8% had diabetes-related ED visits in the six-month period after the classes.

In many cases, the relationships formed by participants during classes have endured. Some become workout buddies.

Recently, CareSource was invited to present the Teaching Kitchen Model at the American Public Health Conference. The research will be featured in related literature.

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About OAHP

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.