Connecting Plans and People: How Ohio Is Redefining Community Reinvestment in Medicaid

At the 2025 Health Management Associates (HMA) Annual Conference in New Orleans, OAHP President and CEO Kelly O’Reilly joined Loren Anthes, principal at Health Management Associates (HMA), for a conversation on how Medicaid managed care organizations (MCOs) and community-based organizations (CBOs) can work together in a nontraditional way to improve community health.

Their session, “Connecting Plans and People: Building Sustainable MCO-CBO Collaborations,” highlighted Ohio’s Community Reinvestment Collaborative Plan, a unique model where all of the state’s Medicaid managed care plans pool funds and decide collectively how to invest in community priorities. This shared approach replaces traditional one-off grantmaking with a coordinated, data-driven system focused on measurable outcomes.

In this Q&A, Kelly and Loren expand on how Ohio’s model came to life, why it’s drawing national attention and how the next phase of this work will continue to align policy, managed care and community partnerships for lasting impact.

Q1: Why did HMA spotlight Ohio’s community reinvestment work at this year’s conference? What makes the state’s model stand out nationally?

Loren:

Ohio has a compelling story to share because its Medicaid plans, OAHP, and Ohio Medicaid built a true collective impact model where all plans pool resources and set priorities together. That structure is rare nationally, and it shows how states can address social determinants of health in a lasting way by embedding community reinvestment directly into managed care contracts rather than relying on short-term pilots. The model combines collaboration, community input and financial accountability, creating a stable, data-driven approach that delivers measurable outcomes. It reflects the core goals of value-based care, and it’s gaining attention from other states looking for scalable frameworks to strengthen community health through Medicaid.

Q2: For readers new to this topic, what exactly is “community reinvestment” in the Medicaid context, and how did Ohio’s approach begin?

Kelly:

Community reinvestment in Ohio began during the NextGen Medicaid procurement in 2020, when plans were required to return a portion of their earned proceeds to local communities. Instead of treating it as a compliance exercise, the plans and OAHP created a shared model where resources are pooled, priorities are set collectively and investments reflect statewide community needs. Early rounds in 2022–2023 helped refine the approach, eventually growing into a more structured collective impact framework with joint decision-making and continuous feedback. What started as a mandate has evolved into an innovative way to strengthen local health systems and fund community priorities more strategically.

Q3: Why did Ohio’s Medicaid plans choose a collective model instead of individual grantmaking, and how does that collaboration work in practice?

Kelly:

Ohio’s Medicaid plans chose a collective model because they recognized that challenges like equity, community health and system improvement are more effectively addressed together than through individual grant programs. All eight plans pool their community reinvestment dollars into one shared fund managed by OAHP, and they jointly set priorities, review proposals and make funding decisions as a group. Removing competition and branding from the process allows the plans to focus solely on what creates meaningful community impact, and it has also built an unusual level of trust among CEOs who normally compete. The plans now meet weekly to align strategy and maintain shared accountability, creating a coordinated approach that’s far easier for community organizations to navigate. This collaborative structure doesn’t replace individual plans initiatives. It adds a collective layer that strengthens the entire Medicaid system.

Q4: You’ve said this approach is “locally determined but systematically facilitated.” Can you explain how that balance plays out, especially through data, contracting or governance?

Loren:

This model works by pairing community-driven priorities with a strong statewide structure. Local partners help define what investments should look like, ensuring the work reflects real needs on the ground, while OAHP, the plans, HMA and our actuarial consultant, Wakely Consulting, provide the governance, data and measurement tools that keep everything aligned. Every project is evaluated using total cost of care and utilization data, so investments are judged on whether they actually improve outcomes. That balance creates both local ownership and systemwide accountability, and it shifts funding toward long-term infrastructure rather than short-term programs. It all works because the plans trust the process and each other, and they see the value of collaborating for the good of the broader system.

Q5: What has this meant for community-based organizations receiving funds? How does the new model simplify or strengthen their partnerships with managed care plans?

Kelly:

For community-based organizations, the new model has been a major simplification. Instead of managing separate applications, contracts and reporting requirements from eight plans, CBOs now use a single, coordinated process with one application, one contract and one reporting system. That significantly reduces administrative and compliance burdens, especially for smaller nonprofits. It also creates more stable, long-term relationships with the plans since everyone is aligned around shared priorities. As a result, CBOs can spend more time delivering services and less time navigating paperwork, strengthening their overall capacity.

Q6: Ohio’s Community Reinvestment Collaborative Plan is moving toward a more sustainable, data-driven phase in 2026. What does that evolution look like, and how will you measure outcomes and long-term impact?

Loren:

In 2026, the Community Reinvestment Collaborative Plan is shifting into a more data-driven phase focused on demonstrating measurable impact. A key change is the use of actuarial modeling, which will link community investments to system-level outcomes such as cost trends, utilization patterns and quality measures. Each project will include bridge funding and clear performance metrics so plans can determine long-term viability based on results. The goal is to move from charitable giving to evidence-based reinvestment that shows a true return in both health outcomes and cost savings. OAHP and Wakely will track how funded interventions translate into improved access, reduced emergency use and stronger population health indicators across the system.