Business Updates

How Ohio Grades Medicaid Managed Care Ë¿¹Ï¶ÌÊÓƵ

March 2nd, 2020 | 2 min read

Ë¿¹Ï¶ÌÊÓƵ Building located in Dayton, OH

The 2019 Ohio Department of Medicaid (ODM) Managed Care Ë¿¹Ï¶ÌÊÓƵ Report Card is a comparison of each plan’s performance across five reporting categories.

  1. Getting Care
  2. Doctor Communication and Service
  3. Keeping Children Healthy
  4. Living with Illness
  5. Women’s Health

The report card serves as a side-by-side comparison of plan performance for consumers specifically addressing areas of interest to consumers in an easy to read, user-friendly format.

Information used for this report is collected from the managed care plans and their members and was reviewed for accuracy by independent organizations. Additionally, 2019 HEDIS® (Healthcare Effectiveness Data and Information Set) and 2019 CAHPS® (Consumer Assessment of Healthcare Providers and Systems) data is used for this report. The yearly report cards create transparency for people choosing a Medicaid managed care plan.

How is the Managed Care Ë¿¹Ï¶ÌÊÓƵ Report Card judged?

Each Managed Care Plan is responsible for collecting and auditing their own survey outcomes and turning over the results to an outside vendor that ODM contracts with – Health Services Advisory Group.  Health Services Advisory Group collects results from all managed care plans, aggregates results and develops the rating system used in the published card.

How does Ë¿¹Ï¶ÌÊÓƵ rank?

Managed Care Ë¿¹Ï¶ÌÊÓƵ Performance Ratings Chart

Ë¿¹Ï¶ÌÊÓƵ is tied for first place in quality on the Ohio Department of Medicaid’s 2019 Managed Care Ë¿¹Ï¶ÌÊÓƵ Report Card. The report card shares aggregated results of Managed Care Program sponsored member surveys for the 2019 period. Ë¿¹Ï¶ÌÊÓƵ was one of two plans to receive 18 stars across five different categories.

See the Press Release.

Using information collected from the managed care plans and their members, Ë¿¹Ï¶ÌÊÓƵ earned five stars in the Women’s Health category, measuring breast cancer, chlamydia and cervical cancer screenings, as well as perinatal and post-partum care. Ë¿¹Ï¶ÌÊÓƵ received four stars in the Doctor’s Communication and Service category, measuring how happy members are with their physicians and how members collaborate with their doctors in decisions about their care.

“Ranking high in quality demonstrates how Ë¿¹Ï¶ÌÊÓƵ puts our members first,” said Steve Ringel, Ë¿¹Ï¶ÌÊÓƵ Ohio Market President. “As a leader in quality, Ë¿¹Ï¶ÌÊÓƵ is proud to bring value-based care to our members and all Medicaid enrollees.”

Ë¿¹Ï¶ÌÊÓƵ provides Medicaid coverage to more than 1.3 million Ohioans, making it the largest provider in Ohio and among the largest in the U.S.

Explore Ë¿¹Ï¶ÌÊÓƵ Medicaid plans online.