CareSource, Ohio’s largest Medicaid managed care provider, was the only new vendor among the four companies that received contracts earlier this week from the Georgia Department of Community Health after intense statewide competitive bidding, Morris said.
“You don’t get too many opportunities to win an award in a state as large as Georgia…and we were the only new plan to be added,” she said. “There were large publicly traded companies that bid and did not win. I think that’s a testament to our 26-year track record of success in Medicaid managed care, and the fact that we are a nonprofit company with a different business model.”
As a nonprofit, CareSource has low administration costs and spends at least 90 percent of its revenue on direct medical care for consumers, setting it apart from the for-profit health insurers that bid for contracts. The company had total revenue of $5.4 billion in 2014.
Beginning next July, CareSource will compete for enrollment with Anthem, Centene and WellCare — health insurers already operating in the state with the largest share of the market.
But Morris described the state’s initial projections for CareSource’s share of the total 1.3 million low-income Medicaid beneficiaries in Georgia as a conservative estimate.
“It’s just an estimate; we expect the number to be higher,” Morris said, noting that Georgia has not expanded Medicaid eligibility under the Affordable Care Act and also does not pay for managed health care services for the state’s aged, blind and disabled — populations that could come online in the future.
In Ohio, Gov. John Kasich’s decision to expand Medicaid eligibility to most low-income, able-bodied individuals has swelled the state’s Medicaid rolls by more than 600,00. At the same time, CareSource has added more than 350,000 expanded Medicaid recipients in Ohio and Kentucky, which also expanded eligibility under the federal health care reform law.
CareSource, whose total membership grew from 1 million to 1.4 million last year, also has plans to expand its Medicaid program into other states, including Indiana, where it formerly provided Medicaid managed care services, and potentially North Carolina, which doesn’t have a medicaid managed care program but is considering adopting the model.
In addition to its Medicaid programs, CareSource also is a leading provider of ACA qualified commercial health insurance plans, sold under the brand name Just4Me in Ohio, Indiana and Kentucky.
Morris was quick to point out the company’s growth and plans for expansion will create jobs in Dayton rather than take them away, as some community leaders may fear.
“We’re hoping there will be other opportunities to grow,” she said. “But when CareSource grows, whether it’s in Ohio or outside the state, Ohio always wins because we always add people here. Downtown Dayton is home to CareSource’s corporate headquarters, and we remain committed to being an anchor for the city.”
CareSource, with a total workforce of 2,427 and annual revenue of currently has about 2,000 employees in downtown Dayton spread among three locations, including the headquarters, a call-center and recently expanded office space in the Ballpark Village area downtown. The new hires in Dayton supporting the Georgia expansion will work at existing locations.
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