CareSource is moving partly to a “community-based care management model” meant to improve the health of the 1 percent of its members deemed at highest risk.
Those Medicaid members are among the highest users of health care services and the most costly to the state Medicaid program, budgeted at $18.8 billion this fiscal year.
CareSource, which now covers about 10 percent of insured Ohioans and through November had 2011 revenues of $2.5 billion, plans to implement the new model by July 1.
“We see it as an important foundation for the future,” said Pamela Morris, CareSource’s president and CEO.
Of the 150 new jobs, about 35 will be based in the Dayton-Cincinnati market.
The remaining new jobs will be in the Columbus and Cleveland areas.
As of July, CareSource employed about 845 people in Dayton.
The patient navigation community model will initially involve about 8,500 to 9,000 of CareSource’s plan members who have medical problems such as diabetes or heart disease, socioeconomic disadvantages, and/or behavioral health care needs. It’s thought that workers who meet face-to-face with members will have a better chance of improving their outcomes than those who make contact with the Medicaid population by phone.
In many ways, Morris said, that face-to-face approach harks back to CareSource’s roots in the 1980s.
“We think we’re going to be able to engage our members, especially those who need our attention, at a whole new level,” Morris said.
CareSource will hire 60 “patient navigators,” whose pay will be $30,000 to $35,000 annually. It hopes to hire people who are unemployed or underemployed, Morris said. It also will hire 90 registered nurses and social workers.
The jobs are in addition to the 590 jobs that CareSource plans to create in the next several years as it prepares to extend coverage to “dual eligibles” (seniors who are eligible for both Medicare and Medicaid); low-income seniors; uninsured adults who will become eligible for Medicaid under the federal health care overhaul; and those who participate in state health care exchanges. At least 500 of those jobs are expected to be in Dayton.
There’s a “high probability” CareSource will invest in a bricks-and-mortar location for the new workers, but it hasn’t made a final decision to do so, Morris said.
According to the state Office of Health Transformation, Medicaid spending is growing at an unsustainable rate — four times faster than the Ohio economy — and now accounts for 30 percent of total state spending and 4 percent of the Ohio economy.
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