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Learn more about the next generation of Ohio Medicaid managed care and what it means for providers

In 2019, the Ohio Department of Medicaid (ODM) launched a series of procurements and strategic initiatives with the goal of creating a next generation managed care program focused on the individual. This focus supports us in doing better for the people we serve and the providers who are our partners.

Medicaid Managed Care Procurement Award

On April 9, 2021, ODM announced the selection of six managed care plans to lead the department’s evolution of managed care services for its more than 3 million members and thousands of medical providers. Additional information about the announcement can be found in the press release and supplemental briefing document

The selection reflects the results of intensive stakeholder engagement efforts to define opportunities to strengthen the structure of Ohio’s $20 billion managed care program. It addresses Governor Mike DeWine’s direction at the beginning of his term to re-evaluate Ohio’s managed care system with the goal of making the system more focused on individuals.  

The six MCOs selected for the next generation managed care program are: 

  • AmeriHealth Caritas Ohio, Inc.
  • Anthem Blue Cross and Blue Shield
  • Buckeye Community Health Plan
  • CareSource Ohio, Inc.
  • Humana Health Plan of Ohio, Inc.
  • Molina Healthcare of Ohio, Inc.
  • UnitedHealthcare Community Plan of Ohio, Inc.

 Contracting with ODM’s Next Generation MCOs

Providers interested in contracting with Ohio Medicaid’s next generation MCOs can contact them via the Provider Relations contact information listed in the table below.

Next Generation MCO Provider Relations Contact Information
 ......MCO .......  ......Phone Number....... Web Address Email

AmeriHealth Caritas Ohio, Inc.

1-833-296-2259​ 

https://www.amerihealthcaritas.com/become-a-provider/join-now-ohio.aspx

ProviderRecruitmentOH@amerihealthcaritas.com 

Anthem Blue Cross and Blue Shield

1-833-623-1513​

https://www.anthem.com/provider/getting-started/  ​

OHMedicaidProviderQuestions@Anthem.com  ​

CareSource Ohio, Inc.​

1-800-488-0134​

https://www.caresource.com/oh/providers/education/become-caresource-provider/

Ohio_Provider_Contracting@caresource.com  ​

Humana Health Plan of Ohio, Inc.  ​

1-877-856-5707

Humana.com/HealthyOH

 OHMedicaidProviderRelations@humana.com

Molina Healthcare of Ohio, Inc.  ​

1-855-322-4079​

www.molinahealthcare.com

OHContractRequests@MolinaHealthCare.com  ​

UnitedHealthcare Community Plan of Ohio, Inc.  ​

 ​800-600-9007​

https://www.uhcprovider.com/en/health-plans-by-state/ohio-health-plans/oh-comm-plan-home.html

N/A​

Buckeye Community Health Plan​

1-866-246-4356 ​Ext - 24291​

https://www.buckeyehealthplan.com/providers/become-a-provider.html

OHNegotiators@CENTENE.COM

Previous Procurement Phases: Request for Applications (RFA) and Requests for Information (RFIs)

We begin by first considering feedback and suggestions from individuals and providers when making decisions about how to evolve the Medicaid managed care program in Ohio. The feedback received through our first Request for Information (RFI #1) informed development of RFI #2, outlining our vision for the next generation of Ohio's Medicaid managed care program. The second RFI sought input from providers, associations, advocacy groups, data and information technology vendors, and managed care organizations. The response period for both RFI #1 and RFI #2 closed on Tuesday, March 3, 2020.

This feedback informed the program design reflected in Ohio Medicaid’s next generation program structure and procurement processes.

Communicating with ODM

The Medicaid mailbox will remain open as a way for providers to communicate with ODM about the current Medicaid managed care program. For feedback or observations related to the Managed Care Procurement, you can also contact us through the Next Generation mailbox or by visiting the Contact Us page.