CareSource

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CareSource is a nonprofit managed care organization headquartered in Dayton, Ohio. It is one of the largest Medicaid managed care plans in the United States, providing health care coverage for Medicaid members, children in the Children's Health Insurance Program (CHIP), and individuals participating in the Health Insurance Marketplace. CareSource also offers Medicare Advantage plans to seniors. The organization is dedicated to improving the health and well-being of its members by offering a range of health care services, including preventive care, primary care, hospitalization, prescriptions, and behavioral health services.

History

CareSource was founded in 1989 with the mission to provide quality health care coverage for Medicaid beneficiaries. Over the years, it has expanded its services and coverage area to include several states beyond Ohio, such as Indiana, Kentucky, West Virginia, and Georgia. The organization has grown significantly since its inception, both in terms of membership and the range of services offered.

Services

CareSource offers a comprehensive suite of health care services to meet the needs of its diverse member base. These services include, but are not limited to:

  • Medicaid Managed Care: Providing health coverage to low-income individuals and families.
  • Children's Health Insurance Program (CHIP): Offering health insurance for children in families with incomes too high to qualify for Medicaid but too low to afford private insurance.
  • Health Insurance Marketplace Plans: Offering health insurance plans through the federal Health Insurance Marketplace created by the Affordable Care Act.
  • Medicare Advantage Plans: Providing Medicare beneficiaries with an alternative to the traditional Medicare program that includes additional benefits.

Member Services

CareSource places a strong emphasis on member services to ensure that its members receive the support they need to navigate the health care system effectively. This includes a 24/7 nurse advice line, case management programs, and health and wellness programs designed to promote healthy living among its members.

Community Involvement

CareSource is deeply committed to the communities it serves, engaging in numerous initiatives aimed at improving community health and well-being. This includes investing in social determinants of health, such as housing, education, and employment services, to address the root causes of poor health outcomes.

Challenges and Controversies

Like many managed care organizations, CareSource faces challenges related to health care costs, regulatory compliance, and ensuring access to quality care. The organization works closely with providers, members, and regulatory agencies to address these challenges and improve the health care system for its members.

Future Directions

CareSource continues to expand its services and coverage areas, with a focus on innovation in health care delivery and payment models. The organization is exploring new ways to integrate technology into health care, such as telehealth and digital health platforms, to improve access to care and health outcomes for its members.

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Contributors: Prab R. Tumpati, MD