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DAYTON — If the region’s economic gloom has a silver lining, CareSource may very well be it.
The nonprofit Medicaid provider has added about 100 jobs so far this year, in part to keep pace with record Medicaid enrollment driven by job losses and the poor economy.
And with Medicaid rolls projected to grow again next year and the health care overhaul further expanding the federal/state health insurance program for the poor and disabled, CareSource’s growth spurt appears to be just beginning.
CareSource expects to add 200 jobs in 2011. While job numbers are expected to plateau in 2012, another 150 jobs are expected in 2013, and 240 more in 2014.
“This will have a very positive impact on our local economy here in Dayton, and we’re very excited to be part of that,” CareSource CEO Pamela Morris said.
CareSource, which has 853,000 members, expects to enroll at least 400,000 more as a result of the health care overhaul.
Preliminary figures indicate conditions are favorable for managed care companies such as CareSource to grow, said Lisa Frazier, research analyst at the Health Policy Institute of Ohio.
In addition to an expansion of Medicaid, some employers could drop their health insurance plans if they see that their employees could qualify for the expanded Medicaid program or for tax credits, which will help those with incomes up to four times the federal poverty level ($88,200 for a family of four). That could further benefit Medicaid providers like CareSource, Frazier said.
The Ohio Department of Job and Family Services this summer estimated that Medicaid, which insures nearly 2.1 million poor and disabled Ohioans, will grow by 554,000 people beginning in 2014. That expansion will cost Ohio taxpayers $1.45 billion from 2014 to 2019, according to state projections, with the federal government covering the bulk of the cost.
Preparing for the influx
To gear up for growth, CareSource has a three-year strategic plan. Its goals include:
• Investing $10 million to $15 million in technology. CareSource expects more new users will want to interact with it online instead of by phone. CareSource also must ensure its core processing systems, which handled some 12 million medical claims in 2009, are prepared for the growth. And electronic fund transfers will soon be implemented so providers are paid more quickly.
• Seeking accreditation from NCQA (National Committee for Quality Assurance) and seeking to improve its members’ health outcomes through new health and wellness incentive programs.
• Ensuring the nonprofit’s network of providers is big enough to meet the needs of an influx of new health care consumers, and finding new ways to partner with physicians and other providers.
“As we prepare for those who will get the subsidies up to 400 percent of the federal poverty level, they may be using different providers than what we have in our network today,” Morris said. “We think the higher-income individuals will be more discerning in terms of looking at your network, and that could indeed drive their decision to pick CareSource versus another plan.”
CareSource also hopes to work with physicians to help them engage patients and ensure they get preventive care, which can head off the need for more expensive acute care.
CareSource has looked at entering other states such as Illinois, Morris said, but it doesn’t have the access to capital that some of its publicly traded competitors have. Still, it may expand its reach elsewhere by working with a physician group, supporting an accountable care organization or a state Medicaid organization that would benefit from CareSource’s infrastructure.
But the chief focus will be on growth opportunities within CareSource’s existing footprint, especially Ohio.
“We want to focus our full attention toward that and not be distracted by other things,” Morris said.
Contact this reporter at (937) 225-7457 or bsutherly@ DaytonDailyNews.com.
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