CareSource President and CEO Erhardt Preitauer said in a statement about the annual report results that the company is still addressing the health challenges brought on by the pandemic, so they still have a lot of work to do. But above that, he said there’s going to be a lot more work because the pandemic has impacted people in a lot of different ways, from substance use disorder to behavioral health to complex care for special populations.
“We have a lot of work ahead of us, but we also have an amazing organization with the best capabilities in the country. I believe that our limitations are really only our own constructs. We’re up for the challenge,” Preitauer said.
CareSource primarily makes its money through government insurance programs. Programs like Ohio Medicaid give CareSource money per member per month and in turn CareSource coordinates their health benefits and pays out claims.
The company reported $11.2 billion in gross revenue in 2020, up from $10.6 billion in 2019. CareSource said 9.7% went toward administration, which is up from 8.3% reported the year prior.
Some highlights of 2021 in the annual report included:
- In March 2020, giving $500,000 to immediate needs related to the coronavirus pandemic, like food access in Ohio and Indiana and childcare to medical workers in Georgia.
- In a Franklin County trial study, they found pregnant women with housing assistance were more likely to have healthy full term babies and as a result of this trial study, CareSource plans to test the Healthy Beginnings at Home model in other communities and at a greater scale.
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- When meeting state and federal claim payment metrics, CareSource reported fewer than 0.01% of claims aged over 30 days.
- Telehealth use also expanded during the pandemic. “Before the pandemic we had less than 10,000 people using telehealth for behavioral health services, and now we’ve got more than 100,000 people. That’s remarkable,” said Jonas Thom, VP of behavioral health.
- The insurer also built more relationships with local jail officials in 2020 “to get them the information that they needed to better serve their folks who are in jail and connect those folks to services outside, so they’re not recidivating back,” Thom said.
There were 2.05 million people enrolled in CareSource 2020, compared to 1.8 million in 2019. The bulk of their members continue to be through the Ohio Medicaid program but the company operated in five states in 2020. Their products include Medicaid, Marketplace, MyCare and Medicare Advantage insurance plans.
This year, CareSource found out it didn’t make the cut to expand to Oklahoma, but was approved as a partner on a new Arkansas Medicaid plan for people with complex behavioral health, developmental and intellectual disabilities.
CareSource’s bid was also accepted to continue being a part of Ohio Medicaid, which is getting an overhaul and rebid all its contracts with new sets of conditions.
Credit: Chris Stewart
Credit: Chris Stewart
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