The program is called OhioRISE. Aetna will work with Gov. Mike DeWine’s Family and Children First Cabinet Council to implement a child and family-centric model featuring new targeted services and intensive care coordination delivered by community partners. A
Aetna also will coordinate with the state’s Medicaid managed care organizations and the new single pharmacy benefit manager to ensure medical and pharmaceutical services and supports are integrated in the child’s comprehensive health plan.
The OhioRISE program addresses gaps in Ohio’s health care system that currently result in 140 Ohio kids living out of state on any given day in order to access the behavioral health services they need. Before OhioRise, some parents told state officials that they surrendered custody of their kids because if the kids were in state custody then the state would pay for their mental health care.
Though multiple state agencies serve a majority of these children, the current absence of accountable, focused coordination to integrate these programs leaves parents facing an overly complex system of care during times of family crisis.
“Too often, parents wrestle with a heart-wrenching choice to either relinquish custody of their child in exchange for life-saving services or face insurmountable health care bills and financial insolvency by seeking care alone,” said Maureen Corcoran, director of Ohio Medicaid. “The current system is at a breaking point. We spend up to $1,100 per day to send children out of state to receive supports needed, and we can do better.”
Ohio Medicaid said Aetna earned the highest total evaluation score among the four proposals received and brings more than 25 years of experience designing and developing similar programs for children and families across the country. The Medicaid department stated that within the first seven months of launching its Mountain Health Promise plan in West Virginia, Aetna reduced the number of children sent out-of-state by 9.6%, decreased the rate of in-state group home placements by 7.4%, and lowered the number of children residing in shelters by 14.5%. Additionally, Aetna recently implemented the new Supporting Kentucky Youth Medicaid managed care program.