Ohio Department of Jobs and Family Services' Enhanced Care Program

By Bridget McAuliffe ( December 2004)

Ohio's Enhanced Care Management is a new Medicaid program to coordinate medical care for elderly and disabled Ohioans with certain chronic diseases. The goal of the program is to reduce Medicaid costs by assuring people with serious but treatable conditions have access to on-going medical treatment. It is widely believed that chronically ill Medicaid patients do not have access to the medical treatment they need to manage their disease, allowing it to worsen over time and requiring excessive hospitalization. Often times, these patients are discharged without an incentive to receive the daily treatment and education they need to avoid the need for future hospitalization.

The Federal government approved Ohio's request this summer to launch the new program with the hope that it will assist in reducing Medicaid costs. The program will focus on the geographically areas that have the greatest number of chronically ill Medicaid recipients. The following 7 counties have been identified: Lucas, Summit, Coshocton, Cuyahoga, Franklin, Guernsey, Hamilton, Montgomery, Morgan, Muskingum, Noble, Perry and Stark. The roll-out began this fall in Lucas and Summit counties, and will be introduced in the remaining counties throughout the 2005 calendar year.

Eligible recipients will receive a letter in the mail from the Ohio Department of Jobs and Family Services (ODJFS) to inform them when the program becomes available in their area, and how to proceed if they would like to participate. It is strictly a voluntary program, and there is an "opt-out" option available. It is anticipated that 30,000 Medicaid recipients will participate in the program.

The Enhanced Care Management program will educate chronically ill patients on how to manage their disease on a daily basis, providing assistance in making and keeping their doctors appointments, and provide access to a nurse helpline to answer any questions regarding their treatment.