Ohio Medicaid announces care management organizations for OhioRISE program

The Ohio Department of Medicaid announced this week the 20 organizations that would launch OhioRISE, a new Medicaid program for children with severe behavioral and mental problems (Source: “Parents have given up custody to get care for children with severe needs. Ohio Medicaid is closer to ending that,” Columbus Dispatch, Feb. 17).

OhioRISE, short for Resilience through Integrated Systems and Excellence, is scheduled to roll out in July with the goal of addressing situations where parents are at risk of giving up custody of their children to the state in order to get the required, unaffordable mental health and residential care needed by a child with severe behavioral and mental health problems. 

Aetna will be the health insurance company overseeing the program, which the department expects to cover up to 60,000 children by the end of the first year. The organizations, called care management entities, will be responsible for coordinating care for a child: Bringing together schools, behavioral health providers, juvenile services and other systems to provide help for complex needs. 

The $1 billion program is partly paid for by savings from other planned Medicaid reforms, such as centralized credentialing and billing systems. Around $19.5 million will be given to the entities to help them start up.