MetroHealth System to provide medical home coverage.
(2.5.13) The MetroHealth System has received approval today from federal officials to launch a Medicaid waiver program that will provide a medical home and health coverage for up to 30,000 uninsured residents of Cuyahoga County. The program begins today.
The program, called MetroHealth Care Plus, is the first in Ohio to provide healthcare coverage to more of the uninsured. It is designed to provide the high-quality services people need to maintain their health, while also reducing healthcare spending.
“We are grateful that the Centers for Medicare and Medicaid Services, the State of Ohio’s Office of Medical Assistance and our own Cuyahoga County government shared our commitment to reduce the uninsured rate in Cuyahoga County, and to improve the health status and quality of care for thousands of county residents,” said Edward Hills, DDS, Interim President and CEO of MetroHealth.
“I particularly I want to thank Ohio Medicaid Director John McCarthy, Cuyahoga County Executive Edward FitzGerald and Cuyahoga County Council for working with us to make this happen,” Dr. Hills added. “I also want to thank U.S. Senator Sherrod Brown, Representatives Marcia Fudge, Marcy Kaptur, Jim Renacci, and former Representatives Steven LaTourette and Dennis Kucinich for expressing their support for the waiver with CMS.”
The MetroHealth System will finance this care locally with the $36 million annual subsidy it receives from Cuyahoga County taxpayers, which allows the MetroHealth Care Plus program to leverage another $64 million in annual federal Medicaid matching funds. No state dollars are being used to pay for the demonstration project.
“MetroHealth will be on the forefront of expanding health coverage to uninsured Ohioans — helping to improve access to appropriate health care and reduce costs to taxpayers and businesses in Ohio,” said Senator Sherrod Brown. “By covering up to 30,000 uninsured Ohioans, MetroHealth will improve the health of Ohioans while reducing costly emergency room visits.”
“I commend all the parties at the federal, state and county level who worked with MetroHealth to bring expanded healthcare coverage to approximately 30,000 uninsured residents of Cuyahoga County,” said Congresswoman Marcia L. Fudge. “This decision will not only enable MetroHealth to provide the quality medical care they need but it will also help significantly reduce healthcare costs for everyone by reducing the use of emergency room care.”
Primary care will be provided by The MetroHealth System’s 17 locations, Neighborhood Family Practice and Care Alliance, all of which carry the distinction of being designated as Level 3 Patient-Centered Medical Homes by the National Committee for Quality Assurance (NCQA).
MetroHealth will also partner with other community agencies to help deliver the care, including Recovery Resources, Murtis Taylor Human Services System, Catholic Charities Services and Stella Maris, among others, as well as a network of ancillary service providers. MetroHealth Care Plus claims processing and related support functions are being provided in conjunction with a third party administrator vendor, Medical Mutual of Ohio Inc.
To be covered under MetroHealth Care Plus, Cuyahoga County residents must be:
- 19 to 64 years old
- Not eligible for regular Medicaid
- Income at or below 133% of the Federal Poverty Level ($14,856 a year for a family of one)
- U.S. citizen or legal resident of the United States for seven years
Enrollees of MetroHealth Care Plus will be assigned to a primary care provider who will coordinate all of their health care. These patients can obtain covered benefits from network providers for such healthcare services as:
- Preventive exams
- Doctor visits
- Prescription medications
- Hospital care
- Emergency services
- Dental care
- Physical and speech therapies
- Home health care
- Mental health services
- Nutrition counseling
- Alcohol and drug abuse services
- Durable medical equipment
- Transportation to MetroHealth medical appointments
To learn more about MetroHealth Care Plus and to apply for eligibility, call 216-957-2325 or visitwww.metrohealth.org/careplus. Applications for the Care Plus program are also available at any MetroHealth location.