CareSource, the nonprofit Medicaid managed care provider headquartered in downtown Dayton, is in the midst of a realignment that will bring eight of the company’s business units under new leadership and create at least 200 new jobs in Ohio this year, company officials said.
Steve Ringel, who has been named to the new position of president of the Ohio Market for CareSource, will lead the realignment, which is being implemented with the help of global management consulting firm Booz & Company.
Ringel will be responsible for overseeing community education, provider relations, member care, consumer advocacy and governmental relations for the company’s Medicaid members, as well as enrollees in its CareSource Just4Me private health plans.
The company began offering health coverage through the federal health insurance marketplace for the first time this year and has enrolled more than 12,000 new customers to private plans.
In addition, CareSource expects to snag anywhere from 40-50 percent of the new business created by the expansion of Medicaid in Ohio, which is expected to add about 275,000 newly eligible enrollees to the Medicaid rolls by late 2015.
“Ohio is becoming a more complicated place from a managed care perspective,” according to Ringel, who said CareSource already controls about 57 percent of the Medicaid market in Ohio. “This (realignment) allows focus and alignment of resources.”
New business model
Ringel will report to CareSource founder, President and Chief Executive Officer Pamela Morris, who described the realignment as a new approach rather than a wholesale restructuring of the company’s business operations.
“In the realignment process, we wanted to set a model for how we would operate in any state, including Ohio, and align our organizational structure to support that model,” Morris said. “With the changing market dynamic, it was just the right time.”
Those changes include an increasingly competitive managed care arena in Ohio, where at least five Medicaid providers compete for customers statewide.
“A year ago, we were the only statewide operator,” said Morris, who noted the company added 85,000 Medicaid members last year even with increased competition.
Those new members helped boost CareSource’s Medicaid enrollment early this year to more than one million members for the first time in the company’s 25-year history, Morris said.
“I just feel a personal ownership over that number,” she said. “It’s certainly a milestone I never really expected us to see; perfect way to start off our 25th year.”
Ringel, who joined CareSource as vice president of operations in 2011, attributes the rapid growth to CareSource’s community outreach efforts and word-of-mouth advertising.
“We are a high-touch, community-based organization that builds long-term relationships, and we’re seeing it play out in every business we’ve gone into,” said Ringel, who has 20 years of experience in the managed care industry.
That includes growing market share in Kentucky, where CareSource now serves people who qualify for both Medicaid and Medicare through a partnership with Humana Inc. The company plans to begin serving so-called dual eligibles in Ohio in May when the MyCare Ohio program begins open enrollment.
On top of its Medicaid enrollment, the company has said it plans to sign anywhere from 50,000 to 150,000 CareSource Just4Me customers in Ohio over the next two years. And that doesn’t include business in new states, such as Indiana and Kentucky, where the company is planning to submit qualified health plan applications to sell insurance in the states’ federal marketplaces next year, Morris said.
Even with an eye on new markets, Ohio will remain the focus of one of Dayton’s fastest-growing companies, with an estimated $3.7 billion in annual revenues and more than 1,700 employees, mostly at its downtown headquarters.
“We’ll have an aligned team focused on our Ohio business because it’s the core of CareSource,” according to Morris, who said growth and diversification in Ohio would create “at a minimum 200 jobs this year.”
Morris said the new hires would be split evenly between Dayton and Cleveland — the center for its MyCare operation in northeast Ohio. And, she said, the company — which occupies more than 350,000 square feet in two buildings downtown — is looking for new office space to accommodate its growing staff.
“We are working on a near-term office space solution,” Morris said, without elaborating further. She said the company would make a formal announcement within the next 30 days.
Established in 1989
$3.7 billion: Estimated in revenue in 2013
$7.3 million: Amount in grants awarded by the CareSource Foundation since 2006
1 million: Total customers in Ohio and Kentucky
1,710: Current CareSource workforce
91: Percentage of revenue spent directly on medical services
15: U.S. ranking for Training Magazine’s Top 125 training organizations