On August 25, the Ohio Department of Medicaid (ODM) projected a go-live date for the Next Generation managed care launch for Thursday, July 1, 2022. Originally, the plan was to launch on Saturday, January 1, 2022, but Medicaid has delayed launch until July 2022.
“Our priority since the beginning of this administration has been on doing this right for the people we serve,” said Ohio Medicaid Director Maureen Corcoran. “A July 2022 go-live gives us time to support and inform our members about the new program, to work with community leaders, and respond to the feedback received from the plans and providers.”
The July 2022 Next Generation launch provides Ohio Medicaid, the managed care entities, and providers the time needed to test and validate systems and processes to ensure readiness prior to going live. Several components of the new program are designed to reduce the administrative burden on providers and streamline access to care.
Design for Ohio Medicaid’s next generation program began in early 2019, with extensive outreach and listening sessions around the state. While the initial timeline targeted implementation for January 2022, this did not anticipate the persistence of COVID-19 and its impact on individuals served by the program and their providers.
Medicaid’s Next Generation program introduces five new components to Ohio’s program: managed care, single pharmacy benefit manager (SPBM), centralized credentialing, fiscal intermediary, and OhioRISE. Implementation involves integrating multiple systems to support a network of more than 170,000 health care providers and pharmacies and millions of Ohioans. The transition places new responsibilities on managed care organizations to oversee the coordination of care, ensure access to services, and confirm community resources are understood and available to members.