Ohio Capitated Financial Alignment Model Demonstration (MyCare Ohio)
Guidance for Ohio Capitated Financial Alignment Model Demonstration (MyCare Ohio), including key dates and related information.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 31, 2020
Ohio Capitated Financial Alignment Model Demonstration (MyCare Ohio)
SPOTLIGHT & RELEASES
| 04/23/2024: CMS released the Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 8. More information is available below. |
Key Dates
December 11, 2012 - CMS and Ohio sign MOU
February 11, 2014 - CMS, Ohio and participating plans execute three-way contract
May 1, 2014 - Start of opt-in enrollment
January 1, 2015 - Scheduled start of passive enrollment
July 1, 2019 - CMS, Ohio and participating plans execute updated three-way contract
February 1, 2020 - CMS, Ohio and participating plans execute updated three-way contract amendment
January 1, 2021 - CMS, Ohio and participating plans execute updated three-way contract amendment
May 1, 2021 - CMS, Ohio and participating plans execute updated three-way contract amendment, extending the demonstration through December 31, 2023
January 1, 2022 - CMS, Ohio and participating plans execute updated three-way contract amendment
November 1, 2023 - CMS, Ohio and participating plans execute an updated three-way contract
MyCare Ohio Model
On December 11, 2012, the Centers for Medicare & Medicaid Services (CMS) announced that the State of Ohio will partner with CMS to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.
Under the demonstration, Ohio and CMS will contract with health plans that will coordinate the delivery of and be accountable for all covered Medicare and Medicaid services for participating Medicare-Medicaid enrollees.
More information from CMS:
- Fact Sheet
- Three-Way Contract (PDF)
- MOU (PDF)
- State Proposal (PDF)
- Third Evaluation Report for the Ohio capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (10/05/2023)
- Second Evaluation Report for the Ohio capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (03/08/2022)
- First Evaluation Report for the Ohio capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (11/29/2018)
- Readiness Review Tool - Phase I (PDF)
- Readiness Review Tool - Phase II (PDF)
- Readiness Review Tool - Phase II Attachment B (PDF)
- Ohio Evaluation Design Plan (PDF)
- Letter of Intent to Extend Scheduled End Date (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 1 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 2 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 3 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 4 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 5 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 6 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 7 (PDF)
- Ohio Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 8 (PDF)
Information for Plans:
- All state-specific information and guidance for plans is available on the Information and Guidance for Plans page.
Information for Beneficiaries and Providers:
- MyCare Ohio Continuity of Care Provisions (PDF)
- MyCare Ohio Ombudsman Program
- MyCare Ohio Provider Outreach Letter (02/02/15) (PDF)
Information from the State of Ohio:
Funding Support:
Want regular email updates? Sign up by visiting this link.
We’re always looking for ways to improve the experience and usability of our webpages. If you’ve Feedback or issues to report, please contact us at MMCOWeb@cms.hhs.gov.
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.