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Buckeye Health Plan Rated Best Medicaid Health Plan for Quality Performance

Date: 12/21/18

The Ohio Department of Medicaid (ODM) awarded Buckeye Health Plan the highest quality rating among all Ohio managed care plans with 20 stars across the five categories on its 2018 Managed Care Plans Report Card published today. Buckeye earned the top, five-star rating for “Keeping Kids Healthy” and “Doctor’s Communication and Service.” Buckeye is Ohio’s second largest managed care plan serving nearly 325,000 Medicaid members statewide.

Ohio Medicaid 2018 Managed Care Plans Report Card
Performance AreasBuckeye Health PlanCareSourceMolina HealthcareParamount AdvantageUnited Healthcare Community Plan
Getting Care**************
Doctors’ Communication and Services*****************
Keeping Kids Healthy****************
Living with Illness**************
Women’s Health***************
TOTAL STARS2014131613

Source: Ohio Medicaid;

ODM also announced that Buckeye performed the best among all plans in the Medicaid pay-for-performance (P4P) incentive program, which provides incentives to all Medicaid health plans for achieving quality-based performance milestones. Buckeye’s P4P performance in the 2018 report was the best of any plan since the state implemented the P4P program six years ago.
“At Buckeye, providing high-quality services to our members is our number-one priority, so we are extremely proud to be ranked best in quality on the state’s report card,” said Bruce Hill, Buckeye president and CEO. “Our top ratings in children’s health, provider communication and services and assisting members who are living with illness are very important to our members. It is a testament to our focus on putting our members at the center of everything we do and to the dedication of our staff and the 30,000-plus dedicated providers in our network who work closely with our members every day and guide them on their journey to better health.”Source: Ohio Medicaid;

Ratings on the state’s report card and P4P program are based primarily on performance as measured by the National Committee for Quality Assurance (NCQA), which rates and compares health plans in Ohio and across the country. NCQA is a private non-profit organization dedicated to improving healthcare quality through annual performance measurements from annual Healthcare Effectiveness Data and Information Set (HEDIS) reviews, and annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.

“Being tops in quality is great for our members,” Hill said. “Our goal is to continue to improve and to elevate care for all Medicaid members, not just the members who choose Buckeye. This is one more way that we are living our mission of transforming the health of our communities, one person at a time.”

“Buckeye’s success can be attributed to working closely with providers to deliver preventive patient care and treatment and closing gaps in care to ensure better health outcomes for Buckeye members,” said Hagy Wegener, vice president of quality improvement for Buckeye. “We are constantly engaging with our members through community outreach programs, member advisory councils, Nurse Advice Line, call center and care management teams. All these interactions are powerful and, married with data tracked by Quality Improvement, they give us essential insights into the challenges and barriers facing vulnerable Ohioans and what programs and services are needed to be responsive to their healthcare needs. The success of our approach is evidenced by Buckeye’s outstanding quality ratings, P4P percentage, and member health outcomes, as well as numerous industry awards for proven effective programs.”

Buckeye’s member engagement teams focus on helping parents understand the importance of routine well-checks and other preventive measures for their children’s health. Buckeye is also dedicated to removing barriers, such as transportation, that keep members from accessing healthcare.

“Buckeye strives to guide our members to better health. We recognize the importance of helping members understand that preventative care leads to a healthier life and a better quality of life,” says Dr. Ronald Charles, vice president of medical affairs for Buckeye. “We take a whole person approach to healthcare and work hard to keep our members on track with their care management plan for physical, mental and emotional health.”

Examples of Buckeye programs that create better patient outcomes and decrease cost include: 

● Addiction in Pregnancy Program: Connects high-risk, pregnant, addicted women with specially trained behavioral healthcare managers for treatment and continued services after delivery. Highly successful in reducing length of stay in special-care and intensive-care nurseries for addicted babies to 9 days versus the national average of 17 days. Resulted in a 30% reduction in cost per Neonatal Abstinence Syndrome NICU baby in the program.

● Medication Therapy Management Program: Helps members optimize therapeutic outcomes and detects and prevents costly medication problems.

● BuckeyeRxPlus Program: Improves medication adherence by targeting members who take 10+ medications daily and/or have a high-cost chronic disease. The program has resulted in adherence rates close to 100 percent, decreased inpatient stays and emergency department visits along with saving approximately $500 per member per month for members participating in the program.

“We are thrilled with BuckeyeRxPlus program’s success,” said Meera Patel-Zook, senior director of pharmacy at Buckeye. “Nonadherence to pharmacy treatment plans is a huge challenge for the U.S. healthcare system, especially for chronically ill patients. At Buckeye, we saw an opportunity to expand upon traditional adherence programs and have achieved tremendous outcomes as a result. We’re continuing to innovate and are excited to pilot a program expansion in 2019 for members discharging from inpatient care. We see a lot of hospital re-admittance due to medication management, and we believe our program can make a substantial impact here.”