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Cleveland, February 2013: The MetroHealth
System has received approval 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, 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 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.
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 US 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 US 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."
“As the first program of its kind in Ohio,
MetroHealth has taken a leadership role in expanding health
coverage for the uninsured and reducing the cost of healthcare,”
said Cuyahoga County Executive Ed FitzGerald. “This help
comes at a time when working families or the recently unemployed
in our state face the burden of not being able to afford health
care coverage and are not eligible at this time for other health
insurance programs.”
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:
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19 to 64 years old
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Uninsured
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Not eligible for regular Medicaid
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Income at or below 133% of the
Federal Poverty Level ($14,856 a year for a family of one)
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U.S. citizen or legal resident of
the United States for 5+ 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:
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Preventive exams
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Doctor visits
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Prescription medications
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Hospital care
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Emergency services
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Dental care
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Physical and speech therapies
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Home health care
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Mental health services
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Nutrition counseling
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Podiatry
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Alcohol and drug abuse services
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Durable medical equipment
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Transportation to MetroHealth
medical appointments
To learn more about MetroHealth Care Plus and to
apply for eligibility, call 216-957-2325 or visit
www.metrohealth.org/careplus. Applications for the Care Plus
program are also available at any MetroHealth location.
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