OhioRISE (Resilience through Integrated Systems and Excellence)

As a part Ohio Medicaid’s effort to launch the next generation of Medicaid, ODM will implement OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral health and multi-system needs.

New nonprofit will decide how to spend hundreds of millions of Ohio’s opioid settlement money

COLUMBUS, Ohio — The decision of how Ohio will spend hundreds of millions of dollars – and maybe more – in opioid settlement money will be up to a new non-profit, whose board met for the first time on Monday. The 29-member OneOhio Recovery Foundation Board consists of state representatives, local government leaders (including Cuyahoga County Executive Armond Budish), addiction treatment experts, and others from around the state. Under an agreement between state and local officials made in 2020 , the new foundation will decide how to distribute more than $440 million (or 55%) of an $808 million settlement reached last year with the nation’s three largest pharmaceutical distributors and drugmaker Johnson & Johnson. Under the agreement, another 30% of the settlement money will get distributed among more than 2,000 local governments in Ohio. The final 15% will go to the state, though Gov. Mike DeWine said OneOhio might also gain control over spending some of the state’s share. The sett

Central Ohio man’s mental health journey chronicled in art

COLUMBUS, Ohio (WCMH) – May is Mental Health Awareness Month, and a central Ohio man is opening up about his struggles to shine a light on the many people who battle bipolar disorder. During his time at the Ohio State Harding Hospital for Behavioral Health, A.J. Heckman discovered healing through art in a series of drawings he’s now titled “Clarified Mania.” The National Alliance on Mental Illness estimates that 7 million people in the United States are diagnosed with bipolar disorder. Heckman said if he can help just one person who might be undiagnosed and plagued with dark, intrusive thoughts, it’s worth it to share his journey, documented through his drawings. With fortitude and newfound strength, Heckman described the dark thoughts and the mania he was feeling this past February when he took crayons to paper as part of his therapy. “And I was having thoughts of suicide,” he said. “Nothing that I dwelled on, but they were intrusive thoughts and kind of taking comfort in the idea tha

Fentanyl cuts a deadly swath as overdose deaths spike in Lucas County and around the country

Almost 90 percent of all overdose deaths in Lucas County in 2020 were caused by the deadly drug. TOLEDO, Ohio — It might have been lost in the crisis of the COVID-19 pandemic, but it never went away. When it comes to the opioid epidemic, the synthetic opioid fentanyl is a killer that’s ruining families. “I said when are you going to hit bottom? When are you going to hit bottom?”  Peggy Montgomery was in a daily battle watching her son, Dustin Doust, battle a drug addiction. Dustin would get caught up in it, get sober again, and then fall back into dangerous habits. She had to confront him. “I finally said, you’re using. He cried and I cried and he said ‘Yeah I am.’ I said, ‘Well what are you using?’ And I never thought I would hear the word heroin. It was like somebody punched me in the heart,” Peggy said. Dustin agreed to go to rehab in Florida and Peggy thought he got better. He even moved back to Ohio. But on Jan. 26, 2018, Peggy heard her husband’s phone ringing early in the morni

Americans are more stressed about money than ever, and it’s hurting our mental health

Americans are more stressed about money than they’ve ever been, according to the American Psychological Association’s latest Stress In America Survey . “Eighty-seven percent of Americans said that inflation and the rising costs of everyday goods is what’s driving their stress,” said Vaile Wright, senior director of health care innovation at the American Psychological Association. More than 40% of U.S. adults say money is negatively impacting their mental health, according to Bankrate’s April 2022 Money and Mental Health report . “I was in debt off and on all of my 20s and early 30s,” Tawnya Schultz, founder of The Money Life Coach, told CNBC. “I was in this debt cycle of trying to get out of debt, paying off debt, getting back into it. And I was just tired of feeling like I could never get out of it or feeling like I was always going to have debt.” Some Americans lack hope they will ever have enough money to retire, with roughly 40% saying their ability to be financially secure in reti

Next Generation of Ohio Medicaid Managed Care

In 2019, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process with a bold, new vision for Ohio’s Medicaid program – one that focuses on people and not just the business of managed care. This is the first structural change since Centers for Medicare & Medicaid Services’ (CMS) approval of Ohio’s program in 2005.   With the projected implementation of Ohio Medicaid’s next generation of managed care on July 1, 2022, ODM intends to put the individual at the center of focus and improve the design, delivery, and timeliness of care coordination. This effort depends on the collective implementation of several strategic initiatives, including: Ohio Medicaid Managed Care Procurement OhioRISE (Resilience through Integrated Systems and Excellence) Single Pharmacy Benefit Manager Fiscal Intermediary (FI) Provider Network Management (PNM) Module & Centralized Credentialing Learn more about the new next generation program timeline on the Managed Care Pro

Changes coming to Ohio Medicaid will require participants to actively pick a plan each year

If you are one of the roughly one in four Ohioans who get their health coverage through the state’s Medicaid program there are changes coming your way this year that will require you to play an active role in selecting your coverage each year from here on out. The “Next Generation” overhaul set to launch in July gets rid of the automatic re-enrollment and has been three years in the making. It is designed to improve efficiencies in the system and administrative cost savings while getting Ohio’s roughly 3 million Medicaid users more involved in their own healthcare choices which can lead to healthier outcomes. If you don’t select a plan, you’ll still have coverage — it’s just an algorithm will be used to do it for you. If you are one of the roughly 1 in 4 Ohioans who get their health coverage through the state’s Medicaid program, there are changes coming your way this year that will require you to play an active role in selecting your coverage each year from here on out. If you give a c