The MetroHealth System announced on Tuesday that the federal government has approved its plan to provide a medical home and health coverage for up to 30,000 uninsured residents of Cuyahoga County.
The program, called MetroHealth Care Plus, is designed to provide the high-quality services people need to maintain their health, while also reducing health care spending.
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.
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:
- 19 to 64 years old
- Not eligible for regular Medicaid
- Income at or below 133% of the Federal Poverty Level ($14,856 a year for a family of one)
- U.S. citizen or legal resident of the United States for seven 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 health care services as:
- Preventive exams
- Doctor visits
- Prescription medications
- Hospital care
- Emergency services
- Dental care
- Physical and speech therapies
- Home health care
- Mental health services
- Nutrition counseling
- Alcohol and drug abuse services
- Durable medical equipment
- Transportation to MetroHealth medical appointments
The program is currently underway.