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By 2010, the company was the third largest Medicaid HMO in the country, with $2.5 billion in revenue and 800,000 members across Ohio and Michigan. [12] In 2010, CareSource announced expansion of its provider network in Southeastern Ohio through a partnership with Quality Care Partners (QCP), a physician-hospital organization (PHO). [13]
CareStar has provided case management services since 1988 in various mid-western states, predominantly in Ohio and Indiana.In 2004, CareStar signed a five-year, $140 million contract with the Ohio Department of Job and Family Services to provide case management services for its medicaid waiver homecare program.
Prior to July 2013, ODJFS was also the state agency responsible for the administration of Ohio's Medicaid program. In July 2013, a new state agency was created, the Ohio Department of Medicaid (ODM), Ohio’s first Executive-level Medicaid agency. ODJFS employs about 2,300 full time employees and has an annual budget of $3.3 billion. [2]
A data structure file is available separately from CMS. [6] As of June 2024, the file download size is 947.84 MB, and the raw database file (npidata_pfile_20050523-20240512.csv) is 9.3 GB when extracted. [7] The size of the data has been steadily growing over time. The size of the raw database file was 8.8GB in June 2023, and 8.2GB in June 2022.
The National Practitioner Data Bank (NPDB) is a database operated by the U.S. Department of Health and Human Services that contains medical malpractice payment and adverse action reports on health care professionals. Hospitals and state licensing boards submit information on physicians and other health care practitioners, including clinical ...
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Introduced for Medicaid in 1989 and Medicare in 1990, this designation allowed HRSA-funded health centers to receive cost-based reimbursement rates. Covered services included those provided by physicians, physician assistants, nurse practitioners, certified nurse midwives, clinical psychologists, and clinical social workers.
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]