One of area’s largest employers prepares for change: What it means to Dayton
The nonprofit insurer now finds itself at a critical moment, undergoing its first-ever transition to a new leader and navigating the always uncertain health care environment.
For the first time in nearly three decades, CareSource will navigate that environment without founding CEO
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Caresource leadership change: What it means for
Morris' successor is
No one disputes that Preitauer has big shoes to fill.
"In a lot of ways CareSource is a reflection of
Early years
It's almost hard to imagine now, but CareSource had a rocky start.
Originally called the Dayton Area Health Plan, it was incorporated in the mid 1980s by local hospital CEOs interested in Medicaid management.
The Medicaid program is jointly funded by the state and federal government to provide health insurance for people with low incomes. It covers about a fourth of
Morris, then executive director of the
"We thought if there was kind of an HMO that would manage the care of patients on Medicaid, we could save the state money and provide better care to the patients," recalled
In managed care, insurers get paid a fixed rate per patient and then the insurer handles claims and assumes any cost overruns. The goal was to give the state predictable and controlled costs and improve health care through coordination.
The first Medicaid managed care plans were piloted starting in the 1970s, though a lot of these plans fell apart at first.
"For a while it stymied any effort to move
A
"It was new. Manged care was not an accepted model of health care in the 1980s. It just was not," she said. "But I knew from my experience working at the county and directly with consumers, seeing their challenges, and also learning manged care, that the model would work."
In 1989, the Dayton Area Health Plan became the state's first mandatory Medicaid managed care plan, with permission from a waiver.
But the waiver had an expiration date. Former
"We knew how serious it was that if we did not get this legislation passed we could no longer operate the Dayton Area Health Plan," Morris said.
The bill made it through
"The bill was like a paragraph long," Morris said. "We have copies in our archives. I can visualize it as we're speaking."
Breitenbach says the insurer's success has validated the effort.
"They could not only provide better care, but cheaper and more effective care," he said.
Rapid growth
CareSource, which started as a
Morris said CareSource's success in
"I think a testament to the model that we created right here in
CareSource's growth in market share has also come with tensions with the providers, including disputes over contracts, claim denials and claims processing. Hospitals say Medicaid underpays, and health systems are always pushing for better reimbursements.
An appeals court in 2017 upheld a
Similar tensions occurred in other states as CareSource rapidly expanded.
Morris said CareSource wasn't always in the position to pay providers the rates they wanted to be paid.
"We worked diligently to avoid contract terminations," she said.
CareSource also agreed to pay
"Any business faces adversity," Morris said of the legal action. "That was an adverse event for us. I contend that you learn more through times of adversity than in the good times. There was a lot of learning and it made CareSource a much stronger company."
'It doesn't rely on me'
During her college years at
Turns out, she has put that baseline of political knowledge to work. CareSource couldn't have gotten started without policy changes and its leaders have continued to weigh in on changes in government funding and policy. Morris was recently elected to the board of
"I would say to my dad afterwards, 'it paid off,'" she said.
"Her passion and vision on trying to provide health care services to under-served and vulnerable populations is very commendable," Bucklew said.
She's been well-compensated for those efforts. Her total compensation was
In the past five years, CareSource's annual revenue has grown from
The Republican governor hopefuls could both change Medicaid expansion if elected to succeed Gov.
Ohio Medicaid is seeking permission to create job requirements for people covered through the expansion, following the Trump administration opening door to states adding the first ever work requirements in the history of the 50-year-old public insurance program.
CareSource's growth is visible to anyone who drives through downtown
"I can remember having to make my case because CareSource was a nonprofit and we did not provide necessarily grants to nonprofits," she said.
But CareSource has continued to invest back in the city with its payroll and growth. It doesn't just have a large office in town, Dickstein said, but also has its headquarters and C-suite talent.
"When they were building their first headquarters building, plenty of people were trying to woo (Morris) out of the city and trying to get her to build elsewhere," Dickstein said. "There were plenty of options that were probably less expensive options. But her commitment to downtown was stellar."
Morris said she doesn't worry about what will happen after she retires.
"It doesn't rely on me. We have a tremendous team at CareSource," she said. "I don't worry for two minutes that that won't continue without me here." she said.
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