$7.3B in expenses

CareSource Ohio, Inc. ("CSOH"), is a nonprofit organization established under the state law of Ohio. CSOH is a member of the CareSource group of nonprofit tax-exempt organizations (the "CareSource Public Charities"). (Continued on Schedule O)The sole member of the CareSource Public Charities is CareSource, an Ohio nonprofit corporation that is tax-exempt under section 501(c)(3) of the Internal Revenue Code of 1986 (the "Code"). The CareSource Public Charities' primary activity for the last three decades has been to provide nonprofit Medicaid, Medicare, and Marketplace health maintenance organization ("HMO") services. As a mission-driven organization, CSOH follows the guidance of the CareSource Public Charities and is focused on transforming health care with innovative programs that address the social determinants of health, health equity, prevention and access to care. CSOH serves nearly 1.2 million Members in Ohio. CSOH'S membership includes: (1) Medicaid consumers, including families with low income, children, pregnant women, adoption and children in foster care, those who are aged, blind or disabled, (2) Medicaid consumers who are eligible for Home and Community Based services through execution of an annual Provider Agreement with the Ohio Department of Medicaid ("ODM"), (3) Dually eligible consumers for Medicare and Medicaid through Ohio's Dual Demonstration program, MyCare, (4) Medicare Advantage consumers, and (5) a Qualified Health Plan offered through the Federal Health Insurance Marketplace, providing low-cost comprehensive coverage for individuals and families. Medicaid: Our Members get all medically-necessary, Medicaid-covered services at no cost. Examples include preventive check-ups, inpatient and outpatient hospital services, and dental care. Members enrolled in our Ohio Medicaid plans have access to the following services: (1) Rewards programs, (2) One-on-one coaching for up to 24 months with a certified Life Coach, (3) Telehealth to talk to a doctor 24/7/365 using a smartphone or computer,(4) Large provider network for easy access to care,(5) Transportation to and from appointments, food pantries, pharmacies, WIC offices and County Department of Job and Family Services (CDJFS) appointments, (6) Vision and dental care, including checkups and teeth cleanings. Members can also get an allowance for a large selection of eyeglasses and an allowance for contact lenses and fitting, (7) Behavioral health resources that support the health of mind, body and spirit,(8) A team of nurses who can answer health questions 24/7/365, (9) Disease management programs, (10) Local care managers to coordinate health care needs and help connect members to community resources such as utility assistance, housing and food banks, and(11) CareSource mobile app for access to member ID card, "how-to" videos and a quick search for doctors. MyCare Ohio: Plans contract with both Medicare and Ohio Medicaid to provide benefits of both programs to its Members in 12 Ohio counties. To improve the way Medicare and Ohio Medicaid benefits work together, Members must enroll in a MyCare Ohio plan. The plan is for people with disabilities, older adults and individuals who need behavioral health services. CareSource Marketplace: Marketplace plans are available in 86 counties in Ohio. CSOH's Marketplace-qualified Vision and Fitness plans cover more than the essential health benefits. They offer adult vision through EyeMed, and a fitness program. There are no lifetime maximums for most benefits, no medical review for enrollment, and we cover an extensive list of prescription drugs. Members enrolled in our Ohio Marketplace plans have access to the following services: (1) $0 copay telehealth office visits via Teladoc with 24/7 access to U.S.-licensed physicians, (2) Ambulatory patient services (outpatient care), (3) Emergency services,(4) Hospitalization, (5) Pregnancy, maternity and newborn care (both before and after birth), (6) Breastfeeding coverage,(7) Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy), (8) Prescription drugs,(9) Rehabilitative and habilitative services and devices, (10) Laboratory services,(11) Preventive and wellness services and chronic disease management, (12) Pediatric services, including dental and vision care, and (13) Birth control coverage. CareSource Dual Advantage: This is a $0 premium plan that combines the benefits of Medicare and Medicaid into one convenient plan and offers more benefits not covered by either Medicare or Medicaid alone. Members enrolled in our Ohio Dual Advantage plans have access to the following services: (1) $6,000 annual limit for preventive and comprehensive dental care through DentaQuest, (2) $1,000 Flex annual allowance to use toward dental, hearing, and vision, (3) Unlimited transportation to health-related appointments including gym, pharmacy, and grocery, (4) $150 monthly allowances for over-the-counter (OTC) items and healthy food at participating retailers, (5) Two meals per day for 14 days after observation or inpatient stay, (6) TruHearing Advanced Level hearing aids, one per ear every three years, (7) Silver&Fit gym membership, home fitness kit, digital workouts, and online resources, (8) Routine vision exam, $450 annual allowance for glasses and/or contacts through EyeMed, (9) BrainHQ online brain health improvement tool, (10) Personal Emergency Response System (PERS) that connects the member to 24-hour help with the push of a button, and (11) 60 hours per year for companion care services. 2024 Highlights We are committed to working every day alongside providers and community partners to make a difference in the lives of our Members as well as communities across the state. One of the handful of ways CSOH supported the whole health of Ohioans in 2024 was through the Outcomes Acceleration for Kids ("OAK") Initiative.OAK is a new program, used as an illustration that Medicaid-managed care is shifting its focus to positive health outcomes instead of the business of care. It was introduced as an innovative program, a partnership among children's hospitals, Medicaid-managed care plans, and the Ohio Department of Medicaid. OAK is a rapid-cycle improvement project, which improves coordination of communication between evolvements in the clinical setting and Medicaid-managed care. It focuses on well care instead of sick care, follow-up care for families after leaving the emergency department, and access to life-saving care for children with sickle cell disease. CSOH invested over $1,125,000 in 2024 under this program.