Buckeye Health Plan: Comprehensive Company Profile

Background

Company Overview

Buckeye Health Plan (Buckeye) is a managed care organization that has been delivering healthcare services across Ohio since 2004. As a wholly-owned subsidiary of Centene Corporation, a leading multi-line healthcare enterprise, Buckeye coordinates comprehensive care for its members. The company is dedicated to transforming the health of the community, one person at a time.

Mission and Vision

Mission: Better health outcomes at lower costs.

Vision: Transforming the health of the community, one person at a time.

Service Offerings

Buckeye provides a range of healthcare services through various programs:

Medicaid: Offers managed care services to Medicaid-eligible individuals across Ohio.

MyCare Ohio: An integrated Medicare-Medicaid plan aimed at coordinating care for dual-eligible individuals.

Medicare Advantage: Through Wellcare By Allwell, provides Medicare Advantage plans with access to case managers and a 24-hour nurse line.

Ambetter: Offers health insurance plans designed for individuals and families in Ohio through the Health Insurance Marketplace.

Geographic Reach

Headquartered in Columbus, Ohio, Buckeye operates regional offices in Akron, Cincinnati, and Toledo, serving all 88 counties in the state.

Key Strategic Focus

Core Objectives

Buckeye's strategic focus centers on providing individualized, whole-person care that addresses physical, social, behavioral, and environmental needs. The company aims to improve health outcomes by removing barriers to care and enhancing access to quality healthcare services.

Areas of Specialization

Integrated Care Programs: Develops programs like MyCare Ohio to coordinate services for dual-eligible members.

Community Engagement: Partners with local organizations to address social determinants of health and improve community well-being.

Key Technologies Utilized

Buckeye employs advanced data analytics and care management systems to identify member needs, coordinate care, and monitor health outcomes effectively.

Primary Markets Targeted

The company primarily serves Medicaid, Medicare, and Health Insurance Marketplace members in Ohio, focusing on underserved and vulnerable populations.

Financials and Funding

Ownership and Financial Standing

Buckeye Health Plan is a wholly-owned subsidiary of Centene Corporation, a Fortune 25 company and leading multi-line healthcare enterprise. Centene's financial strength supports Buckeye's operations and strategic initiatives.

Revenue and Growth

As of 2024, Buckeye's estimated annual revenue is approximately $750 million, with a workforce of around 1,000 employees.

Pipeline Development

Innovative Programs

Buckeye has developed several programs to enhance member care:

Compassionate Connections: An in-home palliative care program that identifies members needing additional supportive services, resulting in significant reductions in emergency room visits and per member per month costs.

Addiction in Pregnancy Program: Connects high-risk, pregnant, addicted women with specialized care, leading to reduced neonatal intensive care unit stays and costs.

Technological Platform and Innovation

Proprietary Technologies

Buckeye utilizes advanced data analytics platforms to assess member needs, predict health risks, and tailor interventions accordingly.

Significant Scientific Methods

The company employs evidence-based clinical protocols and machine learning algorithms to enhance care coordination and improve health outcomes.

Leadership Team

Key Executives

Chris Paterson: Interim President and Chief Executive Officer.

Dr. Brad Lucas, MD, MBA, FACOG: Chief Medical Officer.

Jay Scherler: Chief Operating Officer.

Natalie Lukaszewicz: Vice President, Network Development & Contracting.

Lori Mulichak, RN, MHA, FACHE: Senior Vice President, Population Health & Clinical Operations.

Eric Poklar: Senior Vice President, Legislative & Government Affairs.

Andrew Reitz: Vice President, Compliance.

Daisy Sinha, MBA, MHSA, PMP: Vice President, Operations.

Kevin Rhoades: Vice President, Pharmacy Operations.

Lori Skinner-Campbell, RN, BSN, MSN, MBA: Vice President, Quality Improvement.

Holly Mayer: Chief Financial Officer.

These leaders bring extensive experience in healthcare management, clinical operations, compliance, and quality improvement, driving Buckeye's mission to improve community health.

Leadership Changes

As of the latest available information, Chris Paterson serves as the Interim President and CEO. Details regarding predecessor roles and dates are not specified.

Competitor Profile

Market Insights and Dynamics

The managed care market in Ohio is competitive, with several organizations providing Medicaid and Medicare services. The market is characterized by a focus on quality care, cost management, and addressing social determinants of health.

Competitor Analysis

CareSource: A nonprofit managed care plan serving Medicaid members in Ohio and other states. CareSource is the largest Medicaid plan in Ohio and the second largest in the United States.

Molina Healthcare: Provides Medicaid and Medicare plans across multiple states, including Ohio.

Paramount Advantage: Offers Medicaid managed care services in Ohio.

UnitedHealthcare Community Plan: Provides Medicaid services in Ohio and other states.

These competitors focus on delivering quality healthcare services to Medicaid and Medicare populations, emphasizing care coordination and community engagement.

Strategic Collaborations and Partnerships

Buckeye has established significant partnerships to enhance its service offerings:

Walgreens Health Corners: Launched five Health Corners in collaboration with Walgreens, providing members with access to health services and resources.

Cityblock Health: Partnered to expand services to Medicaid patients in Ohio, focusing on holistic care.

Wayspring: Collaborated to address members' medical and behavioral substance use challenges, identifying and bridging gaps in care.

Weitzman Institute: Partnered to launch Project ECHO®, enhancing provider education and patient care.

Beyond Differences: Collaborated to promote social inclusion initiatives.

These partnerships aim to improve access to care, address social determinants of health, and enhance overall member well-being.

Operational Insights

Strategic Considerations

Buckeye's focus on whole-person care, community engagement, and innovative programs positions it competitively in the Ohio managed care market. Its collaborations with various organizations enhance its ability to address complex health needs and social determinants of health.

Distinct Competitive Advantages

Comprehensive Care Programs: Integrated services like MyCare Ohio provide coordinated care for dual-eligible members.

Community Partnerships: Collaborations with local organizations strengthen community ties and address social determinants of health.

Innovative Initiatives: Programs like Compassionate Connections and Addiction in Pregnancy demonstrate a commitment to addressing complex health issues effectively.

Strategic Opportunities and Future Directions

Strategic Roadmap

Buckeye aims to continue expanding its innovative programs, enhancing care coordination, and strengthening community partnerships to improve health outcomes.

Opportunities for Expansion

Telehealth Services: Expanding telehealth offerings to increase access to care, especially in underserved areas.

Social Determinants of Health: Further addressing factors like housing, food security, and employment to improve overall member well-being.

Positioning for Future Objectives

Leveraging its experience, partnerships, and commitment to whole-person care, Buckeye is well-positioned to adapt to evolving healthcare needs and continue its mission of transforming community health.