Behavioral Health
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Prevention services and systems of care key to implementing OhioRISE

April 4, 2022
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By: Patrick Kanary, Consultant  

OhioRISE, Ohio’s next generation of behavioral health Medicaid for children, youth, and families, continues to roll forward to its ‘live’ date of July 1, 2022. Implementation of OhioRISE[1] is a complex and intensive process with multiple partners at the state and local levels.

 Implementation of OhioRISE is a complex and intensive process with multiple partners at the state and local levels.

Aetna, the OhioRISE vendor responsible for managing the services and supports in their contract with the Ohio Department of Medicaid, just completed a round of ‘Listening Sessions’ designed to hear from those individuals and organizations at the ground level of implementation. A full report on the sessions will be published shortly, but there are interesting findings from those sessions[2].

Demographics of participants and top issues discussed in OhioRISE listening sessions

The Listening Sessions were organized around three key stakeholder groups: Parents/Family/Youth; Providers; and Advocates. A total of 618 individuals participated: 75 Family/Youth; 370 Providers; and 173 Advocates. All five geographic regions of the state were represented. The three top issues of discussion were, in order, Operations, Training and Workforce. These were followed by Communication, Awareness and Political Will.  

During the sessions a variety of themes, concerns, questions, and comments emerged. Some of those key areas included navigation; the role of Care Management Entities (CMEs); crisis; stigma; workforce; role of CANS (Child and Adolescent Needs and Strengths tool); meeting families’ needs; role of Aetna, and many others.  

The preliminary data indicates that the interest is high across the stakeholders and not surprising, providers have a keen interest in keeping informed as well as helping shape the implementation of OhioRISE. The participation level by family/youth group is more likely a reflection of time and access rather than interest. More strategic engagement with family and youth would likely yield additional perspectives and insights.

Suggested improvements for OhioRISE focus on prevention and systems of care

The sessions also provided Aetna the opportunity to hear about what improvements could be made in OhioRISE. These included engagement of multiple ‘systems of care’ (such as juvenile justice, faith communities, education) to assure a comprehensive array of services for multi-system youth; increase provider capacity to manage workforce shortages; communicate with clear, direct language to the various stakeholders; and a focus on prevention services so as to reduce the likelihood of traumatic family disruptions.

 The next Implementing OhioRISE overview will take a closer look at just what a CME is, what it is intended to achieve, and how they will be implemented.

The role of CMEs, as highlighted by the listening sessions, was identified as a major area of interest. The next Implementing OhioRISE overview will take a closer look at just what a CME is, what it is intended to achieve, and how they will be implemented. Selection of the CMEs has already taken place via a competitive process.[3]  

[1] https://managedcare.medicaid.ohio.gov/managed-care/ohiorise  

[2] Source: PowerPoint summary from Aetna  

[3] https://managedcare.medicaid.ohio.gov/managed-care/ohiorise/5-ohiorise+cmes

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