Improving Medicaid and SCHIP Retention in Ohio: Potential Strategies through Managed Care Partnerships

One of the long-standing challenges of Ohio’s Medicaid/SCHIP program has been retention of eligible enrollees. Health providers, advocates, eligibility agencies and clients alike are concerned with this issue, also called “churning”. Churning occurs when individuals lose coverage—often because of procedural barriers—and then regain it after a period of time.

Interrupted periods of eligibility due to churning undermine Medicaid managed care. Churning makes it difficult for a managed care plan (MCP) to coordinate a member’s care and to promote effective ongoing preventive services. In addition, when enrollees repeatedly enter and exit a plan, it is difficult to maintain stability of membership, which in turn impacts an MCP’s financial viability.

A number of other states have developed successful partnerships with MCPs to improve Medicaid/SCHIP retention. This paper outlines the issue, highlights successful strategies, and provides recommendations for how Ohio can strengthen its partnership with MCPs to improve retention.