Maureen Corcoran, director of the Ohio Department of Medicaid, told the Joint Medicaid Oversight Committee that OhioRISE launched on July 1, 2022, and is a specialty managed-care program that sits alongside traditional Medicaid plans to provide intensive behavioral health services to children with complex needs.

Why it matters: OhioRISE centralizes a set of high-intensity supports — care coordination, intensive home‑based treatment, mobile response stabilization, psychiatric residential treatment facilities, and behavioral health respite — under one statewide specialty plan so children do not need to leave their communities for care.

Corcoran summarized the program’s structure and goals, saying OhioRISE functions like a “specialty managed care plan” that coordinates with each child’s regular medical managed care plan and a single pharmacy benefit manager. She described the program as still in its early stages, noting, “we are at the toddler stage,” and pointed to recent service expansion and partnerships intended to make specialty services accessible statewide.

Leanne Kornyan, director of the Ohio Department of Mental Health and Addiction Services, described OhioRISE as part of a broader system-of-care approach, emphasizing that some specialty services were incubated by her agency before being funded through OhioRISE. Kornyan told the committee that mobile response and stabilization services (MRSS) — a rapid in-person crisis response with up to 42 days of follow-up — completed more than 38,000 referrals in state fiscal year 2024 and, she said, “reduced short term respite or crisis stabilization admissions by 52 percent” and produced measurable reductions in arrests, juvenile-detention admissions and emergency-department visits for behavioral health crises.

Local providers and care-management entities described day-to-day implementation. Matt Kresick, CEO of Cadence Care Network (a CME for Trumbull and Mahoning counties), said his network serves roughly 1,173 enrolled youth and employs 73 care coordinators. Habiba Grimes, CEO of Positive Education Program (the CME for central Cuyahoga County), said PEP has served more than 2,500 children through OhioRISE and reported an admission rate to hospitalization of about 1.07 percent for their enrollees. Provider witnesses credited coordinated wraparound teams and home-based treatment for keeping children in community settings that previously would have required relocation or custody changes.

Clinical and operational leaders emphasized the program’s hybrid model: centralized oversight and local execution. Dr. Frank Angotti, executive medical director for behavioral health at Aetna Medicaid, said centralized accountability enables consistent standards and quality monitoring while local CMEs tailor services to community needs. Corcoran and Aetna officials said the CMEs were procured by region to provide catchment-area coverage and to contract with Aetna to deliver higher-intensity care coordination.

Early outcomes and capacity: Speakers pointed to several early performance indicators. Corcoran and witnesses cited HEDIS measures showing OhioRISE outperforming traditional managed-care plans on a set of child behavioral-health metrics since the program’s launch. Kornyan and others reported reductions in emergency-department visits, inpatient stays and out‑of‑state placements. Panelists said intensive home-based treatment had expanded to more than 77 counties and MRSS to more than 50 counties, with a goal of statewide coverage.

Costs, funding and capitation: Committee members pressed for fiscal detail. Corcoran said OhioRISE is funded through Medicaid capitation: the state pays a capitation rate to Aetna that is intended to include the costs of medical services and OhioRISE specialty services; Aetna then contracts with CMEs. Multiple witnesses confirmed that CMEs are paid from capitation dollars. Providers described typical CME arrangements for intensive home‑based episodes: one provider said a contracted rate for high‑intensity home‑based treatment is $3,000 per month per client for a 3–4 month episode; another witness said that, for ongoing monthly budgets, the CME-related per‑member amounts sit on top of the child’s base MCO medical capitation. Corcoran said actuaries initially set rates with limited data and that, as utilization and acuity changed after the pandemic, rates and spending trends were updated.

Workforce and implementation challenges: Witnesses repeatedly cited workforce shortages and local variation in system capacity as the largest implementation risks. Kornyan said OhioMAS is consolidating workforce recruitment and retention efforts to address gaps. Several local leaders — including Trumbull County officials and CMEs — said strong local collaboration accelerated implementation; they also described counties with fewer resources where relationships and capacity remain limited.

Questions from the committee: Legislators asked for more granular fiscal and operational data: the number of children actively receiving regular care coordination (versus being enrolled but not engaged), capitation-rate detail, counts of children kept out of state or out of custody since OhioRISE began, and the number of psychiatric residential treatment facility (PRTF) beds active in Ohio. Witnesses said PRTFs did not exist in Ohio before OhioRISE; as of the hearing they reported three PRTF providers with about 24 certified beds (18 active) and said more beds are in the pipeline. Aetna and state staff said they would provide additional breakdowns and dashboards to the committee.

What remains unsettled: The panel agreed OhioRISE has expanded services and produced measurable reductions in some high‑cost settings, but members and providers said more transparency on enrollment pathways, per‑member engagement rates, the composition of tiered caseloads, and detailed capitation and utilization data is needed for oversight and budgeting. Providers warned that without continued workforce investment and clearer local partnerships, access could vary by county.

The committee requested follow‑up materials and data from Medicaid, Aetna and CMEs. Witnesses and legislators framed the program as “still in toddlerhood” but said OhioRISE is changing access to intensive pediatric behavioral-health care statewide and that continued legislative oversight would focus on outcomes, workforce and fiscal sustainability.