Our Plan

One-size-fits-all models don’t work, so we offer options designed to meet all your employees’ needs.

When you choose OhioHealthy, you can take advantage of:

  • Plan Administration and Services
  • Care Management and Coordination
  • Member and Provider Services
  • Value-Based Program
  •  Plan Administration Services
  • Claims adjudication
  • Payment recovery
  • Employer reporting services
  • Actuarial and account services
  • Integration with point solutions
  •  Care Management and Coordination
  • Care managers
  • Disease management
  • Transitions of care
  • Utilization management
  •  Member and Provider Services
  • Member service center
  • On-site Member Advocates
  • 24/7 healthcare advice from licensed nurses
  • Assistance with complaints and appeals
  • Provider call center
  • Pre-authorizations
  •  Value-Based Program
  • Guaranteed first-year savings
  • Superior customer service
  • Proven quality
  • Improved health outcomes
  • Shared savings with clients

Lower cost, higher value for your healthcare investment.

Our value-based pricing model agreements are uniquely designed around the total cost of care for your employees, instead of the volume of services provided. The doctors and hospitals in our network are rewarded for keeping people healthy and improving the health of chronically ill patients through shared savings.

This innovative care model reduces overall costs for you and your employees and leads to better health, while ensuring you always have access to necessary care.

We believe value-based agreements like ours support the transformation of how healthcare is paid for and delivered, and reduce barriers to maintaining and improving health.

1The OhioHealthy Network does not include providers from The Ohio State University Wexner Medical Center, the James Cancer Hospital or Mount Carmel Health System, or its affiliated physicians.

High Performance Network

  • A large primary network in central Ohio with more than 5,000 healthcare providers, including many hospitals and facilities such as OhioHealth, Nationwide Children’s Hospital and more.
  • More than 3,000 providers are also part of a Clinically Integrated Network (CIN), who work together to coordinate care and are rewarded for delivering higher quality and lower costs.1
  • Highly coordinated care for cancer – OhioHealth is the first certified member of the MD Anderson Cancer Network® in central Ohio, and follows MD Anderson Cancer Center’s nationally recognized best practices.
    OhioHealth facilities and oncologists offer:
    • Patient navigators who connect members to patient education and support services
    • Exceptional facilities close to where members live and work
    • Bing Cancer Center: preventive, diagnostic and outpatient cancer treatment, along with survivorship care and complementary therapies, conveniently located in one place

The Cleveland Clinic, among the nation’s top 5 hospitals for cancer care1, offers a Specialty Services Program for OhioHealthy members receiving specialized care treatment, with travel expenses reimbursed through healthcare benefits. All arrangements and care are highly coordinated by an OhioHealthy Member Advocate.