Name: Jesse Wyatt
Title: Bureau Chief, Long-Term Services and Supports (LTSS)
What is your role in the Next Generation MyCare program?
I am involved in the transition of the MyCare Ohio program from the demonstration to the new Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) model because I lead the LTSS Bureau at the Ohio Department of Medicaid (ODM). Today, that includes all the fee-for-service waivers, except for OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral and multisystem needs. Two big things that are different between MyCare Ohio and the Next Generation Managed Care program is LTSS and Medicare. The LTSS Bureau includes state plan home health and private duty nursing, as well as nursing facility and hospice policy, home choice, and care coordination.
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What are you most excited about for the Next Generation MyCare program?
Improvement in member experience. One might ask why a dual-eligible individual program is needed at all. My response is it can be very difficult for a healthy person to navigate either Medicare or Medicaid much less for someone who has various health concerns. The promise of the Next Generation MyCare program is there is one organization, one point of contact, and one set of paperwork all to help a member navigate both Medicare and Medicaid. It is all about helping members.
What is something everyone should know about you?
I have two degrees from Indiana University and root for the Hoosiers. Also, I can wiggle my ears without using my hands.
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Each AAA region is required to submit a Transition Plan Summary, using the Next Generation MyCare AAA Implementation Transition Plan Summary Template, which summarizes how AAAs will complete activities in ODM’s Implementation Checklist, including how AAAs will work with the Next Generation MyCare Managed Care Organizations (MCOs) to prepare for and begin providing services through the Next Generation MyCare program.
Each AAA region is responsible for:
- Reviewing the items listed in the template and responding to each prompt in 500 words or less.
- Providing questions to Ohio Association of Area Agencies on Aging about the Transition Plan Summary.
- Working with each of the Next Generation MyCare MCOs to receive approval on the Transition Plan Summary before submitting to ODM.
- Uploading the Transition Plan Summary, approved by the Next Generation MyCare MCOs, to the region’s folder on the MCD ODM – Next Gen MyCare AAA Collaboration Microsoft Teams Site no later than the dates listed below:
- AAAs going live on January 1, 2026: Transition Plan Summary due August 1, 2025.
- AAAs going live after January 1, 2026: Transition Plan Summary due September 15, 2025.
For questions about the Next Generation MyCare AAA Implementation Transition Plan Summary, please reach out to the point of contact at your AAA.
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ODM is implementing its Next Generation MyCare program beginning on January 1, 2026. A key feature of the Next Generation MyCare program is its enhanced care coordination model.
Review our new MyCare AAA Care Coordination One Pager to learn more about how the Next Generation MyCare program enhances care coordination for members. Keep reading to learn more about who may be on a member’s care team, including you, and what to do if members have questions.
In the Next Generation MyCare program, members will have a care coordinator who works closely with the member and providers on the member’s care needs.
- If a member has a Next Generation MyCare plan for both their Medicaid and Medicare benefits, they will have one care coordinator. Their care coordinator helps with all their care needs.
- If a member has a Next Generation MyCare plan for both their Medicaid and Medicare benefits, and they are on a waiver, they will have a care coordinator and a waiver service coordinator. They work together to help the member with their needs.
- If a member’s Next Generation MyCare plan only covers their Medicaid benefits, they may have separate teams who help with their Medicaid and Medicare benefits. These two teams may not work together, and the member may need to more actively manage their care.
Individuals on a member’s care team may be from their Next Generation MyCare plan and/or their local AAA.
If a member does not know who their care coordinator is, they can call the care management number on their member ID card for help. If the member wants to make changes to their care team, they can call their Next Generation MyCare plan.
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