CareSource

What CareSource does

CareSource is a Dayton, Ohio-based nonprofit managed care organization founded in 1989 that administers Medicaid, Medicare Advantage (including Dual Eligible Special Needs Plans), and ACA Marketplace health plans for over 2 million members across 13 or more states. Its product portfolio spans Medicaid managed care, the CareSource Dual Advantage D-SNP, the CareSource MyCare Ohio integrated Medicare-Medicaid HMO plan, the CareSource PASSE program for Arkansas members with intellectual/developmental disabilities, Georgia-specific Planning for Healthy Babies and Georgia Pathways programs, a TRICARE PRIME Demo for military beneficiaries, and the CareSource MyLifeSM mobile application enhanced through a 2025 AI partnership with League. CareSource operates JVs and affiliates including HAP CareSource in Michigan, ImagineCare in Florida with Spark Pediatrics, and a 2026-affiliated Community Care, Inc. in Wisconsin, with wholly-owned operating subsidiaries The Columbus Organization (I/DD and behavioral health services) and Radiant Alliance. Revenue is generated primarily through capitation payments from state Medicaid agencies and CMS, supplemented by ACA Marketplace premiums and member-related capitation for MA plans, with distribution via broker/producer networks, navigators, inside sales, and direct community outreach, supported by structured-data and generative-AI analytics powering fraud detection and personalized member engagement.

Name

CareSource

Legal name

CareSource

Website

https://caresource.com

Company type

Private

Founded year

1989

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

CareSource is a Dayton, Ohio-based nonprofit managed care organization founded in 1989 that administers Medicaid, Medicare Advantage (D-SNP), and ACA Marketplace health plans for over 2 million members across 13+ states, with AI-powered member engagement and specialized programs for dual-eligible, I/DD, and behavioral health populations.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Services for the Elderly and Persons with Disabilities (624120), Other Individual and Family Services (624190), Health and Welfare Funds (525120)

SIC

Services-Health Services (8000), Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

Medicaid Expansion (ACA Adult) Managed Care Plans (HLAEAEAB)

akta.pro secondary industries

Aged, Blind & Disabled (ABD) Managed Care Plans (HLAEAEAC), Medicare Member Engagement & Care Management (Utilization, Case/Disease Mgmt) (FSAIAGAL)

Keywords

• Managed care services
• Medicaid health insurance
• Medicare Advantage plans
• Dual eligible programs
• Health insurance marketplace

Headquarters

HQ city

Dayton

HQ country

United States

HQ region

North America

Offices5 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Medicaid Managed Care: CareSource administers Medicaid managed care plans, receiving capitated payments from state governments to provide health coverage to eligible low-income adults, families, children, pregnant women, elderly adults and people with disabilities. This is the primary revenue stream.
2. Medicare Advantage (MA) and Dual Eligible Special Needs Plans (D-SNP): CareSource offers Medicare Advantage plans including Dual Eligible Special Needs Plans that combine Medicare and Medicaid benefits. The company receives capitation payments from CMS for Medicare enrollees.
3. Health Insurance Marketplace (ACA): Individual and family health insurance coverage sold through the Affordable Care Act marketplaces. CareSource participates in exchanges and receives premium payments from subsidized enrollees.

Pricing tiers

Go-to-market motion4 records

Distribution channels6 records

Marketing channels8 records

Core offering

CareSource is a nonprofit managed care organization that administers government-sponsored health insurance plans including Medicaid, Medicare Advantage (Dual Eligible Special Needs Plans), and ACA Marketplace coverage to over 2 million members across 13+ states. The company provides care coordination, supplemental benefits (dental, vision, hearing, fitness, OTC allowances, transportation), and AI-enabled member engagement tools through its MyLife mobile application. CareSource also operates specialty programs addressing social determinants of health, maternal and infant health, behavioral health, and intellectual/developmental disability services.

Product overview

CareSource is a nonprofit, nationally recognized managed care organization offering a multi-plan health insurance portfolio. The core product portfolio includes Medicaid, Medicare Advantage (Dual Advantage D-SNP), Marketplace ACA plans, and integrated MyCare Ohio (HMO D-SNP) combining Medicare and Medicaid. Key digital products include the CareSource MyLife mobile app with AI-powered personalization via League partnership. The MyCare Ohio plan offers distinctive benefits including $287/month Healthy Benefits+ allowance and up to $715 annual rewards. Additional offerings span CareSource PASSE (Arkansas I/DD services), Planning for Healthy Babies (Georgia maternal health), Georgia Pathways, TRICARE PRIME Demo, and the CareSource Foundation community investment program. Partnerships include HAP CareSource in Michigan and affiliations with Community Care Inc. in Wisconsin. The CareSource Re-Entry Program and Life Services address social determinants of health, while the CareSource Invitationals initiative raises youth mental health awareness through collegiate athletics.

Differentiator

Problem solved

Functional benefit

Brands

• MyLife: Digital health companion mobile application for managing health plans
• MyCare Ohio
• Life Services
• CareSource Re-Entry Program
• CareSource Foundation
• CareSource Invitationals

Products and services

• CareSource MyLife Mobile Application Digital health companion mobile application enabling members to manage their health plan, view benefits, access ID cards, find providers, and receive personalized health support through AI-powered features.
• CareSource Medicaid Plans Free or low-cost health insurance for eligible low-income adults, families, children, pregnant women, elderly adults and people with disabilities across multiple states.
• CareSource Dual Advantage (D-SNP) Medicare Advantage plan providing complete Medicare coverage including hospital (Part A), doctor (Part B), and prescription drug (Part D) benefits, plus extras like hearing, dental, vision and fitness benefits for dual-eligible members.
• Marketplace Plans (ACA) Individual and family health insurance coverage through the Affordable Care Act marketplaces for those who do not have employer insurance and do not qualify for Medicare or Medicaid.
• CareSource MyCare Ohio (HMO D-SNP) Fully integrated health plan combining Medicare and Medicaid benefits for Ohioans, including $287/month Healthy Benefits+ allowance, up to $715 annual rewards, dental, vision, hearing, unlimited transportation, and meal delivery benefits.
• CareSource PASSE Provider-led entity serving Arkansas Medicaid members with intellectual/developmental disabilities, offering coordinated care, pharmacy benefits, and care management services.
• Planning for Healthy Babies (GA) Georgia-specific Medicaid program focused on maternal and infant health outcomes for eligible pregnant women and infants.
• Georgia Pathways to Coverage Georgia-specific Medicaid program providing coverage pathways for eligible individuals.
• TRICARE PRIME Demo Military health program demonstration serving TRICARE-eligible beneficiaries with comprehensive health coverage.
• HAP CareSource (MI Coordinated Health) Joint venture between Michigan-based nonprofit HAP and CareSource, offering Michigan Coordinated Health plan and sponsoring community events including the Crim Festival of Races.

Quantifiable outcome

• 20% reduction in avoidable inpatient and ED encounters through Bamboo Bridge pilot programs
• +3 more outcomes

Named customers6 records

Segments5 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

AI capability8 records

Feature3 records

Partnerships

Twelve partnerships are on record, tiered core, significant and supporting.

• Community Care, Inc. (CCI)coreStrategic or Co-development Partner · 1 April 2026CareSource and Community Care, Inc. received regulatory approval to affiliate, aiming to enhance long-term care services in Wisconsin. The partnership combines resources and expertise to address increasing long-term care needs for Wisconsinites, serving over 15,000 adults with disabilities and seniors.
• UNLV School of Public HealthsignificantStrategic or Co-development Partner · 26 March 2026CareSource Foundation invested $300,000 in Community Health Innovation Grants with UNLV School of Public Health. $150,000 awarded to six nonprofit organizations and $150,000 for faculty-led research to improve health outcomes in Nevada focusing on maternal/child health, immunization, and social drivers of health.
• Bamboo HealthsignificantTechnology or Integration · 3 December 2025CareSource participated as a pilot partner for Bamboo Bridge, an AI-enabled behavioral health care navigation platform. Pilot programs demonstrated 20% reduction in avoidable inpatient and ED encounters, 64% patient intake completion rates, and 28% increase in behavioral health services retained within networks.
• Hiring Our HeroessupportingGTM or Marketing Partner · 3 December 2025CareSource partners with Hiring Our Heroes to advance veteran and military spouse employment. Includes participation in Veteran Employment Advisory Council and Military Spouse Employment Advisory Council, engagement in hiring events, and volunteer workshops for military community career journeys.
• PsychArmorsupportingGTM or Marketing Partner · 3 December 2025CareSource launched a Military & Veteran Ready Organization Certification Program in partnership with PsychArmor. The program enhances cultural competency among employees to support active-duty family members, veterans, military retirees and their families.
• LeaguecoreTechnology or Integration · 14 October 2025CareSource partnered with League to enhance its MyLifeSM mobile application, leveraging League's AI-powered platform to deliver personalized and engaging digital health services to over two million members. The collaboration provides tailored health journeys, content, gamification, and tools to improve health outcomes.
• HAP (Health Alliance Plan)coreStrategic or Co-development Partner · 29 August 2024HAP CareSource is a joint venture between Michigan-based nonprofit HAP and national nonprofit CareSource. The partnership operates in Michigan market, sponsoring community events like the 47th annual Crim Festival of Races in Flint, Michigan.
• CarePortalcoreStrategic or Co-development Partner · 15 November 2023CareSource committed $1.5 million to partner with CarePortal, a digital platform connecting local agencies, schools, and pregnancy centers with churches, businesses and individuals to help meet needs of vulnerable children and families. As exclusive managed care partner, CareSource covers licensing fees for implementing partners.
• ImagineCare (Joint Venture with Spark Pediatrics)coreStrategic or Co-development Partner · 15 November 2023ImagineCare is a joint venture between CareSource and Spark Pediatrics combining both organizations' mission-driven approaches for Florida Medicaid recipients. Formed contractual partnerships with 20 nonprofit organizations serving vulnerable Florida residents including Episcopal Children's Services, Who We Play For, and others.
• The Foodbank, Inc.coreStrategic or Co-development PartnerLong-standing partnership for mass food distributions across Ohio communities. CareSource employees volunteer at distributions, company sponsors food bank truck, and provides financial support. Partnership has served thousands of families with 185,000+ pounds of fresh food distributed in single events.
• Jay's Light FoundationcoreStrategic or Co-development PartnerJay's Light was founded by University of Dayton Head Basketball Coach Anthony Grant and his wife Chris in memory of their daughter who died as a result of mental illness. CareSource Invitationals raised over $500,000 to support Jay's Light and other mental health organizations since 2023.
• Kentucky Association of Chiropractors (KAC)supportingStrategic or Co-development PartnerKAC collaborated with Infinedi and ChiroTech Consortium Workgroup to develop a reimbursement dashboard that identified payment issues with CareSource. Data-driven approach secured over $1 million in payments owed to Kentucky chiropractors since January 2021.

Scale indicators12 records

Recent moves7 records

Expansion highlights7 records

Direct peers

• Molina Healthcare: A predominantly government-sponsored managed care organization focused on Medicaid, Marketplace, and Medicare. Molina's state-level Medicaid concentration and marketplace presence closely mirror CareSource's product mix and member populations.
• Health Care Service Corporation (HCSC): The largest customer-owned mutual health insurer in the US, operating Blue Cross Blue Shield plans across five states with growing Medicaid managed care participation. The mutual/nonprofit structure makes it a structural analog to CareSource.
• Centene Corporation: The largest Medicaid managed care organization in the United States, operating Medicaid, Medicare, and Marketplace plans across most states. Centene is CareSource's most direct competitor for state Medicaid contracts and overlapping D-SNP business.
• AmeriHealth Caritas: A national managed care company specializing in Medicaid, Medicare, and CHIP plans with significant presence in markets overlapping CareSource's footprint (Pennsylvania, Kentucky, Michigan, Indiana). Comparable product mix and member populations.

Broad incumbents

• Kaiser Permanente: A nonprofit integrated payer-provider serving Medicaid, Medicare, and commercial members primarily in nine states. As a fellow nonprofit integrated-care model with strong quality ratings, Kaiser is structurally comparable to CareSource.
• Elevance Health (Anthem): A major diversified health insurer with significant Medicaid (Anthem Blue Cross Blue Shield plans) and Medicare Advantage segments. Competes with CareSource across several state markets including Indiana, Georgia, and other shared geographies.
• Humana: A large Medicare Advantage leader with growing Medicaid presence. Humana's D-SNP focus and coordinated-care model are particularly comparable to CareSource's MyCare Ohio and dual-eligible strategy.
• UnitedHealth Group / UnitedHealthcare: The largest US health insurer, with major Medicaid managed care (UnitedHealthcare Community & State) and Medicare Advantage businesses that compete head-to-head with CareSource in many state Medicaid markets.
• The Cigna Group: A large diversified health services company serving Medicaid, Medicare, and commercial populations. Competes with CareSource in select state Medicaid markets and broader employer-sponsored and government health adjacencies.
• CVS Health / Aetna: A vertically integrated payer-provider retailer owning Aetna, with significant Medicare Advantage and Medicaid segments. Competes for state Medicaid contracts and D-SNP membership in several CareSource geographies.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/caresource
• YouTubeyoutube.com/user/ourhealthcaresource
• Facebookfacebook.com/caresource
• LinkedInlinkedin.com/company/caresource-management-group
• Instagraminstagram.com/caresource

Compliance11 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Subsidiaries6 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A5 records

Investments14 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about CareSource