Buckeye Health Plan
Buckeye Health Plan is an Ohio-based managed care organization and Centene subsidiary delivering Medicaid, Medicare Advantage, MyCare Ohio, and ACA Marketplace plans to government-program-eligible Ohio residents, with specialized behavioral health services for children via OhioRISE.
- Company typePrivate
- Founded2004
- HeadquartersColumbus, United States
- Headcount1,001–5,000
- GTM typeB2C
- OfferingServices
What Buckeye Health Plan does
Buckeye Health Plan is a Columbus, Ohio-based managed care organization that has operated since 2004 as a wholly-owned subsidiary of Centene Corporation (NYSE: CNC). The company delivers government-sponsored health insurance to Ohio residents across four core product lines: Medicaid managed care (its primary line, including the Next Generation MyCare contract awarded in 2022), Medicare Advantage (marketed as Wellcare by Buckeye Health Plan), MyCare Ohio for dual Medicare-Medicaid eligibles, and Ambetter-branded Qualified Health Plans on the ACA Marketplace. It also coordinates specialized programs such as OhioRISE (a behavioral health managed care program for children with complex needs, administered in partnership with Aetna, with nearly 20,000 enrollees since its July 2022 launch) and a Next Generation Medicaid Managed Care Program.
The company's underlying technology stack is standard managed-care digital infrastructure rather than proprietary platform IP: the Buckeye HealthConnect member portal, a Medicaid mobile app (with a corresponding iOS/Android app on the Apple App Store and Google Play) integrated with the Wellframe mobile health platform, FHIR-based Patient Access, Provider Directory, and Payer-to-Payer Data Exchange APIs delivered through the Centene Partner Portal (partners.centene.com/apis), telehealth services integrated with Teladoc and Babylon for HEDIS care-gap closure, the Diamond Designation quality-rating system for specialty providers across 28+ Ohio counties, and pharmacy benefit integrations with Gainwell Technologies and Change Healthcare for Ohio Medicaid claims. NCQA Health Plan Accreditation, NCQA LTSS Distinction, and NCQA Health Outcomes Accreditation provide the quality credentials required to compete for state Medicaid contracts.
Revenue mechanics are capitated premiums: Buckeye receives per-member-per-month payments from the Ohio Department of Medicaid for Medicaid members, from CMS for Medicare Advantage and MyCare dual-eligibles, and from ACA Marketplace premium tax credits for Ambetter enrollees. Go-to-market is sales-led through government enrollment channels, supplemented by provider-directed enrollment during care encounters and community-based organization referrals for hard-to-reach populations. Customer segments span Medicaid-eligible Ohio residents (primary), Medicare-eligible seniors and disabled individuals, dual-eligible members under MyCare Ohio, Marketplace enrollees, and specialized cohorts including children in OhioRISE and members with disabilities. The company employs between 1,001 and 5,000 people and is led by President and CEO Steve Province and CFO Christian Miller.
Buckeye Health Plan firmographics
Firmographics- Name
- Buckeye Health Plan
- Legal name
- Buckeye Health Plan
- Website
- https://buckeyehealthplan.com
- Company type
- Private
- Founded year
- 2004
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Short description
- Buckeye Health Plan is an Ohio-based managed care organization and Centene subsidiary delivering Medicaid, Medicare Advantage, MyCare Ohio, and ACA Marketplace plans to government-program-eligible Ohio residents, with specialized behavioral health services for children via OhioRISE.
- Ownership category
- akta.pro rank
Where Buckeye Health Plan is headquartered
LocationHeadquarters
- HQ city
- Columbus
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Buckeye Health Plan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Medicaid Managed Care Premiums: Capitated premiums received from the Ohio Department of Medicaid for managing care for Medicaid-eligible members. Buckeye was awarded the Ohio Medicaid contract for Next Generation MyCare program.
- Medicare Advantage Premiums: Premiums from Medicare Advantage plans including Wellcare by Buckeye Health Plan for Medicare-eligible Ohio residents.
- Health Insurance Marketplace Premiums: Premiums from Ambetter Health Insurance Marketplace plans offered through the Affordable Care Act exchange.
- MyCare Ohio (Dual Eligible) Premiums: Capitated premiums for managing care for individuals eligible for both Medicare and Medicaid (dual eligibles) under the MyCare Ohio program.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Multi-year contract | Medicaid Plan - Government subsidized coverage for eligible Ohio residents |
| Subscription | Monthly | Medicare Advantage - Coverage for Medicare-eligible seniors and individuals with disabilities |
| Subscription | Multi-year contract | MyCare Ohio - Dual eligible coverage for individuals with both Medicare and Medicaid |
| Subscription | Annual | Health Insurance Marketplace (Ambetter) - ACA marketplace plans |
Go-to-market motion1 record
Distribution channels5 records
Marketing channels7 records
Buckeye Health Plan product offering
Product offeringCore offering
Buckeye Health Plan is an Ohio-based managed care organization that delivers government-sponsored health insurance coverage to Medicaid, Medicare Advantage, MyCare Ohio (dual-eligible), and Ambetter Health Insurance Marketplace members. The plan provides capitated care coordination, integrated medical/behavioral/pharmacy/dental/vision benefits, and member engagement programs including a member portal, mobile app, telehealth, transportation, rewards, and social determinants-of-health resources.
Product overview
Buckeye Health Plan is a Ohio Medicaid managed care organization and subsidiary of Centene Corporation offering a portfolio of health insurance plans covering every stage of life. The core product portfolio includes four main health plans: Medicaid Plan, Medicare Advantage, MyCare Ohio (Medicare-Medicaid Plan), and Ambetter (Marketplace). These plans are supported by specialized programs including OhioRISE for behavioral health, Next Generation Managed Care, and various member engagement tools. Key technology-enabled services include Buckeye HealthConnect member portal, mobile app with Wellframe integration, telehealth capabilities, and interoperability APIs. Value-added programs encompass maternal health services (Start Smart for Your Baby, Doula Services), Nurse Advice Line, My Health Pays rewards, transportation services, and Buckeye Community Connect for social determinants of health resources. The Diamond Designation Program provides quality ratings for specialty providers, supporting informed care decisions.
Differentiator
Problem solved
Functional benefit
Brands
- MyCare Ohio: Medicare-Medicaid Plan combining Medicare and Medicaid benefits for dual-eligible individuals
- Wellcare by Buckeye Health Plan
- Ambetter from Buckeye Health Plan
Products and services
- Ohio Medicaid Plan Managed care plan providing comprehensive Medicaid health coverage including medical, behavioral health, pharmacy, dental, and vision benefits for low-income Ohio individuals and families eligible for the Medicaid program.
- Medicare Advantage (Wellcare by Buckeye Health Plan)
Quantifiable outcome
- Nearly 20,000 children enrolled in OhioRISE behavioral health supports since July 2022 launch
- +3 more outcomes
Companies that use Buckeye Health Plan
Customer profileSegments6 records
Ideal customer profiles6 records
Buckeye Health Plan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration9 records
Feature10 records
Buckeye Health Plan partnerships and signals
Strategic signalPartnerships
Three partnerships are on record, tiered core and minor.
- Tuesday HealthcoreTuesday Health expanded its footprint to Ohio through a partnership with Buckeye Health Plan to bring palliative care services to Ohioans with serious illness. The collaboration integrates palliative care early in treatment through interdisciplinary teams and virtual services, aimed at improving patient outcomes and reducing late-stage care costs.
- National Council on Independent Living (NCIL)coreBuckeye Health Plan partnered with the National Council on Independent Living to improve healthcare accessibility for people with disabilities. Buckeye awarded $141,000 in grants to six Ohio healthcare providers for ADA-compliant upgrades including ramps and accessibility equipment to enhance healthcare access.
- Ohio Association of Food BanksminorThe $200,000 investment from Buckeye Health Plan and Centene Foundation supports the Ohio Association of Food Banks to provide access to healthy, nutritious food through Ohio food banks amid ongoing challenges to federal nutrition programs.
Scale indicators6 records
Recent moves6 records
Expansion highlights5 records
Buckeye Health Plan competitors and assessment
Company assessmentDirect peers
- CareSource: Ohio-headquartered nonprofit managed care plan and Buckeye's largest Ohio Medicaid competitor, operating Medicaid, Medicare Advantage, and Marketplace plans in Ohio and several other states.
- Molina Healthcare: National Medicaid-focused MCO with significant Ohio presence, offering Medicaid managed care, Medicare Advantage, and dual-eligible plans across multiple states.
- UnitedHealthcare Community & State: UnitedHealth Group's Medicaid and dual-eligible managed care arm and a major Ohio Medicaid competitor, with deep capital backing from Optum and a vertically integrated payer-provider model.
- Aetna (CVS Health): Operates the OhioRISE behavioral health program in coordination with Buckeye and competes broadly in Ohio Medicaid and Medicare Advantage through CVS Health's integrated payer-provider-pharmacy platform.
- Elevance Health (Anthem Blue Cross Blue Shield of Ohio): Major Ohio Medicaid and Medicare Advantage competitor through Anthem Blue Cross Blue Shield of Ohio, with broad commercial and government-sponsored lines and national scale.
- Humana: Large Medicare Advantage-focused health plan with Ohio Medicaid presence; directly competes with Buckeye's Wellcare Medicare Advantage and broader Medicaid lines.
- AmeriHealth Caritas: National Medicaid-focused MCO serving complex-needs populations across multiple states with a similar whole-person care model and government-program focus to Buckeye.
Regional players
- Priority Health: Michigan-based nonprofit health plan offering Medicaid, Medicare Advantage, and commercial coverage with a similar government-program focus and integrated care model.
- Highmark: Pennsylvania-based integrated payer-provider with Medicaid managed care and Medicare Advantage products, comparable operating model to Buckeye though serving a different geographic market.
Broad incumbents
- Centene Corporation: Buckeye's parent company and the largest Medicaid managed care operator in the U.S., serving government-sponsored healthcare programs across all 50 states with broad capabilities spanning Medicaid, Medicare, Marketplace, and specialty programs.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights6 records
Customer concentration
Buckeye Health Plan social profiles
Digital presenceBuckeye Health Plan compliance and trust
Trust signalCompliance6 records
Buckeye Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Buckeye Health Plan leadership team
Management profileNumber of profiles
Profiles2 records
Buckeye Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Buckeye Health Plan M&A and investment
M&A and investmentM&A
Investments1 record
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Buckeye Health Plan
What does Buckeye Health Plan do?
Buckeye Health Plan is an Ohio-based managed care organization that delivers government-sponsored health insurance coverage to Medicaid, Medicare Advantage, MyCare Ohio (dual-eligible), and Ambetter Health Insurance Marketplace members. The plan provides capitated care coordination, integrated medical/behavioral/pharmacy/dental/vision benefits, and member engagement programs including a member portal, mobile app, telehealth, transportation, rewards, and social determinants-of-health resources.
Is Buckeye Health Plan a public or private company?
Buckeye Health Plan is a private company. It is classified as corporate owned and is currently operating.
When was Buckeye Health Plan founded?
Buckeye Health Plan was founded in 2004. It employs 1,001 to 5,000 people.
Where is Buckeye Health Plan based?
Buckeye Health Plan is headquartered in Columbus, United States, in the North America region.
How does Buckeye Health Plan make money?
Four revenue lines are on record. Medicaid Managed Care Premiums are the primary driver. The others are medicare Advantage Premiums, health Insurance Marketplace Premiums and myCare Ohio (Dual Eligible) Premiums.
Who are Buckeye Health Plan's main competitors?
Direct peers on record are CareSource, Molina Healthcare, UnitedHealthcare Community & State, Aetna (CVS Health), Elevance Health (Anthem Blue Cross Blue Shield of Ohio), Humana and AmeriHealth Caritas. Regional players are Priority Health and Highmark. Centene Corporation is listed as a broad incumbent.
Does Buckeye Health Plan have an API?
Yes. Buckeye Health Plan offers FHIR-based APIs for patient access and provider directory as part of federal interoperability requirements. The Patient Access API allows members to access their health records via third-party applications, and the Provider Directory API enables developer access to provider data. Integration is via the Centene Partner Portal at partners.centene.com/apis. Apps are connected through the CARIN Alliance framework for health information exchange. Developer documentation is at partners.centene.com/apis.