CareSource plans move into Wisconsin’s Medicaid market
Editor’s note: This story was updated on June 3, 2025 at 7 p.m. to remove a reference that CareSource had submitted all needed documentation to state agencies for its affiliation with Community Care. At this time, the insurer has more information to submit.
Ohio health insurance company CareSource is planning more affiliations in Wisconsin, after its first partnership with a Wisconsin health insurer became effective at the start of the year. This time, it’s targeting deals in the Medicaid long-term care space.
Lakeland Care, a Fond du Lac managed care organization that works with Family Care, said in early May it’s seeking to join CareSource. Last fall, Community Care, a managed care organization in Brookfield that serves Family Care and other state programs, said it wants to become part of the health insurance company.
Common Ground Healthcare Cooperative, which offers health insurance through the Affordable Care Act marketplace, joined CareSource Jan. 1. CareSource serves 2 million members through Medicaid, Medicare and ACA plans.
Cathy Mahaffey, who leads Common Ground, serves as CareSource market president for Wisconsin. Long-term, the plan is to have one organization that serves multiple business lines and members.
“We hope to create a plan, CareSource Wisconsin, where we can still leverage all of the local connections we have, the expertise that we have, and the good work that’s done here,” Mahaffey said.
She recently spoke to Wisconsin Health News about the deals.
WHN: What’s been the lead-up to the announcement with Lakeland Care?
Mahaffey: Lakeland Care has a rich history in Wisconsin and matches well with CareSource, because CareSource is dedicated to improving the quality of care for older adults and individuals with disabilities… It kind of makes sense for the two organizations to begin discussions and find that their values are aligned. And if you couple CareSource’s operational excellence with the mission-centered orientation that they have, bringing these organizations together, I think, can do a lot to enhance services for members.
CareSource has invested a lot in their operations. That’s harder for smaller health plans and smaller organizations. Also CareSource has invested a lot in care coordination, and other programs and services, particularly for specialized populations.
WHN: Lakeland and Community Care are competitors. Does that pose a hurdle toward moving forward on these efforts? Would it lead to reduced choices for Family Care members?
Mahaffey: We’re in those early stages of regulatory approval, so we’re working very closely with the Department of Health Services and (the Office of the Commissioner of Insurance), and those types of details are yet to be worked out in terms of how all of that will work as we move forward. So more to come on that. But you’re right. They do compete, and they are in some of the same regions. We’ll see how all of that works as we work through the regulatory approval process.
WHN: Could layoffs or consolidations occur as these two organizations join CareSource?
Mahaffey: Those are natural questions that are asked when you have these types of arrangements. The thing about CareSource, we really appreciate the local relationships and the local expertise that exists within these organizations. And the first thought is absolutely not to just say, ‘How can we dismantle all that?’ That is never the first thought of CareSource.
So just like employees at Common Ground Healthcare Cooperative were able to either continue to work in the Wisconsin market or work within the CareSource enterprise to serve Wisconsin and other states for CareSource, that’s what we’ll be looking to do too. We want to, obviously, keep the good work, all of the things that have been going on in the (long-term services and supports) space. But, again, more details to be worked out. We’re just really in the early stages.
WHN: When will these deals close?
Mahaffey: I don’t want to get ahead of the regulators. Certainly, they have important work to do, and we’re working very transparently, openly and collaboratively with our regulators.
WHN: Family Care used to be all small, local managed care organizations. If these deals move forward, all of the groups will have ties to large national insurers. Is this due to interest from health insurers or the challenges faced by small organizations?
Mahaffey: I can speak to the experience of small nonprofit plans and organizations. Not just in Wisconsin, but in other states as well, it’s becoming more and more challenging for small nonprofits to navigate their way through financial volatility. For operations, it’s often hard for small nonprofits to invest in new systems and things that they need to make sure they’re operating as efficiently as possible.
I do think the landscape is shifting. These small nonprofit plans have the right mission. They have the right approach. They are very member-centered. But it is getting more and more difficult for them to survive. That’s why I think it’s so wonderful that we have CareSource, as a nonprofit option, to make sure that those key principles can stay in place, so the resources are available to these smaller organizations, and they can continue to operate with the members at the center of everything that they do.
WHN: Given CareSource’s movement into the state’s Medicaid program, are you planning to serve other programs like BadgerCare Plus?
Mahaffey: We have certainly talked about BadgerCare Plus, and have interest there, but that’s a timeline kind of in the future. Our main focus is to make sure that we do an excellent job with the ACA population and with this population that Lakeland and Community Care bring us as well. That’s our number one priority: make sure members, providers, key stakeholders, are taken care of, and have as little disruption as possible.
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