COLUMBUS, Ohio (AP) — Ohio is one step closer to implementing changes aimed at better coordinating medical care for some of the state’s sickest and most expensive patients.

Gov. John Kasich’s administration wants to streamline the way health care is delivered to Ohioans enrolled in both Medicaid and Medicare. The state submitted a plan this spring to the federal government to better coordinate care for almost 114,000 so-called “dual-eligible” individuals living in seven urban regions.

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