Transforming Medicaid
OHIO IS MAKING PROGRESS IN TRANSFORMING HEALTH CARE: In 2011, Gov. John Kasich created the Office of Health Transformation to guide Ohio's efforts to modernize Medicaid, streamline health and human services programs and improve overall health system performance. Using an innovative approach and collaboration among multiple state agencies and public- and private-sector partners, Ohio is improving care for vulnerable Ohioans, reducing costs, increasing efficiency and supporting the governor's efforts to create jobs and reduce unemployment.
THIS BUDGET CONTINUES OHIO'S PROGRESS IN TRANSFORMING MEDICAID: Medicaid payment strategies have too often incentivized more services, not better care. Ohio's Jobs Budget 2.0 continues the governor's efforts to reward value instead of volume and provide high-quality services in settings that individuals prefer.
- Improving Program Integrity and Fighting Fraud: Nationally, fraud accounts for approximately 10 percent of all health care waste, so fighting fraud and maximizing integrity and accountability in Medicaid is a key to improving efficiency. Ohio will expand its efforts to improve program integrity through a series of reforms, saving $74 million over the biennium.
- Improving Quality and Reducing Spending by Rewarding Value, Not Volume: This budget continues to reduce Medicaid costs by implementing innovative strategies for paying Medicaid providers.
- Extend Medicaid Coverage to Working, Low-Income Ohioans: Gov. John Kasich and Lt. Gov. Mary Taylor have opposed Obamacare and called for it to be repealed and replaced with reforms that reduce costs and improve health outcomes. Given the results of the presidential election, the Supreme Court's decision and Washington's inaction on real health care reform, Obamacare is the law of the land for now. Therefore, Ohio needs to reduce its impact as much as possible.
- Simplifying and Automating Medicaid Eligibility Determination: Current eligibility determination processes for health and human services programs in Ohio are fragmented, overly complex and rely on outdated, 30-year-old technology. Ohio will simplify the state's current 150+ Medicaid eligibility categories into three groups and implement simplified eligibility processes and information technology systems.
- Updating Provider Regulations to be More Person Centered: Ohio will continue to drive quality improvements in services that are administered in the community and in institutional settings.
SHARING SERVICES ACROSS STATE AND LOCAL JURISDICTION IS THE KEY TO HEALTH AND HUMAN SERVICES PROGRAM IMPROVEMENT: Barriers to innovation are prevalent in health and human services, where policy, spending and administration are split across multiple state agencies and corresponding local systems. We will continue to break down these barriers, creating efficiencies that will improve overall health-system performance and save taxpayer dollars.
BOTTOM LINE: The governor's proposals will continue the nationally recognized transformation of Ohio's Medicaid program by improving care for vulnerable Ohioans, reducing costs for taxpayers and businesses, and making Ohio more attractive to job creators.
- BETTER CARE AND BETTER VALUE: By paying for value, not volume, Medicaid will control costs and improve program performance and health outcomes for vulnerable Ohioans.
- USE ALL THE TOOLS AT OUR DISPOSAL: The budget ensures that Ohioans' federal tax dollars stay in Ohio, protecting jobs and improving health right here at home.
- BALANCE THE BUDGET: Strategic spending decisions and payment reform strategies help mitigate the $521 million state budget impact of the Obamacare "woodwork effect" and ensure the long-term financial stability of the Medicaid program.