Ohio’s is currently transforming its Medicaid delivery
Ohio’s is currently transforming its Medicaid delivery
Ohio’s is currently transforming its Medicaid delivery through the OhioHealth and Human Services Innovation Plan. Initiatives have been graduallyenacted as Ohio
reforms its Medicaid system. Recently, Ohio has beenapproved to receive up to $3,000,000 from the federal government todevelop the State Health Care Innovation plan (Governor’s Office of HealthTransformation, 2013).b.Thisanalysis of the Ohio Medicaid system seeks to explore access to healthcare, health care financing, rationing of health care, quality of health care, andthe effectiveness of the programs as Ohio undergoes this healthcaretransformation.2.Access toHealthCare(Health Policy Institute of Ohio, 2013)a.Health coverage/ insurance statusin Ohiob.Medicaid programs in Ohioi.Healthy start–children youngerthan19 and/or pregnant womenii.Healthy families–parents and children includediii.Aged, blind, or disabled (ABD)–adults 65+ or legally blind/disabledc.Eligibility, application, and renewal in Ohio3.Health Care Financinga.Total Medicaid spending in Ohio was $15,709,320,002 in the 2011 financialyear, the 6thhighest state (Kaiser Family Foundation, 2013)b.Ohio Spends below the US average on acute care, above the US average onlong term care, and matches the US average on disproportionate sharehospital payments(Kaiser Family Foundation, 2013)i.Where money is coming fromii.Where money is being spentc.Cost containment actions(Kaiser Family Foundation, 2013)i.Ohio has enacted changes in provider payment rates, pharmacycontrols, long term careii.Ohio has not enactedchanges in benefits(reductions), eligibility(cuts),copays,application/renewal4.Rationing of Health Carea.Federally mandated services vsOhio provided(optional)services(HealthPolicy Institute of Ohio, 2013)b.Delivery systemsi.Managed Careii.Fee–for–Service5.Quality ofHealthCarea.Health care quality measures assessment(Sebelius, 2013)i.Ohio reports 10 out of 22 health care quality measuresii.National average is 14 out of 22 health care quality measuresb.Ohio Ranks 35thin overall health care in 2012 (United Health Foundation,2013)6.Effectiveness of Programsa.Service Use Indicatorsb.Current Department of Health Transformation Initiatives (Governor’s Officeof Health Transformation, 2013)i.Modernize Medicaid1.Extend coverage to more low–income Ohioans2.Integrate Medicare and Medicaid3.Improve managed care plan performanceii.Streamline health and human servi
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