William Batchelder, the House speaker, and Keith Faber, the Senate president, have repeated the words for months: They aren’t interested in Medicaid “expansion,” they want Medicaid “reform.” The suggestion they make is that reform has been lacking in the joint state and federal program for providing health care to those with low incomes.
Actually, John Kasich and his team have been at the forefront of improving Medicaid, making changes to enhance its effectiveness and efficiency. Here is one policy place where the governor’s penchant for exaggeration doesn’t apply.
The first two-year state budget of his term launched the effort, under the direction of Greg Moody, the director of the Governor’s Office of Health Transformation, and John McCarthy, the state Medicaid director. They led the way in, among other things, reshaping the managed care component and payments to nursing homes, plus taking aim at the disconnects facing those eligible for both Medicaid and Medicare, positioning the programs for collaboration.
The improvements continue in the new state budget, signed by the governor over the weekend. Take the challenge of combating fraud and abuse, too often more slogan than reality. The difficulty for states is that once they identify a problem, they must immediately reimburse the federal government for its share. Next, the state must scramble to collect from the offending provider — no small task. What McCarthy has done is improve the auditing procedures, the state looking to get ahead of the problem, striking pre-emptively, in effect.
Additional changes include an upgrade in the system for paying claims, bringing greater accuracy and likely substantial savings. A new integrated eligibility system promises to save money, and time for those involved, from patients and providers to those administering the program, making Medicaid more responsive.
Don’t miss the large structural changes, creating a Cabinet-level Department of Medicaid, moving to bring the operations under one roof, allowing for improved management and service. More, the departments of mental health and addiction services have been merged into one agency, reflecting the way things often work at the local level, consolidating and streamlining systems, ending overlap and duplication to deliver improved care.
Hard to believe state lawmakers can craft a more comprehensive package of reform. Better that they get more acquainted with the benefits to all Ohioans of expanding Medicaid.