On Friday, the Governor’s Office of Health Transformation launched another promising effort to revamp Medicaid. It called for housing the $18.8 billion health-care program for poor families, the disabled and indigent elderly in a single agency. The streamlining should make the program more accountable, responsive and agile. It meshes well with the steps already in the works, including a state budget that provides a glimpse of the shape a unified Medicaid would take.
The idea of a single agency hardly is new. In 2005, the Ohio Commission to Reform Medicaid included the proposal in its recommendations. A year later, the Ohio Administrative Study Council echoed the thinking. A performance audit released by the state auditor then made its persuasive case, noting that if Ohio wanted an overall health strategy (and it should have one), then Medicaid must be organized “within a super health agency.”
What doesn’t make sense is administering such a crucial program through the current five state departments, Aging, Alcohol and Drug Addiction Services, Developmental Disabilities, Mental Health and Job and Family Services. In theory, overall management falls to Job and Family Services, but the Office of Ohio Health Plans within the department lacks the leverage and resources to make the necessary difference.
Medicaid serves as the largest health-care payer in the state, covering 2.2 million Ohioans, involving 75,000 health-care providers. It is a joint federal and state effort, with the feds picking up roughly 60 percent of the tab. In recent years, the program has expanded, due largely to the troubled economy. Yet it also is true that fewer Ohioans receive their health coverage through their employers, many of those out of work turning to Medicaid.
Add the possible expansion of Medicaid under the Affordable Care Act, an option Gov. John Kasich and his team are evaluating, and it becomes imperative for the state to do all that it can to manage more effectively the program.
So far, the Office of Health Transformation, led smartly by Greg Moody, has looked to improve the sharing of information across state and local systems. It has embarked on updating the process for determining eligibility and improving the system for paying claims. It even has tackled the complicated task of getting Medicaid to work smoothly with Medicare, many Ohioans poor and elderly, and thus eligible for both programs.
With these and other initiatives in motion or in the works, the state has additional reasons to see the benefit in a single agency, achieving greater coordination, ideally, more dollars directed to health care as opposed to shuffling paper.
The merger plan involves representatives from the far-flung offices gathering soon to plot a strategy going forward, lawmakers and stakeholders in the loop. The goal is to have the department up and running by next summer, the new state budget in place, Ohio finally accomplishing what long has been advised, a Medicaid in better position to serve its beneficiaries and taxpayers.