Day 36- Medicaid at 50: State Highlight: Ohio

So much can be said about the Ohio Medicaid program. If someone ever wants me to just start listing things, please hang out with me for at least 5 minutes. It will happen regardless if I know that you’ve read this blog or not. Since I love talking about Ohio and I love talking about home and community-based services– I’ll do both!

In 1986, Ohio created a program called the PASSPORT program. This program allows Ohio residents over the age of 60 learn about their long-term care options and provides in home care, which many older individuals that require institutional level of care prefer. This program is designed to give people an option for a setting that they most prefer. There are many nitty gritty things about this program that can be a bit frustrating. For instance, eligible beneficiaries must meet institutional level of care needs and asset tests are in place which force people to spend down their savings.

That being said, the state has made significant strides to make the program more available to people that need in home services. The state has eliminated waiting lists and has transferred 5,000 people from nursing homes to the community since 2011.

Ohio has also implemented the Financial Alignment model which is designed to coordinate care for people dually eligible for Medicare and Medicaid. According to the state’s most recent update:

As of December 31, 2014, MyCare Ohio plans have enrolled 100,366 Ohioans, processed 3,128,929 claims, and paid provider bills totaling $898,939,665 (more detail below). As with any major program conversion, there have been some issues, but the health plans are working directly with provider associations and others to identify and resolve issues as they arise, and make it as easy as possible for providers to convert from government-run FFS to private health plans.

A more detailed summary from the Kaiser Family Foundation notes that the transition was rocky in part because of a transition to mandatory managed care for Medicaid long-term care services.

In short, a lot is going on with home and community-based services in Ohio and it will be a state to watch as they work to provide long-term services to more people in the home and community.

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