As part of his biennial budget plan, Gov. John Kasich wants to move the last group of Medicaid beneficiaries into private managed care plans (Source: “Kasich administration makes final push to Medicaid managed care,” Feb. 1, 2017).
Nearly 90 percent of the 3 million poor and disabled Ohioans enrolled in Medicaid are already in managed care. The rest, with some exceptions, would transition from fee-for-service beginning in July 2018, under Kasich’s two-year budget plan. The more than 150,000 remaining fee-for-service Medicaid enrollees are mostly elderly and disabled Ohioans receiving long-term care services at home or in nursing facilities.
Until recently, most states have excluded the elderly and disabled from managed care because of their complex needs, but that's changing as states seek to reign in rising health care costs. However, Greg Moody, director of the Governor's Office of Health Transformation, said "Our motivation is not savings driven (but) we believe better care coordination has produced savings." Rather, the administration wants to create incentives for health care providers to keep patients healthy and eliminate gaps in services. These last, and most complex, beneficiaries to move into managed care probably need care coordination the most, he added.
But the proposal is creating angst for some who worry that the care won't be as high quality. "Managed care companies have struggled because they don't have the expertise in long-term care," said Pete Van Runkle, executive director of the Ohio Health Care Association which represents the nursing home industry.