Ohio Governor John R. Kasich’s Director of Office of Health Transformation [OHT], Greg Moody, and Ohio Medicaid Director John McCarthy acted as a skilled tag team Tuesday, when they alternated time at the podium presenting a fact-filled package of Medicaid system improvement updates to the bi-partisan Healthier Ohio Working Group of the Ohio House Finance and Appropriations Committee.
Reforms, reforms and more reforms
The 14 House Members who showed up mid-afternoon to listen to the dynamic duo of health program professionals go through pages of PowerPoint slides did so by way of a House-approved amendment to the state’s two-year budget proposal that called for more discussions on Medicaid program reforms even though House Republicans removed it over the objection of Gov. Kasich, who said it would bring billions in federal funds and create thousands of jobs by 2020.
The group is continuing the conversation on health care reform with a policy focus on further transforming Medicaid and employing a range of other programs aimed at successfully promoting more Ohioans from needing public assistance.
Next week the committee will receive a status report on current conditions by the two offices. The emphasis of that report, facilitator Rep. Tom Amstutz said in a meeting announcement, will be on Medicaid populations with the greatest potential to obtain the income and resources that enable them to graduate to greater self-sufficiency, including accessing private health care services rather than Medicaid.
Watch Greg Moody on 60 Seconds Ohio
According to information Moody and McCarthy distributed to Members today, Medicaid is Ohio’s largest health payer—83,000 doctors, hospital, nursing homes and other providers cared for 2.2 million Medicaid patients in 2012.
Medicaid spending increased 33 percent in the three years prior to Gov. Kasich taking office, four times faster than Ohio’s economy. Moody said Gov. Kasich’s first Medicaid reform budget held spending to less than 3 percent growth in 2012 and saved Ohio taxpayers $2 billion over two years.
Moody and McCarthy stressed that Medicaid can be used to achieve other reforms, including improving residents’ health, reducing health care costs including uncompensated care, boosting enrollment in private health insurance plans, requiring greater personal responsibility through cost sharing, connecting people with additions to treatment and prevent their accessing narcotics through the health care system, promoting employment and job training services that move able-bodied Ohioans into work and decrease Medicaid caseloads and leveraging the purchasing power of the state’s Medicaid program to accelerate private sector health care payment innovation.
Ohioans spend more per person on health care than residents in all but 17 other states, according to information from the OHT, that added that 36 states have a healthier workforce than Ohio.
Just a few high-cost cases account for most health spending, OHT information reported. It noted that one percent of the US population consumes 23 percent of total health spending. Five percent of the US population consumes 50 percent of total health spending. Most people [50%], OHT said, have few or no health care expenses and consumer on 3 percent of total health spending.
Moody said Gov. Kasich made it clear that Job #1 for reforms is to grow the economy. “Don’t let the fear of failure prevent you from taking the risk necessary to innovate,” said the governor, whose mantra has been to “innovate at the speed of business.”
Moody and McCarthy told working group Members, chaired today by Anne Gonzales (R-District 9), that managed care reforms can work and that a team is in place to execute those changes.
Both directors tried not to raise expectations too high going forward, but they placed big bets on big savings from home health visits as an efficient and affordable alternative to the costs associated with the more than 900 skilled nursing facilities across the state, a number they said was far more than other states.
The duo said Ohio ranks 37 in health outcomes—higher spending is not resulting in better care, they said. They said there’s a need to get the right information in the right place at the time to improve care, and reward better care not just more care.
Moody said they reformed Medicaid payment with innovations. Yet despite all the reforms, there still remain more than 1.5 million uninsured Ohioan, three-quarters of who are working.
Medicaid spending came in $590 million under budget in 2012, which helps explain by Ohio leads the nation in reforms to modernize Medicaid.
McCarthy said health care providers are “knock down the doors” trying to get into the system, which he said is good because it expands providers, which in turns means no one provider can hold the state hostage for lack of competition.
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