New Contracts with Managed Care Plans will Focus on Patient Wellness and Experience.

By Cathy Candisky 
The Columbus Dispatch

Posted Feb 9, 2020 at 5:36 AM

State Medicaid officials are seeking input on ways to improve the health and patient experience of the nearly 3 million poor and disabled Ohioans covered by the tax-funded insurance program.

The request comes as the state prepares to rebid contracts with private health insurance companies hired to manage the bulk of the Medicaid program. This year, the operators of Medicaid’s five managed care plans will be paid about $20 billion for administering services for about 90% of program beneficiaries.

Officials say the new contracts give them an opportunity to move toward a patient-centered system emphasizing wellness and prevention.

“We want Ohio’s most vulnerable people to have access to the best health care available, and it starts by listening to the ideas, needs and concerns of those touched by Medicaid,” Gov. Mike DeWine said in a statement this week.

The input, he said, “will help the Ohio Department of Medicaid create a transparent program that strengthens the mental, physical and emotional well being of Ohioans.”

DeWine ordered the rebidding of managed care contracts shortly after taking office a year ago, largely in response to concerns that private companies hired by the plans to manage prescription drug benefits were overcharging the state. But based on its formal “request for information” released this week, the state is looking at much broader changes to the Medicaid program.

Input is being sought from managed care plans, potential vendors and other interested parties. (The agency previously collected feedback from patients, their families, advocate groups and health care providers.)

Medicaid Director Maureen Corcoran said in a statement, “By putting the individual in the center of our field of vision, we change the focus, defining forward-looking programs based on personal impact and health outcome.”

The agency outlined several goals, including: improving wellness and health outcomes; emphasizing a personalized care experience; reducing administrative burdens and other support for health care providers; improving care for children and adults with complex needs; and increasing program transparency and accountability by making a wide-range of data available in real time.

And since the state will soon require able-bodied adults to work or train for a job at least 20 hours a week, the agency is also asking how managed care plans can support employment and education opportunities.

Input can be submitted to the Department of Medicaid through March 3. Contract criteria will be outlined and bids requested later this year.

Full article:  https://www.dispatch.com/…/medicaid-officials-want-your-two…

The Ohio AAP is encouraged to see that overburdensome payment and credentialing processes would be eased to allow pediatricians to focus on what matters – the patients and families they take care of each day. Additionally, allowing for specialized focused care for children and adolescents who face behavioral health conditions is a step in the right direction to address this growing need.

A dedicated website – managedcare.medicaid.ohio.gov – for the managed care procurement is a resource for those interested in learning more about the process and our work to date. Responses from RFI #1 will be made available on this website in the near future. Updates, announcements, links and reminders will be tweeted through the Department’s twitter handle, @OhioMedicaid. Lastly, stakeholders are also encouraged to utilize the procurement team’s dedicated email inbox (MCProcurement@medicaid.ohio.gov) to submit feedback regarding the Medicaid managed care program to ODM.

 


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