Ohio's Medicaid costs could jump by 49 percent
Monday, January 31, 2011
Ohio's Medicaid costs could jump by 49 percent
By Catherine Candisky, The Columbus Dispatch
Left unchanged, Medicaid will cost Ohio taxpayers an additional
$1.6 billion next year.
That's a 49 percent jump in the state's share of costs for the
health-care program covering more than 2 million poor and disabled
Ohioans, pushing to $4.9 billion the cost to the state for the next
fiscal year.
Most of the increase to Ohioans is due to the loss of federal
stimulus money. The federal government has been covering a higher
share of Medicaid costs to help states during the recession, but
that help ends June 30. In addition, state officials are projecting
an increase in enrollment and utilization of services, both of
which also will drive up costs.
Fresh off his appointment to head the new Governor's Office of
Health Transformation, Greg Moody shared those numbers last week
with representatives of hospitals, nursing homes, insurers and
other Medicaid stakeholders as he sought their help to rein in
costs.
Doing nothing, Moody said in an interview, is not an option.
The other number he and his staff are keenly aware of: the days
until Kasich must deliver his state budget plan for the next two
years - 44 days from today - on March 15.
Despite the short time frame, Moody said his goal is to put a
plan in place that will improve people's health while lowering
program costs. High on the administration's to-do list is expanding
preventive care to keep people from getting sick or developing
chronic conditions and better coordination of care to avoid
duplicating services and costly hospital admissions.
Another priority will be to expand home and community-based care
for the elderly and disabled to reduce nursing home costs which now
gobble up about 20 percent of Medicaid costs. Ohio has tried with
some success to rebalance its long-term care system but still lags
behind other states.
Moody said the administration also will evaluate the rates paid
to hospitals, nursing homes, doctors and other care providers,
which could bring more immediate savings than efforts such as
preventive care.
He said he has not been given any dollar amount to cut from
Medicaid.
"It's going to be tough going and there are going to have to be
sacrifices," John Begala, executive director of the Center for
Community Solutions, a Cleveland-based nonprofit, said after
meeting with Moody last week. "It's fair game for everybody to be a
budget hawk on Medicaid, and there is no way this happens without
providers stepping up and accepting something less than they
have."
The federal stimulus money allowed Ohio and many other states to
avoid throwing people off Medicaid or eliminating some of the
services covered, but that may change.
Kasich was among 33 Republican governors who earlier this month
asked the Obama administration to let states cut Medicaid
enrollment without losing federal aid. Under the new health-care
law, states that restrict eligibility in their programs lose
federal support, which generally covers about 60 percent of
costs.
The state's $4.9 billion share is up from $3.3 billion. Total
program costs - state and federal shares combined - are projected
to top $15.3 billion next year and climb to more than $16.5 billion
the following year, according to Moody's office.
"It's a big number," said Tim Maglione, of the Ohio State
Medical Association.
"We are focusing on the kinds of things that can promote savings
and promote the concept of wellness and prevention. It may not have
a dollar savings today, but it can generate savings down the
road."
The physicians' group will recommend expanding preventive care,
chronic disease management, programs that reward positive outcomes
and additional protections from medical liability it believes would
save money.
"Everyone in the system is going to have to come to the table
with efficiencies in their own systems," said Kelly McGivern,
president and chief executive officer of the Ohio Association of
Health Plans, which represents health insurance companies.
Association members coordinate care for 1.5 million Medicaid
recipients, mostly children and mothers. McGivern said the efforts
have saved $2 million over the current two-year state budget and
that more money could be saved by expanding those efforts to
services such as prescription drugs and mental-health.