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Ohio Patients Thrive With Medicaid Managed Care

posted by AHIP

on April 16, 2019

Managed Care Plans Deliver Value to State and Enrollees

Millions of children, older adults, people with disabilities, and 2 million veterans depend on Medicaid. Nationwide, of the more than 70 million Americans enrolled in Medicaid, 68% receive their coverage through private managed care plans.

Medicaid is particularly important for Ohioans. In Ohio, 21% of residents are covered by Medicaid. That’s 2.4 million out of the state’s population of 11.6 million—including more than 1 million kids who are covered by Medicaid or the Healthy Start Program, Ohio’s children’s health insurance program.

And for them, Medicaid managed care means better access to quality care, and greater control of costs, and streamlined administration for the state.

Through Medicaid, Ohio’s Medicaid health plans helped improve the quality of patient care and saved $4.4 billion over the last 2 years. That’s according to a report from the Ohio Association of Health Plans.

The report found several important advantages of managed care over traditional fee-for-service models:

  1. Flexibility to provide additional benefits, such as wellness programs or transportation to doctor’s appointments, which can support access to health care and good health outcomes.
  2. Accountability for achieving quality and outcome goals, meeting performance requirements of the Ohio Department of Medicaid.
  3. Member support to help enrollees navigate the health system and coordinate care for people with chronic or complicated conditions.
  4. Innovation to attract and keep members happy with their coverage and care, as well as creating and testing new programs and services to improve health.

Health Insurance Providers Address Social Barriers to Good Health

As they serve some of Ohio’s most vulnerable citizens, Medicaid managed care plans are focused on the social needs (such as nutrition, employment, housing, and transportation issues) that affect a person’s health, well-being, and quality of life.

To address health and other needs, Medicaid plans create individual care plans for their members, identify barriers to care, and educate members, all of which can lead to better health outcomes at lower costs. For example, reducing the use of costly emergency care, or partnering with a rideshare service to help patients make it to their appointments.

Improving Care Quality Through Innovation

Programs to tackle specific social determinants and influencers of health are one way the state evaluates health plans for care quality. And to that end, the Medicaid managed care plans in Ohio have developed programs that:

  • Support community resources that work to reduce infant mortality
  • Target members with food insecurity through a food as medicine program
  • Combat the opioid epidemic
  • Address childhood obesity
  • Develop job training services
  • Support quit smoking programs

Across the country, more than 54 million low-income individuals rely on private health plans for Medicaid coverage. The state-level look at the value of Medicaid in Ohio shows how Medicaid health plans are committed to improving the health and lives of people.