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Ohio takes first steps toward big Medicaid overhaul

Ohio Medicaid, which provides health care to more than a quarter of the state’s population, is poised to take a big step in a major overhaul of the program.


Gov. Mike DeWine on Tuesday said that on Wednesday a request for applications will hit the streets seeking pitches from companies to manage the care of more than 90% of Ohio Medicaid recipients.


“This is the first major overhaul of Medicaid in 15 years,” DeWine said.


That might be overstated. In 2013, under former Gov. John Kasich, Ohio greatly expanded the Medicaid rolls under the Affordable Care Act. It was one of several big changes to Medicaid over the years.


At present, five care organizations manage the bulk of the $27 billion Ohio Medicaid spends annually. But DeWine said state officials have been in the field for months, meeting with patients, providers such as doctors, dentists and pharmacists, as well as the companies that manage the care plans.


“From these conversations and this process, we have developed a new plan, a new vision, for Ohio’s Medicaid program, one that focuses on people and not just on the business of managed care,” he said. “A vision of what we hope will be a better, healthier, more productive state of Ohio.”


The governor said Medicaid will also restructure its programs for children with serious behavioral health problems.


The reforms are ambitious and they were praised by some policy experts as long overdue.

“Frankly, I’m happy to see (this) move forward,” tweeted Loren Anthes, who leads the Cleveland-based Center for Community Solutions’ Center for Medicaid Policy. “It’s been long overdue need for the state to revisit these valuable contracts. Devil’s in the details, but we could be doing a lot better than we are. I can’t wait to review the proposal.”

However, some others have questioned whether the Medicaid’s leadership has the bandwidth to complete the overhaul by next summer, when it’s supposed to be complete. Not only is the state in the midst of a historic pandemic, the department has failed to meet important deadlines to disburse supplemental payments to pharmacists and to create a single pharmacy benefit manager.


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