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Ohio.com...
Success
in budgeting
July 7, 2011
Making
changes in the Medicaid program
always is a delicate juggling act involving costs and the widely
different
needs of beneficiary groups and providers of health-care services.
Reformers
face the test that they not create new problems while trying to fix
existing
ones.
It
is a big credit to Gov. John
Kasich, his Office of Health Transformation and the
Republican-controlled
legislature that the new state budget launches reforms that promise to
improve
the structure and services of Ohio Medicaid. On the whole, the budget
legislation moves the health-care program for poor families, the
disabled and
the elderly poor a long way toward greater efficiency in finances and
services.
Not least, the reformers avoided the typical reflex at the first sign
of budget
trouble: slashing optional but critical benefits such as dental and eye
care
for the poor.
It
has long been recognized that in
structure and operation, Ohio Medicaid, which spent more than $18
billion in
total this past fiscal year, is fragmented, the quality of care uneven
and
spending skewed heavily to high-cost institutional care for a small
percentage
of disabled and elderly clients.
Kasich
set the right priority to
realign the program, with the aim to coordinate better the care of the
2.2
million Ohioans the program serves, thereby lowering costs and raising
the bar
for quality. The budget, for instance, provides funding to establish a
pediatric accountable care system that would enable the state to
contract with
managed-care insurers to provide comprehensive care for disabled
children with
special needs. To that end, the budget also paves the way for Ohio’s
children’s
hospitals to become accountable care organizations, able to contract
for the
specialized care of children with fragile health.
Similarly,
various measures in the
budget legislation advance integrated care of seniors and adults with
disabilities and multiple chronic illnesses. Funding to implement
concepts such
as health homes and an Integrated Care Delivery System promises
patients easier
access in a single setting to services for their physical and
behavioral health
care as well as other social needs.
The
budget also significantly expands
options in long-term care. It thus goes some distance to address the
longstanding problem of seniors defaulting to nursing homes because of
the
limited availability of slots for home and community-based programs.
The
legislation creates a unified budget for long-term care. It combines
five
popular waivers for home and community based services, increasing
funding for
these options by $532 million and opening up space over the next two
years for
an additional 12,890 Ohioans to receive long-term care, cheaper, in the
settings they prefer.
To
be sure, much gnashing of teeth
accompanied the legislative process. In the end, it achieved better
care for
poor families, seniors and disabled.
Read
it at Ohio.com
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