Category: Medicaid

October 29, 2018

18 Questions for the 2018 Election: Medicaid

John Kasich’s administration has been marked by some of the most significant and impactful policy changes in Ohio’s Medicaid program during its history. Before the governor took office, there was no Medicaid expansion, Medicaid was under the purview of the Ohio Department of Job and Family Services and the beginnings of the opioid crisis were...

October 16, 2018

New SNAP exemptions affect Cuyahoga, Lucas counties

By: Loren Anthes, Public Policy Fellow, Medicaid Policy Center Adam White, Policy and Planning Assistant   In a recent report, The Center for Community Solutions presented data that illustrates how rural Appalachian counties, which are predominately made up of white families, disproportionately benefit from Ohio’s waiver of work requirements for the Supplemental Nutrition Assistance Program (SNAP, formerly...

August 21, 2018

Analysis of Ohio’s report on Medicaid expansion

On Tuesday, August 21, the Ohio Department of Medicaid (ODM) released the second “assessment” of the Medicaid expansion as a follow-up to the first, General Assembly required, assessment from 2016. In this document the ODM found the following: EMPLOYMENT Employment for enrollees went up 15%, meaning 1 in 2 expansion enrollees are working The most...

August 16, 2018

Ohio Medicaid ends “spread” pricing for prescription drugs, discussion around contractual Medicaid overhead costs just beginning

By: Loren Anthes, Public Policy Fellow, Medicaid Policy Center Adam White, Policy and Planning Assistant   Background The Ohio Department of Medicaid (ODM) announced on Tuesday, August 14 that it is directing Medicaid Managed Care Organizations (MCOs) to cancel contracts with Pharmacy Benefit Managers (PBMs) that use a “spread pricing” model. Spread pricing allows PBMs to keep...

July 30, 2018

If You Want to Cut Costs in Medicaid, Sharpen Your Knives: Innovation in Medicaid Pharmacy

Pharmacy is a Byzantine policy area that confounds and frustrates wonks, reporters and policymakers alike. However, it is common knowledge that the pharmacy benefit in Medicaid is, if anything, a major driver of cost. While this is well known and was most recently identified by the Joint Medicaid Oversight Committee’s (JMOC) actuary in late 2016,...

July 16, 2018

Managed Care Organizations and Medicaid Performance

I recently authored an Issue Brief on the role data plays in Ohio’s Medicaid program. In developing that piece, I tried to approach data as a tool in business infrastructure development for the government “as an insurance organization,” which, for all intents and purposes, is what Medicaid is. If the mission of this insurance organization...

July 2, 2018

Administration, Managed Care Plans Signal They’re Ready for Final Phase of Behavioral Health Redesign, June JMOC Pt. 1

This is the first of a two-part blog covering the June 28, 2018 meeting of the Joint Medicaid Oversight Committee. The second part addresses the committee’s discussion on pharmacy benefit managers (PBMs), and can be found here. On July 1, behavioral health providers began submitting claims for services to Ohio’s five Medicaid managed care plans...