Category: Ohio

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 20, 2018

Transportation for people with disabilities, older adults takes center stage at HSAN meeting

The August 10 meeting of the Human Service Advocacy Network (HSAN) featured special guest Randy Cole, Executive Director of the Ohio Turnpike and Infrastructure Commission. His remarks to the approximately 30 attendees touched on a number of topics that impact the world of transportation, including both the rapid advancement of technology and the change in...

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

Elder Abuse: Who is most at risk of Self-Neglect?

Elder Abuse Awareness Month may be over for 2018, but the impact of elder abuse lasts all year. Elder abuse is defined by the U.S. Administration for Community Living as “any knowing, intentional or negligent act by a caregiver or any other person that causes harm or serious risk of harm to a vulnerable adult.”...

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...

June 11, 2018

982 Ohioans were diagnosed with HIV last year. This number could be zero.

I recently received updated HIV epidemiology (the study of the distribution of disease in a population) from my public health partners at the Cuyahoga County Board of Health. The good news is the county’s HIV infection rate in 2016 was down, albeit modestly, for the fourth consecutive year, to 194 new diagnoses. Almost 1,000 new...

May 29, 2018

A “PEP” talk from Dr. Bruce Perry on Clinical Approach to Combat Adverse Childhood Experiences

Though the impacts of toxic stress and Adverse Childhood Experiences (ACEs) can be overwhelming, Dr. Bruce Perry of the Child Trauma Academy gave an inspiring and informative talk in Cleveland on May 15 on the effects of such trauma, and ways to build and empower a trauma informed community. Though I have participated in many...