In “Part III: Recommendations” of the Strategic Review of Medicaid series, we take the information outlined in the previous two sections and synthesize some policy concepts that are worth considering once the Kasich Administration ends. While there has been a tremendous amount of change over the course of the last eight years, much of which has put Ohio on the path toward better value, there is plenty of opportunity to advance the program and improve Ohio’s overall value ranking, nationwide.

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National research demonstrates the majority of cost in healthcare lies in price, utilization, social determinants and overhead. As the previous sections showed, this environment is apparent in Ohio as well, so the following recommendations are being made:

  1. Maintain Current Value-Based Efforts
  2. Revise MCO Contracts to Account for Social Determinants
  3. Increase Program Integrity
  4. Build Consumer-Focused Value
  5. Look at Non-Medicaid Policies to Affect Health

The policy development process in each of these areas requires bold political will. However, when digging into the data behind these recommendations, each of these represent evidence-based strategies for decreasing costs and improving outcomes without sacrificing access to care.

National research demonstrates the majority of cost in healthcare lies in price, utilization, social determinants and overhead.

Surely, these recommendations will take collaboration, adjustment, revision and enhancement – that is the nature of policymaking. Hopefully, by thinking about these three parts in totality, the recommendations offered here provide the basis for discussion between the various parts of the health care delivery system that depend on a sustainable, cost-effective Medicaid to function.

Scroll through the presentation below. To download all of the slides click here.