DeWine announces first major overhaul of Medicaid program in 15 years

Posted at 2:00 PM, Sep 29, 2020
and last updated 2020-09-29 18:30:47-04

Governor DeWine announced his administration's plans for the first major overhaul of Ohio's Medicaid system in 15 years during his Tuesday afternoon press conference.

"The Department of Medicaid is the largest provider of health insurance in the state of Ohio," said DeWine. "Medicaid covers 3 million Ohioans. Of those, nearly 90% are enrolled in a managed care plan, including nearly every child enrolled in Medicaid in the state of Ohio."

DeWine said the new plan will be a gradual overhaul and will not disrupt care or coverage for anyone currently enrolled in Medicaid, but will hopefully change the system and create a better, more effective method of care for recipients.

According to DeWine, major goals of the new plan include increasing care for children with behavioral and mental health issues, providing more avenues for preventative care through primary physicians as opposed to emergency room care and increasing transparency between physicians and patients.

"Tomorrow, a new application will open for those businesses interested in providing managed care plans for children and adults within the Medicaid program," said DeWine. "Selected plans, ones that are selected, will be an essential piece of improving the health and lives of millions of Ohioans. Not only will selected plans work with my administration to build better systems of care, but they also play a special role in helping their members develop good health habits such as using primary care instead of the emergency rooms, getting needed vaccinations and attending prenatal visits for pregnant women."

The new model for the Medicaid system in Ohio will focus on all of the following:

  • Improving care for children who have complex needs.
  • Emphasize the personalized care experience of the patient.
  • Improving wellness and health outcomes – getting in front of the problem and focusing on wellness.
  • Giving doctors and other medical providers more time to spend with patients and patients having more frequent and lengthier conversations with their doctors.
  • Increasing transparency and accountability, cross-managing care to improve members care and experience and making sure all recipients understand their prescription drug benefits and other benefits.

He said the changes planned are a result of both the COVID-19 pandemic and data that suggests the majority of teens in Ohio's foster care system are living in residential treatment centers and often struggling with mental health issues, substance abuse and behavioral issues that have arisen from trauma.

"Almost half of teenagers who are in foster care over the age of 15 live in a residential treatment center," said DeWine. "Children's experiences leading up to and in the foster care system can leave them with trauma and other significant behavioral health needs. In fact, nearly two-thirds of all Medicaid spending on Ohio's foster care youth is for behavioral health services, showing that their mental health needs far outpace their physical health needs."

The provisions specifically designed for children and teen's mental health will be a second provision that will be created later this fall, DeWine said.

Watch the full conference below: