In another effort to save tax dollars and fill holes in the state budget, Gov. John Kasich and his health care advisers will streamline the state’s Medicaid system by altering the availability of care plans and condensing care regions.
There are currently 38 health plans and 10 regions in the state of Ohio, which provide services to more than 1.6 million Ohioans each year. When changes in the system are implemented Jan. 1, 2013, the availability will condense to five statewide plans and only three geographic regions.
The change is billed as a way to simplify the way it offers coverage, eventually making a more sustainable, efficiently run program, which will supposedly trump the short-term inconveniences caused by the switch.
New selected managed care organizations include: Aetna Better Health of Ohio, CareSource, Meridian Health Plan, Paramount Advantage and United Healthcare Community Plan of Ohio.
Streamlining the selection of managed care organizations available should help dual-eligible patients — those eligible for both Medicare and Medicaid Services — who often encounter difficulty in coordinating coverage with both Medicaid and Medicare services, says Jim Ashmore, performance improvement section chief for Hamilton County Department of Job and Family Services (HCJFS).
Although the changes are generally perceived as positive, service providers, including doctors and health centers, acknowledge that the disruption in services could cause confusion when recipients are forced to obtain new providers and Medicaid cards.
In Kentucky, the three private managed care companies providing Medicaid services to more than 500,000 patients have reportedly received an influx of care-related complaints, including problems with inefficiency in authorizing services and payment issues.
Ashmore contends patients have little to
worry about: When the transition is made, everyone will likely receive
an enrollment package in the mail that will outline steps to switch over
to new care providers.
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