What should I be doing instead of this?
by Hannah McCartney 05.03.2012
Posted In: News at 11:51 AM | Permalink | Comments (1)

Changes in Ohio Medicaid Coming Next January

Experts weigh pros and cons in transition

In yet another effort to save tax dollars and fill holes in the state budget, Ohio Gov. John Kasich and his health care advisers will streamline the state’s Medicaid system by altering the availability to 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 January 1, 2013, the availability will condense to five statewide plans and only three geographic regions, according to a press release from the Ohio Department of Job and Family Services (ODJFS).  The change is billed by Kasich's office 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. According to The Enquirer, Medicaid costs the state of Ohio around $4.8 billion each year — nearly one fifth of the state’s budget. Those costs continue to grow. Bloomberg Businessweek reports that the new plan will also mandate higher care standards and offer financial incentives to doctors, hospitals and other providers to help improve care quality and patient health.Selected managed care organizations include: Aetna Better Health of Ohio, CareSource, Meridian Health Plan, Paramount Advantage and United Healthcare Community Plan of Ohio. Managed care organizations who lost the bid include incumbent providers Centene, AmeriGroup and Molina Healthcare, among others. According to the Wall Street Journal, the loss of business marks a blow for those providers, who have benefited from covering "dual-eligible" patients — those eligible for both Medicare and Medicaid services. WSJ reports that dual-eligible patients are seen as a $300 billion opportunity for managed care firms. Because Ohio is pushing to start better coordinating care for dual-eligible patients, dropped insurers will likely lose a piece of that pie. Streamlining the selection of managed care organizations available should help, in turn, streamline processes for dual-eligible patients, who often encounter difficultly 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).ODJFS reports that the new providers were selected using a fair, through and open application process that was “based on applicants’ past performance in coordinating care and providing high-quality health outcomes.” Although the changes are generally perceived as a positive move forward, service providers, including doctors and health centers, acknowledge that the disruption in services could cause serious confusion when recipients are forced to find new providers and obtain new Medicaid cards. In Kentucky, the three private managed care companies which provided Medicaid services to more than 500,000 patients have received an influx of care-related complaints, including inefficiency in authorizing services and payment issues.  Ashmore challenges the notion that the transition will be a bumpy one, noting 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 new care providers.
by Hannah McCartney 04.26.2012
at 10:17 AM | Permalink | Comments (0)
screen shot 2012-04-27 at 9.27.50 am

Some Ohioans Could Lose Landlines

New bill might drop home phone services in parts of state

To a Generation Y-er, a touch-tone cord phone without access to Internet might sound like something from the stone ages — a trinket only found in the antique confines of a grandparent's cobwebbed homestead. It appears that's little more than perception, though: According to the Center for Disease Control and Prevention, more than three of every 10 American homes used only wireless telephones during the first half of 2011 — an increase of almost 2 percent since the second half of 2010. That means that aside from the 30 percent who do rely on cellphones, there's still a large hunk of the population — about 70 percent — who rely on communication through landline services. A bill currently pending in the state House of Representatives could eliminate landline phone services across several geographic areas of Ohio, leaving those who are unable or opposed to joining the wireless phone craze in a telecommunications pickle. The bill, Senate Bill 271, would no longer require phone companies to provide basic landline service in certain Ohio areas; similar bills have been passed in Indiana and Wisconsin. Tuesday's release of study commissioned by Technologies for Ohio's Tomorrow, which concluded that broadband investments in the state of Ohio create between 15,000 and 30,000 jobs in the state each year, has strengthened support for the bill's passage. Phone companies support the bill because they claim it would allow them to invest the under-utilized funds supporting landline services in newer, higher-demand technologies, such as cell phones. Opponents, including the AARP and the Ohio Consumers' Counsel, vocalize that that 70 percent marks rural, elderly and lower-income demographics who rely on landline services to make vital emergency calls. The language of the bill mandates that phone companies would be permitted to withdraw basic landline services the area is deemed "competitive" — meaning there are other phone service providers in the area, even if their service doesn't reach everywhere — by the Public Utilities Commission of Ohio. To maintain landline service, some residents would be forced to upgrade to packages including expensive services they don't need, or simply lose access to landline phone service altogether. “It is not hyperbole to argue that a devastating consequence of the deregulation of basic local exchange phone service will be higher unaffordable rates that will force those living on fixed incomes to sacrifice other necessities like food, medicine, heat and/or electricity,” said Jane Taylor, state director for AARP Ohio, in a letter written last week to the chairman of the House Public Utilities Committee, according to the Cleveland Plain Dealer. There's no doubt that the bill would be a positive for phone companies — the telecommunications industry is rapidly evolving, and the wireless phone industry is booming more then ever with the fierce competition among smartphone retailers. Landline phone services are facing the sort of irrelevancy among today's telecommunications services also experienced by phone books, payphones and telegraphs. But even in if an area is considered "fully competitive," the availability of strong, reliable phone service isn't necessarily ubiquitous.It makes fiscal and technological sense that one day will bring the full transition from landline phone service to wireless phone use — but it appears that nearly 70 percent of telecommunications users aren't ready for that transition, and wireless phone providers haven't figured out a way to provide the same level of reliable, comprehensive service offered by landline phones. If the bill is approved by the Ohio House of Representatives and then signed into law by Ohio Gov. John Kasich, the new regulations would go into effect in 2013.