(The Center Square) – A bipartisan group of Ohio legislators wants to change the state’s Medicaid program in a way they say could save hundreds of millions of dollars each year.
The plan, called Medicaid Savings Act, would reduce administrative costs by simplifying the Medicaid system, which would increase the numbers of physicians participating in the program and reduce emergency care and urgent care visits.
It is modeled after the Medicaid program in Connecticut.
“We know that this has worked in Connecticut,” State Sen. Louis W. Blessing, R-Colerain Township, said at a news conference. “And we know that this is going to work in Ohio for Medicaid overall.”
Medicaid is a joint state-federal program that pays for health care for people with low incomes.
Ohio’s Medicaid program contracts with seven “managed care” organizations to administer the program, State Sen. Beth Liston, D-Dublin, said, and it’s a complicated system.
“Every doctor’s office, every hospital negotiates different contract terms, navigates different systems of denials, prior authorization – even just figuring out what people can receive under their particular plan.” Liston said. “Each patient has to jump through hoops to access the care that Medicaid is supposed to provide.”
Simplifying the process would make it easier for patients and providers and save a lot of money, Liston said.
The legislation would remove the managed care organizations from the process and replace it with one contract with a single organization to administer the program.
“The first year that Connecticut put this into place, provider participation increased by 33%,” Liston said.
The savings allowed Connecticut to increase rates paid to primary care physicians, as more Medicaid patients went to their regular doctors for treatment.
“They saw there was a decrease in emergency room visits which is truly a decrease in cost to the system,” Liston said.
Costs dropped in Connecticut and are still lower than Medicaid programs in neighboring states and national averages, even though the cost of living is among the highest in the country, she added.
The savings helped lessen the blow of looming federal cuts in the Medicaid program, Liston said.
“Is this a magic bullet that can fix all things in Medicaid?” the senator asked. “No. but I think we’re really looking down the barrel of a gun with federal cuts coming up.”
By some estimates, the changes could save between $450 million and $800 million a year, legislators said.
