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Written by: Mediware on Thursday, January 12, 2012 Posted in:

According to a recent article by The Republic, state officials in Ohio are working to alter the way that health care services are distributed to the 190,000 Ohioans who are both Medicaid and Medicare recipients in order to offer dual eligible individuals a single point of coordination.

Before officials move forward with the proposed changes highlighted in the draft proposal, released Tuesday, January 10, 2011 by Governor John Kasich’s Office of Health Transformation, plans have been made to collect feedback from health care providers, dual enrollees, and relevant advocate groups. They will use this feedback to create a final plan that will then be submitted to federal officials for approval.

Medicaid offers coverage to the poor though state and federal funding, while Medicare supports the elderly and disabled. Medicaid services often include payment for long-term care services, while Medicare will cover costs related to doctor and hospital visits.

Essentially, there is no coordination of care between Medicaid and Medicare. The two systems function independently of each other. According to state officials, insufficient coordination of care has led to “long-term care, behavioral and physical health services being poorly coordinated.” Resultantly, dual eligible individuals end up with worse health outcomes, which inevitably cost the system more.

Greg Moody, Director of Governor Kasich’s Office of Health Transformation, explains that, “As a person moves from one environment to another, there’s nothing about these programs that kind of keeps track of that.”

State officials know that it is this lack of communication that can lead to more costly health services.  For example, “a patient could be discharged from the hospital to a nursing home, instead of less costly, home-based care, because the two programs aren’t talking to each other in the same setting.”

Officials envision the future system operating quite differently. The state will contract with an organization, like an area agency on aging or hospital, to act as a single point of contact. This should help make the system easier to navigate for patients and providers alike.

The initiative will focus on keeping people healthy in addition to treating sickness.

To read more about the proposal in The Republic article, click here.

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