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Ohio Medicaid drives toward a reimagined managed care program focused on the individual

For immediate release: February 4, 2020

Lisa Lawless, Communications Director, Ohio Department of Medicaid
614-752-3567 ǀ elizabeth.lawless@medicaid.ohio.gov
Kevin R. Walter, Press Secretary, Ohio Department of Medicaid
614-752-3688 ǀ kevin.walter@medicaid.ohio.gov

Ohio Medicaid drives toward a reimagined managed care program focused on the individual 

COLUMBUS, Ohio — The Ohio Department of Medicaid (ODM) today released a request for information (RFI) outlining its vision for a reimagined statewide managed care program. The RFI seeks input from providers, associations, advocacy groups, data and information technology vendors, and managed care organizations.

“We want Ohio’s most vulnerable people to have access to the best health care available, and it starts by listening to the ideas, needs, and concerns of those touched by Medicaid,” said Governor Mike DeWine. “The information we gain through the RFI, combined with what’s been learned from previous meetings, listening sessions, and constituent online submissions, will help ODM create a transparent program that strengthens the mental, physical, and emotional wellbeing of Ohioans.”

This RFI is a continuation of the process initiated by Governor DeWine to implement some of the most innovative health care reforms in the country. It examines the current health care experience of nearly 3 million Ohio Medicaid consumers and offers ideas to reduce barriers, streamline access, and enhance health care delivery.

“How we view the health care system defines what we see as problems or opportunities,” said Maureen Corcoran, director of ODM. “By putting the individual in the center of our field of vision, we change the focus, defining forward-looking programs based on personal impact and health outcome.”

With the reimagining of the Medicaid system in Ohio, ODM hopes to improve the design, delivery, and timeliness of care coordination. ODM requests input to achieve the following goals:

Improve wellness and health outcomes. To improve health outcomes and support individual wellness, ODM invites input on ways to formalize coordinated care partnerships between community-based organizations and managed care organizations that will reduce infant mortality and preterm births, increase healthy behaviors, promote tobacco cessation, and address health care inequities.

Emphasize a personalized care experience. The RFI invites ideas that strengthen the managed care organization and provider capabilities to deliver more personalized care. It seeks feedback on improving member-provider communications, technologies to increase consumer engagement, and programs to enhance wellness behaviors and outcomes for individuals and their families as they access a continuum of care tailored to their unique needs. 

Support providers in better patient care. In order to better support providers, ODM requests ideas and best practices to reduce administrative burdens, such as centralized credentialing, standardized authorizations, and simplified medication management.

Improve care for children and adults with complex needs. To strengthen care for children and adults with complex medical and behavioral health needs, ODM plans to develop a formalized model of care coordination, to tailor behavioral health services to meet the unique needs of children served by multiple state systems and with other complex behavioral health needs, and to create robust partnerships between community-based organizations and managed care organizations.

Increase program transparency and accountability. Program transparency through the use and analysis of realtime, reliable data can dramatically strengthen care oversight and outcomes. ODM seeks input to enhance data analytics and consumer health care dashboards, such as its recently introduced unified prescription drug list, to streamline support and drive accountability across the continuum of care.

During RFI#1, phase one of ODM’s managed care reimagining, the agency collected input from nearly 1,000 individuals, providers, and advocates across Ohio through face-to-face meetings, formal listening sessions, and online, email, and mail submissions.

Responses to RFI#2 can be submitted to ODM beginning today through Tuesday, March 3, at 4:00 pm EST. Throughout the managed care procurement process, the Managed Care Procurement mailbox – mcprocurement@medicaid.ohio.gov – will remain open as a way for individuals, providers, and advocates to communicate with ODM about the managed care program. Information about the first RFI is on ODM’s dedicated managed care procurement website at managedcare.medicaid.ohio.gov.