Submitted by achenault on Wed, 06/17/2015 – 4:54pm
Legislators are well aware that last year’s MyCare enrollment into Medicaid managed care was chaotic for many of the 100,000 older adult and disabled Ohioans and that many problems persist. That’s why advocates for MyCare consumers were surprised that the Senate rejected a proposed amendment to authorize and fund an independent evaluation of Ohio, following the first year of the Medicaid enrollment.
Supported by Ohio Consumer Voice for Integrated Care, Area Agencies on Aging, and others, the proposed evaluation would examine consumer experiences with MyCare – their level of satisfaction, what choices they’ve made, how their lives have been impacted, whether they’ve experienced delays in getting needed services, whether they’re lives have been improved. Such an evaluation would allow advocates, consumers, and the managed care plans to both target areas of improvement and build upon aspects that are working well for consumers.
Given current debates over plans to integrate behavioral health services into Medicaid managed care, the evaluation of consumer experience during and after Medicaid managed care enrollment should offer perspective on potential risks and benefits, as well as safeguards to put into place. Many MyCare Ohio enrollees have multiple chronic health conditions or complex personal care needs, making disruptions in services potentially life-threatening. The same is true of people with serious mental illness, many of whom rely on a complex network of supports to remain stabilized.
MyCare Ohio is a three-year demonstration, at the end of which state and federal policymakers will have to make decisions on its future. Yet the federal evaluation of the demonstration will be conducted only after it has ended – too late to make mid-course corrections.
Ohio Consumer Voice for Integrated Care believes in the promise of MyCare Ohio – better care coordination across settings, better care, and better quality of life for dually eligible Ohioans who have received fragmented, often poor, care from two systems that were not designed to work together. But we know that much system and process improvement needs to happen before consumers realize the promise – and an early evaluation will help target those improvements.
OCVIC will continue to educate lawmakers about the benefits of the evaluation. Those who agree on the benefits of the evaluation can contact their state legislators to educate them as well.