Consumer input CAN change our health care system for the better. In a recent blog, we shared how our survey of MyCare Ohio enrollees’ experiences informed decisions to improve care coordination and the availability of all services, supplies, and equipment. We’ve continued to use the survey findings to advocate for changes to make health care work better for all MyCare Ohio enrollees, and we’re happy to share another success!

Ohio Consumer Voice for Integrated Care (OCVIC) is UHCAN Ohio’s statewide coalition that is working to improve the care of older adults and people with disabilities enrolled in MyCare Ohio by bringing the voice of consumers to the Ohio Department of Medicaid (ODM) and Managed Care Organizations (MCOs). Our efforts influenced the Ohio Department of Medicaid to create a new measurement that guides the Managed Care Organizations to reduce the time it takes to approve a request or process an appeal for Durable Medical Equipment (DME). Our survey identified this as a problem for many enrollees, showing that:

80% of respondents reported that they require the use of DME, yet 73% stated they did not receive a needed upgrade or replacement in a timely manner.

This change means enrollees will get their needed equipment faster or their appeal processed faster.

Thanks to the all the people who distributed the survey and the over 3,000 enrollees who shared their concerns and experiences. Together we can get Ohioans the care they need to lead healthier lives through an organized consumer voice. To join the coalition or learn more about what OCVIC is doing, contact John Arnold.

From the beginning of MyCare Ohio, there has been a push to ensure all enrollees signed their All Service Plan (ASP). The ASP is a document that the Case Manager (CM) develops with the input of the Interdisciplinary Team and the enrollee. It specifies all the services necessary for the member to remain in their home. The ASP lists the goals, the needed services, the service providers, the cost of services, who is liable for payment, any decision regarding the member’s options, and the enrollee’s home care team members. It is important the member and providers receive a copy of the ASP and understand its contents.

For too long, we were hearing from enrollees that they hadn’t seen or signed their ASP. The Ohio Consumer Voice for Integrated Care (OCVIC), a coalition of UHCAN Ohio, worked with the Managed Care Organizations (MCO) and the Ohio Department of Medicaid (ODM) to put in place a mechanism that ensures each enrollee’s ASP has the required signature. That signature ensures the enrollee has reviewed, understood, and agreed to the contents of the ASP.

OCVIC has learned that the signature is an audit item for ODM. With this change, enrollees will have greater access to effect change and remain in a setting of their choosing, making health care work better for them. OCVIC thanks ODM for putting in place this additional oversight to help improve lives of all consumers.