OPLC Releases Report

New Medicaid Managed Care Contract Positions Ohio to Substantially Improve Access to Health Care for Vulnerable People

Columbus—Today, the Ohio Poverty Law Center released its report, A Brighter Future for Ohio’s Medicaid Managed Care Program, which examines provisions of the new Medicaid Managed Care contract that should improve legal aid clients’ ability to access services. The Ohio Department of Medicaid released its Request for Applications for the provision of Managed Care health care services to Ohioans enrolled in the program on September 30, 2020. The Department is expected to award contracts as early as this week.

“If fully implemented and enforced, the new Medicaid plan can dramatically improve program performance and outcomes for the one in four Ohioans who receives health care coverage through Medicaid managed care,” said Graham Bowman, staff attorney for the Ohio Poverty Law Center. “The new contract positions Ohio to make substantial improvements in addressing access issues for low-income Ohioans.”

The Ohio Department of Medicaid sought comments on the state of its managed care program from Medicaid recipients, advocates, and other consumer stakeholders throughout 2019 and received nearly 1,000 responses. The legal aid community responded by highlighting multiple issues that needed to be addressed to better serve low-income Ohioans. The report highlights four areas where the new contract makes improvements that can significantly improve the managed care program:

  • Services to children, especially those with complex health issues,
  • Grievance and appeals process requirements for contracted plans,
  • Care coordination, and
  • Social determinants of health.

“Improved care coordination and financial support for community-based organizations will improve care and address social determinants of health,” Bowman continued. “We are hopeful that the words in the contract will be transformed into action by the companies selected to carry Ohio’s Medicaid managed care program forward.”