By Catherine Candisky
Despite higher-than-expected enrollment of Ohioans newly eligible for Medicaid, overall costs of the tax-funded health-insurance program in the most-recent fiscal year were nearly $2 billion below original estimates.
According to a report released on Wednesday by Gov. John Kasich's administration, total Medicaid spending was $23.5 billion in the fiscal year that ended June 30; that was 7.6 percent less than projected.
State Medicaid officials credited a number of recent initiatives and efficiencies in the health-insurance program, which now covers 3 million poor and disabled Ohioans.
Medicaid Director John McCarthy said savings have been achieved through expanded home-based care for seniors, shorter nursing-home stays, expanded managed care, capitated reimbursement policies -- pay per patient rather than per patient visit -- and other cost-controlling efforts.
"This is a good example of where you have better management tools, you can better manage the program and control costs," said Greg Moody, director of the Governor's Office of Health Transformation.
The program also has new automated systems to more accurately determine the eligibility of applicants and to pay care providers. As of May, about 90,000 people who were no longer eligible had lost benefits.
Moody said work continues on improving primary care by focusing more on keeping people healthy rather than just treating them when they are sick, and by more efficiently treating the most common conditions, such as high blood pressure and diabetes.
The state's lower-than-anticipated tab came in the wake of Kasich's controversial decision two years ago to expand Medicaid under President Barack Obama's Affordable Care Act.
Expanded eligibility brought more than 500,000 low-income adults without dependent children onto Medicaid rolls last year, pushing overall enrollment to nearly 3 million. Although enrollment in the expansion population was 150,000 higher than anticipated, state officials said, it was offset by a drop in traditional enrollment.
"The improving economy has helped move people off Medicaid and into the (health-insurance) exchanges," said state Sen. Dave Burke, who chairs the Joint Medicaid Oversight Committee.
The panel has closely watched per-member, per-month costs to gauge the success of cost-saving initiatives. The goal, Burke said, is to limit increases in the state's share of Medicaid costs to 4 percent or less a year.
Ohio Medicaid spending grew 3 percent in the most-recent fiscal year, down from 4.6 percent in the previous year.
"We want this to continue," Burke said. "It's good public policy regardless of who is governor."
(c)2015 The Columbus Dispatch (Columbus, Ohio)