Director McCarthy outlines Ohio Medicaid enrollment reforms

Speaking at a meeting of the Health Policy Institute of Ohio’s Access Collaborative last week, Ohio Medicaid Director John McCarthy outlined several initiatives undertaken by the Kasich administration that are aimed at simplifying the process of enrolling in Medicaid.

“This is not an eligibility expansion, and it’s not a contraction either,” McCarthy said. “The purpose is just to make it easier to get into the program.”

McCarthy said his office is optimistic that the plan announced recently to allow certain providers across the state to enroll pregnant women and children in Medicaid almost immediately will ensure more of those who are eligible for the program will sign up. The practice, known as presumptive eligibility, is already offered for children in 17 states and for pregnant women in 31 states.

McCarthy said the administration also has applied for a waiver from the federal Centers for Medicare and Medicaid Services to further modernize the eligibility process, with a focus on Ohioans enrolled in the aged, blind and disabled category of Medicaid who live in a community setting.

Although Ohio Medicaid is in the process of making significant changes to the ways Ohioans enroll in Medicaid, at the same time that the state is preparing for dramatic changes to Medicaid in 2014 as part of the ACA, McCarthy said the state has no additional funds for outreach.

McCarthy said his office will be relying on partnering with community organizations to educate potentially Medicaid eligible populations about the changes in the program, with a particular emphasis on enrolling children who are eligible for coverage.  

“The issue for us is, how do we get local organizations to get the word out?” he said. “Our purpose is to make sure people who are eligible get the services they need, so we want to work with everyone we can to try to do better outreach and let people know how to get enrolled.”

 He also encouraged community organizations who provide care coordination services to the uninsured to reach out to Medicaid managed care plans to establish partnerships, acknowledging that local expertise should be part of the team approach to care for vulnerable Ohioans.