Health care access and Medicaid in Ohio
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Transcript of Health care access and Medicaid in Ohio
Health Care Access and Medicaid in Ohio
WILL PETRIKSTATE DIRECTOR
GAIL CLENDENINCOMM. DIRECTOR
a statewide coalition of over 470 organizations working together to promote health and human service budget and policy solutions so that all Ohioans live better lives.
Advocates for Ohio’s Future is…
Click here to endorse our missionor
go to www.advocatesforohio.org
Join our coalition to advocate for strong families and communities.
We’re Moving!
On October 10 AOF is moving to:
37 West Broad Street, Suite 1100 Columbus, OH 43215
Although we are moving, our phone number and email address will remain the same. We will continue to share office space with the Public Children Services Association of Ohio (PCSAO) in our new location.
• Help you take action for strong families and communities in many issue areas
• Inform & Share Resources
• What’s happening at the state level?
AOF’s NEW Monthly Webinar Series
Col Owens - Co-Chair of Advocates
for Ohio’s Future and Senior Attorneyat Legal Aid of Southwest Ohio
Julie Di Rossi King - COO of
the Ohio Association ofCommunity Health Centers
MEDICAID EXPANSION 2013
• High AOF priority for 2013 budget
• AOF leadership played key roles in statewide coalition work and in regional coalitions
MEDICAID EXPANSION 2013 Expansion through
Controlling Board action
Controlling Board action sunsets June 30, 2015
Health Care Access and Medicaid in Ohio
Julie DiRossi-King, COO Ohio Association of Community Health CentersOctober 9, 2014
ACCESS – QUALITY - VALUE
Our Missions
10/2/201411
OACHC To ensure access to
high-quality affordable health care for all Ohioans through the growth and development of Ohio's Community Health Centers.
Health Center To provide
comprehensive, culturally competent, quality primary health care services to medically underserved communities and vulnerable populations.
ACCESS – QUALITY - VALUE
Ohio Association of Community Health Centers (OACHC)Professional trade association representing Ohio’s Federally Qualified Health Center (FQHC) and Look-Alike (FQHC LA) networks (commonly referred to as CHCs) 43 FQHCs and FQHC LAs in Ohio Healthcare home and family doctor for more than 550,000
Ohioans annually, representing over 2M patient visits Providing high-quality, affordable, primary and preventive
health care and care management services regardless of insurance status or ability to pay
Over 205 locations in 55 of Ohio’s 88 counties
1210/2/2014
ACCESS – QUALITY - VALUE
Medicaid Extension – Background Info In 2013, approximately 1.5 million
uninsured Ohioans
Oct. 2013 - under the leadership of Governor Kasich coupled with actions of the Controlling Board, Ohio extended Medicaid eligibility for adults up to 138% FPL ($27,000 for a family of three) effective January 2014 through June 30, 2015
10/2/201413
ACCESS – QUALITY - VALUE
10/2/201414
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Medicaid Extension – Background (cont’d) Dec. 2013 - Benefits.Ohio.gov opened
for enrollment (coverage effective Jan 1 2014)
In the first six months (through June 30, 2014), more than 592,390 Ohioans were connected to Medicaid coverage, including 338,707 individuals who were "newly eligible".
10/3/201415
ACCESS – QUALITY - VALUE
Medicaid Group 8 Enrollment*Health Policy Institute of Ohio
www.healthpolicyohio.org
10/3/201416
ACCESS – QUALITY - VALUE
Ohio Marketplace Enrollment*Health Policy Institute of Ohio
www.healthpolicyohio.org
10/3/201417
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Medicaid Presumptive Eligibility PE is used by states to provide
immediate access to needed health services while completing the application process for coverage in Medicaid and the Children’s Health Insurance Program (CHIP).
2014 - Ohio delivered PE functionality to allow hospitals and FQHCs to enroll all patients directly into Medicaid
10/2/201418
ACCESS – QUALITY - VALUE
Ohio Enrollment Coalitions Ohio Network for Health Coverage and Enrollment
(ONCE) ensures outreach, education and enrollment efforts in Ohio are coordinated and effective
ONCE brings together statewide, regional, and local organizations to foster collaboration and help uninsured Ohioans understand and enroll in new coverage opportunities.
For more information and to join the ONCE network, please visit www.onceohio.org
Regional Coalitions for local assisters including Cleveland Cincinnati Columbus Dayton and more
10/3/201419
ACCESS – QUALITY - VALUE
Snapshot of Ohio’s Consumer Assistors Navigators
At least 75 in Ohio
Certified Application Counselors (CACs) Approximately 450 in Ohio 300 providing services at 130 of the 200+
FQHC sites (providing over 115K consumer assists thru 6.30.14)
County Department of Job and Family Services Ohio’s Managed Care Plans
10/3/201420
ACCESS – QUALITY - VALUE
Role of FQHC CACs CHCs will raise the awareness of affordable
insurance options and provide in-person eligibility and enrollment assistance to current uninsured patients and the community by:
Hire new staffTrain existing staffConduct in-reach, community outreach and
educationHelp consumers understand coverage optionsHelp consumers determine eligibilityHelp consumers enroll in the Marketplace,
Medicaid, or CHIP Nationally, CHC assisters accounted for 26% of all
assisters in year 1
10/3/201421
05/03/202322
Eligible but not yet Enrolled Uninsurance rate for Ohio adults between the ages of
18 and 64 fell from 17 percent last year to 11 percent in May 2014, leaving 800K Ohioans w/o health coverage
Hard to Reach Populations – “trusted messengers” needed for:
Communities of color Ethnic and refugee communities Rural communities LGBTQ communities Veterans Homeless ACCESS – QUALITY - VALUE
05/03/2023
ACCESS – QUALITY - VALUE
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Common Health Behaviors of Newly-Enrolled but Long-term Uninsured
High rates of untreated multiple chronic health conditions, mental illness, substance abuse, etc.
Inappropriately use the ER for primary care (non-emergency needs)
Uncertain how to navigate the health care landscape
05/03/2023
ACCESS – QUALITY - VALUE
24
From Coverage to Care Medicaid managed care plans, community
organizations, and FQHCs and other providers are teaching newly insured to use healthcare appropriately
Increase consumer health literacy Insurance terminology (deductibles co-pays, renewal,
etc.) What’s covered How to find a provider How to be an active health care consumer When to seek emergency care
ACCESS – QUALITY - VALUE
Ohio’s Medicaid Program Moving Forward Expect Gov. Kasich will include funding
for the continuation of the extension of Medicaid in his SFY 2016-17 budget
However it is unclear exactly what it will look like once introduced and as it moves through both legislative chambers
10/3/201425
ACCESS – QUALITY - VALUE
10/2/201426
Thank You!For additional information please visit the OACHC website at www.ohiochc.org
OACHC4150 Indianola AvenueColumbus, Ohio 43214614.884.3101
Julie DiRossi-KingChief Operating [email protected]
Looking Forward to 2015 State Budget
Col Owens
2015 BUDGET: MAINTAIN PRESENT MEDICAID PROGRAM
• Controlling Board action sunsets June 30, 2015, closure of next budget session
• Controlling Board not a viable option for re-approval
• Likely 400,000 newly eligible enrollees by 2015
• Hopefully harder to take health care away from people than not give it to begin with
GRASSROOTS WORK WITH LEGISLATORS
• Regional Coalitions reconvening, educating grassroots activists regarding new situation
• Need for documentation of successes of Medicaid in 2014, i.e., development of stories
• Need for regional activists to meet with, educate legislators on successes and benefits
• Need for maximum media coverage of benefits of 2014 program
GOAL: MAINTAIN, NOT EXPAND, MEDICAID
• Do not use phrase “Medicaid expansion” in 2015 budget advocacy
• Instead, focus on maintaining the program we presently have,
– “health care access” or “Medicaid program” as a whole
• As alternatives to taking Medicaid down, may be proposals to “reform” it. Examples
– Arkansas model, buy all into insurance– Indiana model, put all into HSA’s
Our Challenge: Share the Success of Healthcare in Ohio
Will Petrik
WHY SHOULD WE USE STORY TELLING FOR ADVOCACY?
• They put a human face on issues surrounding Medicaid• Personal stories have a greater impact on lawmakers than
numbers alone• Help to show that the impact of Medicaid expansion is wide
and deep. The impacts are statewide and affect:• Individuals• Communities• Families• Businesses
WHAT DOES A STORY LOOK LIKE?
• A brief essay• A short video• Legislative testimony• A story in the media
Click here to check out examples of Medicaid stories.
TIPS FOR COLLECTING STORIES:LISTEN AND ASK GOOD QUESTIONS!
• Before questions - provide details that help readers understand that not having access to health care could happen to anyone, which will help the reader relate to the challenges the storyteller faced.
• What was your health situation prior to having Medicaid/coverage?
• What was your employment prior to having Medicaid/Coverage?• Were there other causes for not having health coverage or
having insufficient health coverage (i.e. a major life change)?
EXAMPLE QUESTIONS CONTINUED
• After questions - provide details about how the storyteller’s situation changed after gaining Medicaid/coverage.
• Has your health situation changed since having Medicaid/coverage? If so, how?
• Did your financial situation change after you obtained Medicaid/coverage?
• What difference has having coverage made in your life?
WHO MAKES A GOOD STORYTELLER?
• Consumers - emphasis on how coverage has benefitted them
• Employers• Veterans• Social Workers• Primary Care Providers• Criminal Justice System
• Churches• Dental/Dentists• Behavioral Health Providers• Child Welfare• Navigators/Certified Application
Counselors/other enrollment specialists
Akron: Contact Tracy Carter at [email protected], 234-312-5257 or Thomas Turner at [email protected], 330-489-1421
Cincinnati/Southwest Ohio: Contact Col Owens at [email protected], 513-362-2841 Next meeting: October 16 at 10 a.m. at Interact for Health, Rookwood Tower 3805 Edwards
Road, Cincinnati, OH 45209. RSVP to Col Owens.
Columbus: Cathy Levine at [email protected], 614-456-0060 ext. 222 Next meeting: October 21 at 3 p.m. at the Ohio Hospital Association, in the PNC Building, 155
East Broad Street, Columbus, OH 43215. RSVP to Cathy Levine.
Dayton: Contact Jessica Mead at [email protected] or 614-255-4615
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JOIN YOUR LOCAL MEDICAID ADVOCACY COALITION
JOIN YOUR LOCAL MEDICAID ADVOCACY COALITION
Northeast Ohio: Contact Loren Anthes at [email protected] or Marcia Levine at [email protected] Next meeting: Tomorrow at 9AM. The call-in number is 1-605-475-5950. The passcode is:
9409397.
Southeast Ohio: Contact Julie DiRossi-King at [email protected], 614-884-3101 ext. 226 Next meeting: October 15, 11 a.m. The call-in number is 1-800-250-2600 followed by code
2204999#. RSVP to Julie DiRossi-King. Toledo: Contact Tim Schneider at [email protected], 419-469-
3710 or Barb Petee at [email protected], 419-469-3894
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TAKE ACTION: ENSURE MEDICAID FUNDING CONTINUES
1. Submit one health care story to OhioSPEAKS by the end of
November
2. Join your regional Medicaid advocacy coalition
Q&A
• Unmute using the phone icon on top center of
your computer screen or by pressing *6 on
phone
• Type your question into the chat bar
COMING UP NEXT
Webinar on Thursday, November 13 10-11:00 A.M.
Adult Protective Services: Building a statewide system that protects older Ohioans
Stay tuned for the release of health care videos from Advocates for Ohio’s Future
Advocates for Ohio’s Future37 West Broad St., Suite 1100Columbus, OH 43215www.advocatesforohio.org
Will Petrik | [email protected]
Gail Clendenin | [email protected]