Office of Health Transformation Update
May 16, 2017
Demonstrating Value 
A new study published by the National Association of States United for Aging and Disabilities (NASUAD) describes the benefits for states that have adopted managed long term services and supports (MLTSS).  These states report that relying on private sector managed care plans to coordinate long term services and supports has allowed them to:
  • Improve member experience, quality of life, and health outcomes;
  • Rebalance Medicaid spending away from institutions to home and community based alternatives;
  • Reduce waiting lists for home and community options and increase access to services; and
  • Increase budget predictably and manage costs.

Ohio has achieved similar results through the MyCare Ohio program, which relies on managed care plans to coordinate services for Medicare-Medicaid enrollees in 29 counties. In just three years, MyCare plans reduced nursing facility stays four percent and decreased per member costs 6.8 percent. Currently MyCare plans save the Medicaid program and Ohio taxpayers $2.4 million every month.

Governor Kasich's budget would build on the success of MyCare and MLTSS programs in other states by extending the benefits of managed long term services and supports to more Ohioans. It would set aside the current one-size-fits-all reimbursement system that pays nursing facilities and other providers without regard to quality and instead rely on private sector managed care plans to pay more for quality as an incentive for providers to improve. The House of Representatives voted to delay these reforms until 2021 and the issue is now under consideration in the Ohio Senate.

Demonstrating the Value of Managed Long Term Services and Supports
MyCare Ohio Report