Ohio officials spread word on new Medicaid benefit

State officials are spreading the word about a plan to better coordinate care for Medicaid beneficiaries with severe mental illness who also face chronic medical issues, such as heart disease or diabetes.
Associated Press
Oct 15, 2012

Under the new service, providers would partner with doctors, pharmacists, social workers and others to better address the patient's mental and physical health needs.

The benefit is now available to Medicaid recipients in Butler, Adams, Scioto, Lawrence and Lucas counties. All of Ohio's 88 counties are expected to provide the service by next year.

Roughly 177,000 state residents could be eligible, but not all are expected to need or choose to get the service.

The state's Medicaid director and others planned to discuss the new benefit at an event Monday in Toledo.

Tracy Plouck, director of the state's Department of Mental Health, has said the idea of the new benefit is to lower future Medicaid spending on those with serious and persistent mental illness without cutting back their services.

People with mental illness represent about 10 percent of Ohio's Medicaid population but 26 percent of all Medicaid spending, according to state figures.

"This is an attempt to break down the barriers that currently exist between physical health care and mental health services," Plouck said in a statement. "By linking comprehensive, long-term medical and behavioral health to social services, we are hoping to assist more Ohioans in living healthier lives."

The so-called health home service is covered under an individual's current Medicaid plan, so there is no charge to the patient. Participation in the program is voluntary.

The benefit aims to get doctors and other health professionals to communicate with behavioral health centers about the patients' conditions and ways to improve their health. The idea allows for more sharing of electronic medical records and coordinating among medical professionals, socials workers and others.

For instance, a care manager at a mental health center could help a Medicaid beneficiary who has abscesses in his or her mouth get the much needed dental care. That coordination then leads to better health and likely helps the person avoid possible health complications down the road.

Care managers would also assist beneficiaries in finding a family doctor, nutritionist or other specialist. Under the service, patients will get reminders about regular medical check-ups and connections to transportation and child care.

Officials anticipate the service will lead to fewer, more expensive emergency room visits and nursing home and hospital stays.

 

Comments

grandmasgirl

First they need to weed out all the people who are faking mental illness. This is one of the hardest "illnesses" to diagnose. I know that there are many out there with this disease. I also know that there are people who fake it.

deertracker

Exactly how do you know this?

The Big Dog's back

Probably from looking in the mirror.

totallyamazed

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Medicare and/or Medicaid fraud by both patient and/or providers? There's no way that could be happening, yeah right.

I'd have to bet that those who are in need of serious mental health services don't receive it because:

A) They're not aware that there's something wrong with them.
B) They deny it due to embarrassment (though, mental health problems are as real and treatable in many cases as that of physical problems).
C) Programs have been yanked to help those truly in need.

As far as those milking the system on Medicare and/or Medicaid, a quick Google search on fraud concerning both these programs turns up a gazillion hits.
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