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Thursday, December 5, 2013

MyCare Ohio: Education Forum helps, but much more information needed

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Of the people who responded to a survey about the recent MyCare Ohio Education Forum, most reported they gained better understanding of the state’s new managed care system, but it is clear that much more information is needed.

“MyCare Ohio is a work in progress with many yet unanswered questions,” one survey respondent wrote. “More information will be forthcoming that will help consumers understand their options and responsibility.”

In answer to a question about the most important thing they learned, another person wrote: “…that there is a lot more education needed by providers and care managers.”

More than 300 people attended the event which was presented by Council on Aging (COA) November 20 at The Vineyard in Springdale. Those attending represented home health providers, assisted living and nursing home facilities, hospitals, COA staff members, and other health care and social service organizations.

Council on Aging was the first Area Agency on Aging in Ohio to present a MyCare Ohio information event. It was targeted to professionals who provide services to people who are eligible to enroll in MyCare Ohio. The goal of the meeting was to help professionals better understand the new system and its impact on their organizations and the people they serve.

What is MyCare Ohio?

MyCare Ohio is a new system of managed care plans which have been selected by the state to coordinate the physical, behavioral, and long-term care services for individuals over the age of 18 who are eligible for both Medicaid and Medicare. This includes people with disabilities, older adults and individuals who receive behavioral health services.

Enrollment in MyCare Ohio is mandatory for those who are eligible. Voluntary enrollment begins March 1, 2014 with mandatory enrollment effective May 1, 2014. Ohio Department of Medicaid will send people instructions on how to enroll. In our five-county region, people will select to join one of two managed care health plans which the state has selected to serve our area: either Aetna Better Health of Ohio or Molina Healthcare.

The goals of MyCare Ohio are to improve health, enhance care, and reduce costs for a vulnerable segment of the population. Known as “dually-eligible” because they may receive benefits from both Medicare and Medicaid, these individuals tend to be frail, have complex medical conditions, have low incomes, and are in need of more support to access and coordinate the care they need.

People may choose to opt out of the Medicare portion of their plan in order to receive Medicare services from doctors and other providers who might be outside the plan network. But those who opt in for both Medicare and Medicaid services, will have the convenience and coordination of one place to contact for their health care, long-term care, and behavioral health needs.

Lots of questions

Presenters at the event included representatives of Ohio Department of Medicaid, Council on Aging, Aetna, Molina, UHCAN’s Ohio Consumer Voices for Integrated Care project, and the Center for Independent Living Options.

Nearly one-fourth of those who attended the event responded to the emailed evaluation survey. Asked to mention something that was not adequately addressed or answered, people gave many responses, including:

  • Benefit packages available from the health plans (Aetna and Molina)
  • Concern about capacity of the state’s Medicaid hotline as the point of inquiry for people enrolling
  • Coordination with hospice benefits and services 
  • Role of care managers and waiver service coordinators
  • Enrollment process
  • Details on payment rates and processes
  • Impact on billing by skilled nursing facilities
  • Effect on people who have Medicare Advantage Plans, in addition to Medicaid services

…and more!

Council on Aging is trying to share more information as it becomes available from the Ohio Department of Medicaid and share links to organizations with key roles in MyCare Ohio.

Click here for MyCare Ohio information on our web site, including a page for consumers and a page for providers.

Please help us reach more people by forwarding information to others and encouraging them to sign up  to receive updates. 

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