Provider Groups Praise Sentiments of Medicaid's Plans for Managed Care Bidding

The Ohio Department of Medicaid's second solicitation of feedback for the upcoming managed care bidding process shows the agency took providers' concerns to heart, numerous provider groups said in a memo to ODM Director Maureen Corcoran.

More than 20 associations representing physicians, hospitals and others signed on to a letter to Corcoran last week commending ODM for the direction taken in its second request for information (RFI) in the managed care re-procurement cycle.

Signatories include the American College of Emergency Physicians Ohio Chapter; LeadingAge Ohio; Ohio Academy of Family Physicians; Ohio Alliance of Recovery Providers; Ohio Association of Community Health Centers; Ohio Association for Treatment of Opioid Dependence; Ohio Children's Alliance; Ohio Children's Hospital Association; Ohio Community Corrections Association; Ohio Council of Behavioral Health and Family Services Providers; Ohio Counseling Association; Ohio Dental Association; Ohio Emergency Medicine Physicians Alliance; Ohio Health Care Association; Ohio Hematology Oncology Society; Ohio Hospital Association; Ohio Pharmacists Association; Ohio Psychiatric Physicians Association; Ohio Renal Association; Ohio Speech & Hearing Governmental Affairs Coalition; and Ohio State Medical Association.

Gov. Mike DeWine directed ODM to re-bid managed care contracts at the outset of his administration. The department put out its first RFI in June, seeking a more general array of feedback. The second RFI, issued a few weeks ago, indicates the ways ODM is seeking to build a more individualized care system and outlines roles for other vendors aside from managed care companies to assist in that goal. (See The Hannah Report, 2/4/20, 6/13/19.)

The provider groups said they were particularly heartened by indications ODM will try to standardize how providers deal with managed care plans.

"We are especially encouraged by the recognition of and support for increased standardization and reduced administrative burden in key areas such as billing, medical necessity determinations, credentialing and prior authorization processes among others. While these administrative issues may not appear to be transformative on their face, they will impact the Medicaid system in a profound way. As providers, we know that there is currently a huge administrative burden caused by six different standards and processes for daily activities like billing and prior authorization. This burden not only makes our work more costly and complex, but more importantly, it impedes the time and resources available for actual patient care. In the most simple, real world terms, we believe that streamlining these standards and processes means Medicaid providers can spend more time and resources actually treating the patient instead of shuffling through paperwork. It also means that more providers may be willing to accept Medicaid patients, thereby increasing access to care in a very meaningful way," the memo states.

The associations said they plan to give more detailed feedback on the second RFI as well, "both collectively and as individual organizations."


Story originally published in The Hannah Report on February 25, 2020.  Copyright 2020 Hannah News Service, Inc.