Wednesday, November 06, 2013

Health Watch Wednesdays | Give Kasich his due on Medicaid Expansion

Ohio's Governor follows President's lead with positive reforms of his own
We have lived with Gov. John Kasich long enough to know the good and the bad. We can’t forget his heartless balancing of the state budget on the backs of local municipalities and school districts. Indelible also was his ruthless attempt to squash working men and women who choose to be unionized.

Alongside these substantial negative markers must now be placed his leadership in securing Medicaid expansion in Ohio. We were among those skeptics who thought he might be content to be on record in favor of expansion, while allowing the Neanderthal Republicans to strangle Medicaid expansion by bogus “reform” initiatives.

Today we listened to Greg Moody, the director of the governor’s Office of Health Transformation address a select group of health industry providers and advocates. He was speaking at the Cleveland Clinic as keynote for the final installment of the Center for Community Solutions’ 2013 Health and Human Services Institute. The event was in Bunts Auditorium on the Clinic’s main campus.

 Asking the question, “Why do we pay for more and more and more instead of better and better and better?” Moody laid out a convincing presentation of the Kasich administration’s efforts to reform Ohio’s horrific healthcare system. Dubbed the Ohio Health and Human Services Transformation Plan, Moody presented the critical path approach to modernize Ohio’s Medicaid regime, streamline the state’s health and human services, and to establish a closer and more rational relationship between the cost of health care services and the value of the services rendered.

“We pay for individual units of service so we get a lot of individual units of service,” Moody said, “whether they improve health outcomes or not.” Moody was recruited to Ohio by Kasich to lead efforts to rationalize Ohio’s health care policies, reform the labyrinthine paths by which such healthcare is delivered, and to correlate cost to value.

One desired goal of this effort is to improve Ohio’s dismal standing as a state with relatively high per capital health care costs while having being in the bottom quartile in terms of health outcomes.
States listed L to R in order of best health outcomes. Ohio is in red.
Moody effectively drove home the Governor’s commitment to a sounder health care system when he showed a slide that depicted all of Kasich’s top aides focusing on strategies to secure a favorable ruling on Medicaid expansion from the state’s Board of Control. That outcome came late last month after what Moody depicted as an intense two-month effort ordered by Kasich to secure such a ruling.

Of course, nowhere in Moody’s presentation, or even in the panel discussion that followed, was there any direct mention of the Affordable Health Care Act, sometimes referred to as Obamacare, much less any acknowledgement that this historic legislation was a catalyst to the state’s reform efforts, or the reform efforts of the healthcare industry in general.

Moody did acknowledge “poverty is highly correlated” to all kinds of negative health outcomes, and flatly declared that addressing poverty is the surest way to improve the health of Ohioans.

Most interesting to us in the panel discussion that riffed on Moody’s mood was the common sense assertion by Thom Craig that “mental health care should be integrated into regular health care system.” Craig, the senior program officer for mental health of the Margaret Clark Morgan Foundation, said that “we are all a little bit mentally ill and we are all a little bit mentally well.”
Rita Horwitz, Better Health Greater Cleveland
Michael McMillan, Cleveland Clinic

Thom Craig, Margaret Clark Morgan Foundation
Also on the panel were Rita Horwitz, RN, the director of business development and operations for Better Health Greater Cleveland, and Michael McMillan, executive director of market and network services for the Cleveland Clinic.

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