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Ohio Medicaid Managed Care Procurement Update Medical Care Advisory - PowerPoint PPT Presentation

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Ohio Medicaid Managed Care Procurement Update Medical Care Advisory Committee (MCAC) Thursday, February 20, 2020 Managed Care Mission Statement Medicaid Managed Care Procurement Project Phases Current Phase RFI #1 RFI #2 Implementation,

  1. Ohio Medicaid Managed Care Procurement Update Medical Care Advisory Committee (MCAC) Thursday, February 20, 2020

  2. Managed Care Mission Statement

  3. Medicaid Managed Care Procurement Project Phases Current Phase RFI #1 RFI #2 Implementation, RFA and Feedback from Feedback from Readiness & Post Award Individuals & Potential Implementation Providers Bidders Gather input and Gather input on Communicate major Collaborate to ensure feedback from capacity to address milestones related to a smooth individuals and potential changes, RFA release, response implementation providers first based on feedback evaluation & contract and understand from individuals and award experience post- providers implementation The current focus of the managed care procurement is on gathering feedback to inform future design decisions. 3

  4. RFI #1 Feedback Snapshot A look at who has been providing input through RFI #1 Individuals We Internal ODM & Serve Others Partner As of February 10, Advocacy Agencies Organizations 2020, we have received a total of 965 responses to RFI #1 Providers Vendors Community-Based Provider Organizations Associations 4

  5. Listening Sessions with Individuals ODM traveled across the state to meet directly with managed care members Toledo Cleveland (3) Ashtabula Lake Lucas Fulton Williams Ottawa Lima Middlefield Geauga Cuyahoga Wood Erie Sandusky Defiance Henry Trumbull Lorain Portage Huron Seneca Summit Paulding Medina Putnam Mahoning Hancock Columbus (2) Akron & Barberton Ashland Crawford Van Wert Wayne Wyandot Stark Columbiana Allen Richland Hardin Carroll Auglaize Marion Holmes Mercer Morrow Jefferson Tuscarawas Knox Waverly Logan Lisbon Shelby Union Coshocton Harrison Delaware Champaign Darke Licking Miami Guernsey Belmont Franklin Muskingum Clark Madison Dayton Montgomery Steubenville Noble Preble Fairfield Monroe Greene Perry Pickaway Morgan Fayette Hocking Butler Washington Warren Clinton Ross Athens Vinton Cincinnati (2) Marysville Highland Hamilton Meigs Pike Clermont Jackson Brown Adams Gallia Scioto Ironton Marietta Lawrence 149 Individuals – 42 Partner Organizations – 19 Sessions 5

  6. RFI #1 Feedback from Individuals What we heard from individuals, caregivers and advocates Access to Services Member Experience Benefits Administration Providers & Treatment • • • • Access to specialty, Plan comparison Benefits are viewed as a FQHCs are a critical vision, and dental lifeline source of health care • Personalized care services • • Denials cause fear and Access to out-of-state • Up-to-date provider • Community uncertainty providers rosters organization • Perceptions about • Targeted and clearer partnerships benefit limits communications • Discrepancy between • Resources for • Robust care prior authorization understanding benefits coordination for processes • individuals with Differences between • Transportation complex needs managed care plan availability and cost benefits administration • Appreciation for • Enhanced access to • conducting meetings Confusion around care coordination outside Columbus Medicaid vs. Medicare 6 coverage

  7. RFI #1 Feedback from Providers & Associations What we heard from providers and associations Develop a single claims portal Centralized credentialing of all Medicaid providers by ODM Continue investment in Support providers’ value based purchasing activities to leverage models but ensure that community supports providers share in the (through dollars or risk/reward technology) to connect individuals to social Medicaid services organizations Service Delivery Innovations Ensure coordination of care for multi-system Standardize prior youth through seamless authorization delivery of services requirements and forms Support integrated networks of electronic Enhanced care coordination model for medical records for all providers and individuals with the most complex managed care organizations to allow behavioral health needs (e.g. mental necessary access to patient data heath and/or substance use disorder)

  8. RFI #2 Overview Outlining our vision to implement some of the most innovative health care reforms in the country Goals for a Reimagined Medicaid System in Ohio Improve Emphasize a Improve Care Increase Support Wellness and Personalized for Children Program Providers in Health Care and Adults Transparency Better Outcomes Experience with Complex and Patient Care Needs Accountability 8

  9. RFI #2 Input Requested Improve Wellness and Health Outcomes To improve health outcomes and support individual wellness, ODM invites input on ways to formalize coordinated care partnerships between community-based organizations and managed care Improve organizations that will reduce infant mortality and preterm births, Wellness and increase healthy behaviors, promote tobacco cessation, and address Health health care inequities. Outcomes 9

  10. RFI #2 Input Requested Emphasize a Personalized Care Experience The RFI invites ideas that strengthen the managed care organization and provider capabilities to deliver more personalized care. It seeks feedback on improving member-provider communications, technologies to Emphasize a increase consumer engagement and programs to enhance wellness Personalized behaviors and outcomes for individuals and their families as they access Care a continuum of care tailored to their unique needs. Experience 10

  11. RFI #2 Input Requested Support Providers in Better Patient Care In order to better support providers, ODM requests ideas and best practices to reduce administrative burdens such as centralized Support credentialing, standardized authorizations, and simplified medication Providers in management. Better Patient Care 11

  12. RFI #2 Input Requested Improve Care for Children and Adults with Complex Needs To strengthen care for children and adults with complex medical and behavioral health needs, ODM plans to develop a formalized model of care coordination, to tailor behavioral health services to meet the unique needs of children served by multiple state systems and children Improve Care with other complex behavioral health needs, and to create robust for Children partnerships between community-based organizations and managed and Adults care organizations. with Complex Needs 12

  13. RFI #2 Input Requested Increase Program Transparency and Accountability Program transparency through the use and analysis of real-time, reliable data can dramatically strengthen care oversight and outcomes. ODM seeks input to enhance data analytics and consumer health care Increase dashboards, such as its newly introduced unified prescription drug list, Program to streamline support and drive accountability across the continuum of Transparency care. and Accountability 13

  14. RFI #2 Milestones & Considerations Key things to know about the RFI #2 phase of the managed care procurement RFI #2 Timeline Additional Resources February 4, 2020 We are committed to ongoing, two-way RFI #2 released communication between stakeholders and ODM February 12, 2020 Managed Care Procurement Website Question & Answer (Q&A) managedcare.medicaid.ohio.gov period closes at 8:00 a.m. EST March 3, 2020 Managed Care Procurement Mailbox RFI #2 responses due at MCProcurement@medicaid.ohio.gov 4:00 p.m. EST March 16 - 27, 2020 ODM interview period and request for clarifications April 3, 2020 Request for clarification closes at 8:00 a.m. EDT 14

  15. Questions? Ohio Medicaid managed care procurement 15

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