Increasing Coverage and Improving Medicaid Enrollment Processes in Ohio
Medicaid expansion had a considerable impact on the Cleveland community and their health care system by providing coverage to over 360,000 newly eligible Ohioans (as of August 2014). In 2014, although Ohio Governor John Kasich expanded Medicaid to cover more uninsured residents through the Controlling Board, the full state legislature had not approved it. This meant that Ohio was able to accept Medicaid funds from the federal government, but to continue doing so, the legislature must reauthorize this decision as part of a two-year budget cycle. Medicaid coverage allows individuals to get needed health care and supports the safety net infrastructure.
The Partnership for Cleveland Health Care Safety Net is the collaboration of five federally qualified health centers (FQHCs) and the area’s largest safety net hospital system, MetroHealth.
To achieve its goals, the Cleveland Partnership engaged in:
- Planning and executing events that highlight the increase in coverage and access to care because of Medicaid expansion.
- Educating policymakers about the importance of Medicaid for Cleveland’s safety-net providers and their patients.
- And convening a policy roundtable with key stakeholders to discuss the implications of the State Budget.
Resources and Support from the National Partnership
The National Partnership supported this initiative by providing information on policy options that could improve outreach and enrollment in Medicaid, as well as linking the partners with resources at the national level. The National Partnership also facilitated and participated in discussions with local stakeholders to help plan their educational efforts in Cleveland and statewide. The Cleveland Partnership had the unique opportunity to leverage their experiences with a Medicaid Waiver Demonstration that involved MetroHealth and two of their partner health centers. The National Partnership also assisted in examining any legislative or regulatory issues that are identified during the 2015 legislative session.
The Power of Collaboration in Increasing Coverage and Improving Medicaid Enrollment Processes
Addressing the issues of increasing coverage and improving Medicaid enrollment processes required a high degree of collaboration, as the Medicaid program significantly affects safety net providers and their patients. Historically, collaboration had been present amongst the FQHCs, and with MetroHealth, on various issues including local efforts to expand Medicaid coverage in Ohio, as well as improve access to care for uninsured and underinsured patients. Below are examples of past collaborative efforts:
- Northeast Ohio Medicaid Expansion Coalition (NEO-MEC): NEO-MEC is a partnership of religious congregations, health care providers, community organizations, businesses, insurers, medical professionals, consumer groups, and advocates working together to help the state expand Medicaid to all Ohioans now eligible under the Affordable Care Act.
- 1115 Waiver that involved MetroHealth and two FQHCs in their service area: The demonstration provided coverage to uninsured adults who have family income at or below 113% of the Federal Poverty Line, who reside in Cuyahoga County, and who are not otherwise eligible for comprehensive benefits under the Medicaid state plan. Eligible adults received benefits through the MetroHealth System and its community partner network providers.
- Cuyahoga Health Access Partnership (CHAP): is a non-profit organization dedicated to providing a coordinated system of healthcare access for the county’s low-income, uninsured adults. CHAP was founded on the principle of shared responsibility and is represented by its founding members, including hospital systems, community health centers, free clinics, local governments, foundations, and other key organizations in the Cuyahoga County health arena. CHAP’s first major initiative is the Access Plan, which makes it easier for uninsured adults to get the health care they need. Through its coordinated network, CHAP connects patients without insurance to providers whom offer discounted primary care and specialty care.
- Better Health of Greater Cleveland: Better Health Greater Cleveland is a regional healthcare improvement collaborative. Established in February 2007, initiatives and integrated programs are aimed at improving health care, health and reducing cost by providing high-quality and appropriate care. Primary care is the principal focus of Better Health’s work. Since 2007, Better Health has doubled the number of primary care providers to more than 600 in 69 practice sites of 10 health systems.
Further collaboration was fostered during the planning of a National Health Center Week 2014 event via the following steps:
- a team of staff from all organizations met on a consistent basis,
- all organizations were represented at the event,
- all partners shared responsibilities that were key to the success of the event (i.e. identifying and inviting speakers, venue, fundraising, budget, invitation, etc.),