2017 Atlantic States Fiscal Leaders Meeting Ohio Medicaid Pre-Release Enrollment Program

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1 2017 Atlantic States Fiscal Leaders Meeting Ohio Medicaid Pre-Release Enrollment Program Kara Miller, Chief Care Management and Quality Improvement Section February 25, 2017 M a k i n g Ohio B e tter

2 Ohio Medicaid Medicaid is Ohio s largest health payer. Over 90,000 hospitals, nursing homes and other providers deliver services for nearly 3 million individuals insured by Medicaid. 2014: Extended Medicaid eligibility to Ohioans aged at or below 138% FPL. 86% of Medicaid consumers are covered by contracted managed care plans available statewide. 2/17/2017 2

3 Ohio s Inmate Population 27 institutions located across the state There are currently over 50,000 inmates» 91.6% male, 8.4% female» Average age: 37 years male, 36 years female» Average stay in prison: 2.3 years» 18% of inmates are over 50 years of age High prevalence of chronic care, mental health issues, and history of drug/alcohol addiction Sources: ODRC Fact Sheet, February /17/2017 3

4 Medicaid Pre-Release Enrollment Program Program Partners:» Ohio Department of Rehabilitation and Corrections (ODRC) and Ohio Department of Medicaid (ODM)» Ohio Mental Health and Addiction Services (OhioMHAS) and Ohio Department of Health (ODH)» Medicaid Managed Care Plans» Medicaid Consumer Hotline 2/17/2017 4

5 Pre-Release Program Goals Access to Health Services Reduce Recidivism Improve Health Outcomes 2/17/2017 5

6 Pre-Release Program: Process Overview Pre-enrollment class Peer to Peer Medicaid Guides Enrollment class Sign Medicaid Authorization Provide forwarding address Complete Release of Information Medicaid eligibility determined If eligible, individual is enrolled in a managed care plan Pre-Release Care Management Available to individuals with high acuity of needs MCP care manager assigned who develops transition plan Reviews transition plan in video conference with individual Insurance card provided and individual successfully transitions to health care plan upon release If an individual chooses to opt-out, information is again provided about federal mandate and tax penalty If Medicaid is denied, individual can appeal decision 2/17/2017 6

7 Care Management: Who is Eligible?»Mental Illness»Substance Abuse»Chronic Condition»HIV Positive»Hepatitis C»Pregnancy Must meet two or more to qualify Qualify automatically 2/17/2017 7

8 Care Management: Transition to the Community Days prior to release 7 14 Days prior to release Date of release Pre-screen: Does individual qualify? MCP care manager assigned & develops transition plan Care manager and individual review transition plan via teleconference Individual receives final copy of transition plan and insurance card Post-Release Individual access health care services and maintains relationship with care manager. 2/17/2017 8

9 Accomplishments Trained 150 Peer to Peer Medicaid Guides Approximately 10,000 individuals able to access Medicaid benefits on day of release Approximately 1,500 individuals received transition assistance from an MCP care manager prior to release. 2/17/2017 9

10 What s to Come Robust program evaluation underway» Evaluate short- & long-term impact on program participants» Trend over time and compare with other Medicaid cohorts (Group VIII, ABD, CFC) Exploring opportunities presented in April 2016 SMD letter and partnership expansion opportunities 2/17/

11 Keys to Success Strong interagency partnerships with director level leadership Program design aligned with staffing and technology resources Piloting program with a slow ramp up was essential Strong communication across agencies and partners with ability to be agile 2/17/

12 Questions? Contact: Kara Miller Chief, Care Management and Quality Improvement The Ohio Department of Medicaid /17/

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