EDITORIAL: Don't make the state wait for managed care in nursing homes

June 16--The Ohio Senate must make up its mind: Follow the lead of Gov. John Kasich or take a page from the House and delay the shift of long-term health services and supports to managed care. The Senate version of the two-year state budget, released this week, leaves the question open.

Perhaps there is a middle way, as suggested by Larry Obhof, the Senate president, in an interview with the Gongwer News Service. Ohio would be better served by the governor's approach. Two dozen or so states already have made the move. They largely have experienced improved health quality and outcomes, along with savings.

The governor's Office of Health Transformation has conducted MyCare Ohio, a pilot program, the past three years. It reports significant progress of late, including a 4 percent reduction in the use of nursing homes, more recipients remaining in the less expensive alternative, or where they prefer to be -- in their homes.

The concept is familiar, seeking to depart from the traditional, and costly, fee-for-service model to improved coordination and deployment of care. Ohio long has lagged behind the advances of other states, reflecting, in part, the political clout of the nursing home lobby.

It has been discouraging to see the state rate poorly for the performance of nursing homes. A recent study by the Scripps Gerontology Center at Miami University found that nursing homes in the state scored below the national average in 10 quality measures.

It matters then that an AARP scorecard shows the state achieving gains, climbing from 44 to 34 among the states in the quality of its long-term care services and supports. The governor and his team deserve credit for pressing the case for managed care, engaging in tough battles others have ducked.

Not that this effort has gone smoothly. The MyCare Ohio pilot has had a bumpy path, especially in making timely payments and processing prior authorizations. Those troubles help to explain the delay proposed by the House, the implementation date pushed back to 2021, allowing time for study.

Actually, study makes sense, this effort, as events affirm, requiring constant evaluation. What the Senate shouldn't miss is there is room for study -- and moving ahead.

MyCare Ohio not only saves the state $2.4 million per month. It has made strides in repairing its shortcomings. That is evident in the Ohio Association of Area Agencies on Aging, Leading Edge Ohio and the Academy of Senior Health Sciences voicing their support for going forward without delay.

They took their concerns to the administration and opened a dialogue for addressing them.

That kind of conversation must continue. It will prove most valuable if it is part of a stronger commitment to reshaping long-term care. A leading priority of Senate budget has been finding savings. MyCare Ohio fits the profile. It also has delivered higher quality. Hard to imagine? Ask the states that have launched and realized success. Ohio shouldn't wait to take the next step.

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