ODM Outlines MyCare transition plans
This week, LeadingAge Ohio staff met with the Ohio Department of Medicaid (ODM) to review its plans for transitioning the MyCare Ohio program to a fully-integrated dually eligible Special Needs Plan (FIDE-SNP) no later than 2025. ODM provided an overview of the “conversion charter,” a document required by the Centers for Medicare & Medicaid Services (CMS) that outlines the stakeholder process that ODM will engage in, how the FIDE-SNP will maximize integration, how it will provide ongoing support to the ombudsman after federal funding ceases, and other policy and operational steps that may be considered in the course of the conversation process.
One key decision that will need to take place ahead of the bidding process is the geographic region that the FIDE-SNP will cover, namely, whether the plan will be limited to the current MyCare counties, whether it will be statewide and if statewide, what new geographic boundaries will be needed (i.e., create a single statewide plan, keep existing regions and add a rural region, or redraw the regions altogether). Other considerations include how the FIDE-SNP will be integrated with other Medicaid NExt Generation structures like the Ohio Medicaid Enterprise System (OMES), including centralized credentialing and an anticipated fiscal intermediary, and other key considerations like improving transportation services and promoting more value-based contracting with nursing facilities.
ODM asked for initial feedback in six areas:
- Program location: state-wide, current coverage area, or another option
- Self-direction enhancements
- Care coordination arrangements and delegation
- Enhancing Behavioral health care coordination for younger members
- Network Adequacy Requirements
- Enrollment Broker Process
To weigh in on changes you would like to see in the MyCare conversion, email Susan Wallace at firstname.lastname@example.org.