Advocates worry about Medicaid change
The state currently gives county
The current state budget, however, authorizes replacing the county-based system with a statewide, third-party “transportation broker” to manage non-emergency medical transportation services.
States are federally required to provide Medicaid recipients with non-emergency medical transportation services. Most states use third-party brokers to coordinate it, paying them a set amount per person, said
Whether run by a statewide broker or at the county level, Musumeci said, providing Medicaid-insured people with non-emergency transportation is generally cost-effective for states because it helps avoid more expensive treatment later if people require an emergency room visit or hospitalization. Paying a fixed amount per person also provides states with cost predictability, she said.
Unique challenges
State Rep.
“We think people here know the area better and can devise a plan specifically for what the people here need,” Edwards said.
Nelsonville resident
“It’s really a help,” Nelson said. “I do use it. I hope they keep it.”
The change is needed because the current system works inconsistently in delivering transportation services from county to county, and has limited accountability for what is provided and how the money is spent, Ohio Medicaid spokeswoman
“The goal is to provide consistent transportation services for all Ohioans covered by Medicaid and more efficiently arrange for their transportation needs,” Ayers said.
Details on potential savings to the state are not known yet, she said.
Rural, southeastern and southern
“We have a higher percentage of poor people; poor people are less likely to have their own transportation and people have to travel farther to get medical services,” he said.
In comparison, Frech said, metropolitan counties have medical professionals located closer to where people live, and people also have more access to public transit. This is why the average non-emergency transportation cost per Medicaid patient generally is lower in metro areas than in the rural, Appalachian counties.
Frech is concerned that a statewide broker paid a set amount per person to run transportation services could wind up making money in the urban counties and losing money in Appalachian Ohio areas. He fears that could lead to reductions in the transportation services available in his region.
Unanswered questions
Some states like
Reports by the
More generally, advocates for the poor are concerned that paying transportation brokers fixed amounts could lead the brokers to reduce services, said
“By definition, capitated means you get to keep more money the less you spend providing services,” she said.
Uncertainty about Ohio’s proposed system is prompting questions.
Among a total combined population of about 120,000 in Hocking,
His agency has contracts with 15 transit services, including
“In our part of the state, where transportation is such a barrier for low-income people, it is imperative that systems to address the issue are created with as much local input and decision-making capability as possible,” Zielinski said. “We do not believe that a statewide, or even regional, system will be able to individually address all of the unique challenges our part of the state faces.”
Ohio Medicaid currently spends approximately
Ohio Medicaid officials will continue to seek community input in developing the new system, she said. When the new system will start has not been established.
CREDIT: MARY BETH LANE
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