ProMedica officials meet with DeWine over Medicaid

Aug. 21--ProMedica leaders working to make the health-care system's insurance arm financially viable took their concerns about the expense of Medicaid coverage to Columbus this week.

Paramount Health Care Inc., a ProMedica subsidiary, posted a $28.5 million first-quarter operating loss, prompting the insurance firm to consider dropping Medicaid coverage if it proves economically unsustainable. Paramount is one of five insurance providers that administers the Ohio Department of Medicaid's plans, which provide health-care coverage to more than 2.9 million Ohioans.

ProMedica President and CEO Randy Oostra, Paramount President Lori Johnston, Paramount Chief Financial Officer Jeff Martin, and Paramount Board Chairman Jim White met Tuesday with Gov. Mike DeWine and Medicaid Director Maureen Corcoran to discuss their concerns.

Dan Tierney, a spokesman for the governor, said Mr. DeWine "is always willing to meet with" Medicaid managed-care providers, such as Paramount.

"He's done this with others in the market here in Ohio and will continue to take the meetings," Mr. Tierney said.

ProMedica officials in June said Medicaid membership has shifted to those with greater health-care needs and ensuing higher costs, adding reimbursement rates can lag behind the trend. In a June conference call with investors, ProMedica Chief Financial Officer Steve Cavanaugh called the financial struggles "an industrywide issue in the state of Ohio."

"I think ultimately if we are not able to find a way to get this business to where it's economically sustainable, we would ultimately probably choose to exit the business," he said. "Now, we are hopeful that's not the outcome. We want to stay in this business."

ProMedica is a participating Medicaid health-care provider, and officials have said that status would not be affected if Paramount stops administering Medicaid plans.

"Since we are still in the process of exploring how, together with the state, we could overcome the challenges associated with offering the Medicaid product line, we do not have any additional information to provide at this time," ProMedica spokesman Tausha Moore said in a statement. "Our goal is to continue to be a leader in servicing the Medicaid population."

Paramount serves about 240,000 people in the statewide Medicaid plan. Officials have said if the provider does get out of the Medicaid business, they would work with the state to transition those affected to another participating Medicaid plan so no one would lose coverage.

The other statewide plans are administered by Buckeye Health Plan, CareSource, Molina Healthcare, and UnitedHealthcare. Low-income individuals, pregnant women, infants and children, older adults, and people with disabilities may qualify for Medicaid coverage in Ohio, according to the state department.

Staff writer Jim Provance contributed to this report.

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