Ohio Medicaid director outlines $3.6 billion cost-containment plan and next-generation managed care expansion

Maureen Corcoran, director of the Ohio Department of Medicaid, told the House Medicaid Committee on March 3 that the governor's budget includes cost-containment measures and program priorities intended to hold down state spending while expanding targeted services.

Corcoran said the budget reflects two years of “next generation” reforms that combine delivery-system redesign with new information technology. “If we can't see the care, we can't see the medications, we can't see who's getting paid,” Corcoran said, arguing that Ohio's Ohio Medicaid Enterprise System (OMES) and centralized pharmacy benefit management have greatly increased transparency and operational efficiency.

The nut graf: The Department projects more than $3.6 billion in state general revenue savings, including programmatic changes (eligibility and utilization management) and revenue offsets. The plan relies on managed-care delivery reforms, an expanded centralized pharmacy program, and a mix of hospital financing adjustments tied to quality metrics.

Most important details first: Corcoran credited the single pharmacy benefit manager and OMES for delivering both administrative…