Health and Human Services (HHS) Secretary Kathleen Sebelius today announced to reporters on a conference call Thursday the first recipients of State Innovation Model awards, enabled through the Affordable Care Act.
Sebelius, daughter of former Ohio Governor Jack Gilligan and former Governor of Kansas, said the nearly $300 million in awards will provide flexibility and support to states to help them deliver high-quality health care, lower costs, and improve their health system performance.
"As a former governor, I understand the real sense of urgency that states feel to improve the health of their populations while also reducing total health care costs, and it’s critical that the many elements of health care in each state -- including Medicaid, public health, and workforce training -- work together," she said in prepared remarks. "We are encouraged by the progress states have made and look forward to continuing to work with them as they move forward."
Twenty-five states will receive funding to test new models of care that will improve health, lower costs and additional flexibility and resources to enhance care. HHS also released a new report titled Medicaid Moving Forward, which underscores the innovative efforts states and HHS have already undertaken to improve care and lower costs in their Medicaid programs.
An additional 19 states will receive awards to further develop proposals for comprehensive health care transformation.
Ohio is among the states receiving innovation funds that will help them implement their plans for health care delivery system transformation. Over the next 6 months, the State of Ohio will receive up to $3,000,000 to develop its State Health Care Innovation Plan, subject to successful completion of the terms and conditions for the State Innovation Model initiative. Ohio and Idaho were the only two states HHS selected to receive the maximum grant award of $3 million.
Greg Moody, director of the Governor’s Office of Health Transformation [OHT], said the goal is to promote wellness and prevention through effective, patient-centered care that meets the health needs of individuals and creates a healthy and productive workforce.
Moody said Ohio will use the SIM grant to develop a comprehensive plan to expand the use of patient-centered medical homes and episode-based payments for acute medical events to most Ohioans who receive coverage under Medicaid, Medicare and commercial health plans.
Six states—Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont—were selected to use Model Testing award funds to test multi-payer payment and service delivery models, including approaches already under way at CMS, such as Accountable Care Organizations, on a broader scale within their state.
CMS Acting Administrator Marilyn Tavenner said states have taken important steps in partnership with HHS, private payers, Medicaid, CHIP and their public health departments. "The State Innovation Model awards are designed to bring additional flexibility to states on their path to improving their health care systems."
Kasich SOTS includes Medicaid expansion
Governor Kasich created OHT following his election in 2010 to help reform Ohio’s health care payment and delivery systems, Moody noted, adding that the HHS award is an opportunity to significantly improve overall health system performance. "We have already made great strides, and we look forward to working with our public- and private-sector partners to take another leap forward."
In his State of the State speech Tuesday in Lima, Gov. Kasich said he's well aware of the transformations needed in Medicaid and Medicare, learned over the course of his 18 years in Congress, some as the Chairman of the House Budget Committee. Kasich the program engineer said he's hopeful Federal regulators like HHS will figure out that what his team has done in Ohio is the path they should follow. "And when they finally, the federal government, finally figures out how to begin to solve the problems of Medicare and Medicaid, we will be ready to navigate those changes." he said in his SOTS.
Kasich was characteristically blunt this week about his inherent hostility to the ACA. "You know, I’m not a supporter of Obamacare. We rejected the federal government telling us to run the state - run exchange. They didn’t give us the flexibility that would have been best for our state. Mary [Taylor, Lt. Gov] and I sat down, we weren’t going to go for that. Didn’t make sense for us. We - - I don’t believe in the individual mandate. I don’t like a lot of the programs that are going to drive insurance rates up," he said with evangelical fervor.
He said his decision to extend Medicaid was based on many benefits, including the positive impact this decision can have on the mentally ill and the addicted.
HHS funds will enable Ohio to develop a plan to improve overall health system performance through statewide implementation of innovative payment and delivery models. Per the report, "Ohio proposes a planning process that engages public and private stakeholders to formalize a comprehensive plan to build upon ongoing transformation activities, with potential refinements based on learning to date and stakeholder feedback. The goal of the project will be to create a road map for expanding the capacity and availability of qualified medical homes to most Ohioans, and to define and administer episode-based payments for acute medical events across Medicaid/CHIP, Medicare, and commercially insured patients.
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