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Columbus
Dispatch...
Kasich’s budget
tackles Medicaid spending
Initiatives
focus on low-weight babies, poor’s visits to ER
By Catherine Candisky and Joe Vardon
Thursday, March 10, 2011
Reducing the number of low-weight babies born in Ohio will be one of
the initiatives to lower health-care costs that Gov. John Kasich is
expected to unveil in his state budget next week.
The proposal will be part of a broader effort by the Republican’s
administration to rein in Medicaid spending by reducing hospitalization
and other high-cost care covered by the tax-funded program, which
provides health care to 2 million poor and disabled Ohioans.
Today, Kasich discussed low birth-weight babies and another initiative
to reduce the cost of home visits by nurses and other health-care aides.
“They’re just rushing in and getting their 56 bucks and then they’re
going to the next one and the next one; that’s not what we want out of
home health care,” Kasich said. “We want to make sure there are people
in there really doing their jobs.”
Nurses are paid $54.95 for the first hour and $5.69 for every 15
minutes after, the Ohio Department of Job and Family Services says.
However, each patient visit starts the clock anew at the $54.95 rate.
The initiative to help low-weight infants was a surprise - even to some
of Kasich’s advisers - in his State of the State speech this week.
The governor’s Office of Health Transformation projects that taxpayers
could save more than $155 million in Medicaid costs if hospital stays
for tiny newborns are reduced.
“We’re going to do a better job of taking care of low birth-weight
babies by taking better care of their mothers,” the governor pledged.
Newborns with low birth weights who must remain hospitalized for
serious health problems “incur six times the costs of other babies,” he
said.
The governor proposed that the state could reverse the trend by
“staying in touch” with the mothers and providing the “prenatal care
they need so we don’t have more low-weight babies born.”
Medicaid, funded by the state and federal governments, pays for two of
every five births in Ohio.
According to the job and family services agency, Medicaid paid $1,898
on average in 2007 for the birth of a healthy baby compared with
$10,944 to care for a low-weight infant, defined as those between 3.3
and 5.8 pounds at birth. The cost of care for of a very low-weight
birth, less than 3.3 pounds, was a staggering $78,436.
The governor’s budget also will include efforts to keep more seniors
out of nursing homes by making home and community-based services more
available.
According to statistics provided by the administration, Ohio spends 44
percent more than the national average of caring for elderly Medicaid
recipients - much of that attributed to nursing-home costs.
Kasich also will try to reduce the number of people showing up at
hospital emergency rooms because they don’t have their own doctor.
“I don’t want to have to have a person run to an emergency room if we
can have somebody available, a primary-care doctor to take care of them
in the middle of the night,” Kasich said in his Tuesday speech.
“You know how much money that saves? And you know how much more humane
it is? Have you ever sat in the emergency room? How about, you know, if
we have a program that says we ought to coordinate care?”
Ohio taxpayers spent $1.35 billion last year on 1.8 percent of Medicaid
recipients who mostly went to hospitals, including emergency rooms, for
care, according to office statistics. Much of those costs could have
been avoided if the person had gone to a primary-care doctor.
Eric Poklar, of the governor’s Office of Health Transformation, said
efforts to curb Medicaid costs will focus heavily on the 5 percent of
recipients who account for 50 percent of spending.
“These are areas where if we can do something better to coordinate care
for these children and their parents, it will have a significant
outcome for the children, the parents and taxpayers,” Poklar said.
Karen Hughes, of the Ohio Department of Health, said 8.6 percent of the
babies born Ohio in 2008 were of low weight, slightly higher than the
national average of 8.2 percent.
Mothers more likely to give birth to low-weight babies tend to be
black, smoke, younger than 15 or older than 45 and get less care during
pregnancy.
Hughes said improving the quality of health care women receive before
they conceive and during pregnancy can help prevent low birth-weight
babies. Examples: helping women plan for pregnancy by maintaining a
healthy weight and quitting smoking, and making sure they receive
medical care during their pregnancy.
“It’s such good policy because it’s good for the mother, it’s
absolutely good for the child because it prevents other problems later
in life ... and it prevents incredible cost to the state,” said Gayle
Channing Tenenbaum, spokeswoman for the Public Children Services
Association of Ohio.
The Ohio Council for Homecare and Hospice did return phone messages
seeking comment on Kasich’s remarks about home-care providers.
Read it at The Columbus Dispatch
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