Mental Health Services Providers Say Medicaid Managed Care Redesign Is Straining Their Resources

Apr 19, 2018

The state is moving mental health and addiction services for low income Ohioans into Medicaid managed care by July 1, and it’s the biggest and most complicated change the behavioral health system in Ohio has ever seen. But a survey of more than a hundred of those providers shows the redesign is straining their finances and could shut them down.

More than 60 percent of the behavioral health and family services providers who responded to the survey said they were getting less money than they budgeted for from Medicaid, and just over half have less than two months’ worth of the cash they need to operate.  Lori Criss speaks for those providers. “The cash flow problems, the resource challenges, the claims rejection volume – all of those kind of bureaucratic business things are putting providers in a position where they might run out of gas before they cross the finish line,” Criss said.

Criss said most providers have had problems with their own systems or the state in submitting claims, and many providers report their claims are being denied more than 15 percent of the time.