1. We Are Balanced in Ohio: What Shall Follow this Major Accomplishment?
Shahla Mehdizadeh, Ph.D.
39th Annual Conference of the Ohio Association of Gerontology and Education
April 24th, 2015

2. What Am I Talking About?
Through a continuous and persistent state policy, Ohio has reached a point that the Medicaid dollars spent on Long-Term Services and Supports (LTSS) provided in facilities and community has reached a balance for all people with a disability.
The number of people cared for in community surpassed those receiving care in facilities in 2008.
How have we achieved this?
How do we compare with other states?
What do we need to do to maintain this balance or improve upon it?

3. The Talk of the Town
Columbus Dispatch
Summer 2014

4. Medicaid LTSS Expenditures and Utilization by Settings
Participants in 2013

5. How Do We Compare with Other States and U.S.?
(For 2012, PACE included in HCBS)
To make the comparison possible, mental health expenditures and LTSS “like” expenditures (not part of
waivers) are excluded.

6. Per Member, Per Month for all LTSS Programs & Facilities in Ohio, 2005-2013
Almost all waivers’ and facilities’ PMPM has declined since 2011.

7. Comparing Total Medicaid LTSS Over Time (Not Adjusted), 2007-2013

8. Are We Adding to the Number of People Medicaid is Paying for Their LTSS Over Time?
Yes the number
But the proportion is
Just keeping up with aging population.
34.6
31.8

9. Comparing Number of Participants Received LTSS, Paid by Medicaid, 2007-2013

10. Comparing the Number of Persons and Persons-Year Received LTSS

11. Can We Maintain this Trend?
Projections of Ohio’s Populations with Disabilities
Year
Total Population
Population with Severe Physical or Cognitive Disability
Total Population with Physical Disability and up to 200% Poverty Income Threshold
Population with Severe Developmental or Intellectual Disability
Population with Severe Mental Illness
2015
11,638,998
197,247
62,235
66,285
509,575
2020
11,707,724
213,864
67,187
65,616
509,943
2025
11,749,993
235,783
73,782
64,708
506,047
2030
11,763,264
262,703
81,923
63,751
502,026

12. Have We Created a Sustainable Trend to Pursue in Future?
Growth of the 60+ Population & the Patterns of Change in LTSS Exp.

13. How Ohio Achieved the Balance, and How to
Sustain It?
Increased availability of HCBS for all populations with disability and monitored and diverted facility-based care utilization
Reduced Per Member, Per Month expenditures on HCBS and facility-based care
To maintain this balance State needs to:
Become continuously innovative by offering alternatives to facility-based care
Help consumers remain independent by alleviating environmental barriers
Educate them on availability of assistive devices and services so they can remain independent even when they have a disability.