MetroHealth wins feds' approval for expansion of Medicaid coverage

The MetroHealth System has received the final seal of approval from federal regulators on a complex legal maneuver that could extend Medicaid coverage to as many as 30,000 people in Ohio's Cuyahoga County who otherwise couldn't pay for their healthcare.

The health system, which is subsidized by Cuyahoga County, has been working on the so-called Medicaid “waiver” since the fall of 2011. The plan would extend healthcare coverage for county residents ages 19 to 64 who are uninsured, not eligible for regular Medicaid and have an income at or below 133% of the federal poverty level, which equates to $14,856 for an individual.

MetroHealth plans to start enrolling patients immediately.

“This isn't enough to cover all of our uninsured patients,” said John Corlett, MetroHealth's vice president of government relations and community affairs. “It doesn't meet the needs of everyone, but it meets the needs of a significant number of our patients.”

Because MetroHealth is a public entity, it plans to use its $36 million county subsidy to draw about $64 million in additional federal matching funds to finance the Medicaid expansion. No state dollars will be used to pay for the program, which the health system has dubbed “MetroHealth Care Plus.”

Expanding Medicaid to cover more of the county's poorest residents — who typically are the most expensive to treat because they often use the emergency room for routine care or have neglected their medical needs — could prove beneficial to MetroHealth's finances. Serving as the county's safety-net hospital has forced MetroHealth to stomach millions of dollars in unpaid health care bills, which system officials have cited as a contributing factor to its shaky finances.

Those enrolled in the program would have access to health care at MetroHealth's 17 locations throughout the county.

Following Cook County's lead

The feds' approval of the waiver comes after Gov. John Kasich's announcement yesterday that he'd like Ohio to move forward with an expansion of Medicaid eligibility in 2014 — a key component of President Barack Obama's health care overhaul that the U.S. Supreme Court ruled last year individual states could forego. Mr. Corlett said the waiver will help the health system understand what 2014 might look like under the full implementation of the president's health care reform law.

Expecting an influx of newly insured patients, MetroHealth last year finished tweaking its primary care operations at its satellite clinics and is doing the same for its specialty service lines. Some of those changes included freeing physicians from administrative duties and shifting scheduling models to accommodate more patients.

“The waiver will really give our patients, MetroHealth and Cuyahoga County a head start on 2014,” Mr. Corlett said.

In a prepared statement, County Executive Ed FitzGerald — who is contemplating a run for governor — praised the waiver as the “first program of its kind in Ohio” and lauded MetroHealth's efforts to expand coverage to the uninsured.

“This help comes at a time when working families or the recently unemployed in our state face the burden of not being able to afford health care coverage and are not eligible at this time for other health insurance programs,” Mr. FitzGerald said in a statement.

Last October, Cook County in Illinois started enrolling individuals in a similar program — albeit on a much larger scale. The Cook County program immediately extended coverage to 115,000 individuals who wouldn't be eligible for Medicaid until it was expanded in 2014 as of the president's health care law. rwise couldn't pay for their healthcare.



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