FINALLY, Media Coverage on the Redesign Delay!!

Almost everyone in the behavioral health community agrees: Ohio should redesign its coding for services and billing so that it aligns with national standards. The change will expand access to treatment and care, thus benefiting those with mental illness and addictions. All of that is especially helpful in view of the opioid epidemic and the troubling increase in the rate of suicide across the state.

Here is a moment when an arcane discussion of rules and other bureaucratic elements touches real lives. The challenge is to get the timing of the implementation right without putting those in need at risk of missing care.

The state, via the departments of Medicaid and Mental Health and Addiction Services, plus the Office of Health Transformation, wants to launch the redesign on July 1, or the start of the new budget year. Gov. John Kasich and his team point to the two years of preparation, working with the array of stakeholders. They stress the value in the expanded services, and they are right about the improvements.

Many of the larger organizations, including the Summit County Alcohol, Drug Addiction and Mental Health Services Board, favor moving forward on schedule. They have deployed resources to get their shops ready.

What members of the Ohio House encountered were cries of “slow down” from smaller organizations and providers. Thus, the House included in the budget plan it recently approved a provision that calls for delaying the start six months, or to Jan. 1, 2018.

Now state senators are hearing a replay of the arguments. Part of the concern involves past as prologue. Many organizations recall the troubles with the rollout of MyCare Ohio, the managed care platform for long-term care for the indigent elderly. They worry about a repeat and point to familiar shortcomings they see, for instance, rules still to be finalized and limited testing, already five months behind the original timeline.

More than anything, they are concerned about timely payment, the cash flowing sufficiently to keep up with the need for current care and treatment. This isn’t about their bottom lines. It goes to the top priority: patients having access to necessary services.

In that way, an administration determined to go forward must be prepared for unintended consequences and ensure timely reimbursement. It has taken such steps in the past with hospitals and nursing homes. If some organizations have let things slip in this instance and now face an imminent deadline, those shortcomings won’t matter if Ohioans hit obstacles to treatment.

Perhaps there could be an option for “early adopters,” those who are ready to go to the new system, while others gain time. That would be a variation on the testing just getting started, which itself may build confidence in the coming weeks as the Statehouse advances the budget.

If not a middle way, the state Senate and the administration have reason to be impressed with the chorus of concern. As many have noted, there is nothing requiring the July 1 deadline. It falls to the governor and department officials team to make clear that they are prepared for contingencies, especially the worse.

If they are not, then senators would do well to accept the House delay. The first priority is sustaining patient access to care.