December 20, 2022

Workforce, Healthcare Affordability Loomed Large in 2022 Priorities

Kelly O’Reilly, President and CEO, Ohio Association of Health Plans

As 2022 comes to a close, OAHP has a lot of good work to look back on in the past year — and plenty of plans for the new year. Our mission of advancing affordable, high-quality healthcare drives our work to build relationships with all stakeholders and advocate for smart policies at the state level.

Building up Ohio’s healthcare workforce, especially for behavioral healthcare, remains among our highest priorities. At our Executive Forum in the spring, Ohio Department of Mental Health and Addiction Services Director Lori Criss shared some encouraging news about the commitment Gov. Mike DeWine has made to building a better behavioral health system, supported by a robust workforce. That commitment includes a $230 million recruitment effort involving multiple state agencies, universities, community colleges and workforce boards.

Throughout the year, we also conferred with stakeholders including the Ohio Council for Home Care & Hospice and the Association of Area Agencies on Aging to discuss long-term and home care workforce — another area where there is a critical need. In July, the Ohio Department of Medicaid invited us to testify before the Governor’s Direct Care Workforce Task Force. In that testimony, OAHP provided several ideas to grow the workforce over time in both of these important areas.

Our work on behalf of commercial health insurance plans kicked into a higher gear in 2022 as we amended our bylaws to make the Commercial Plan Committee a permanent part of our infrastructure. We conducted a “listening tour” of stakeholders including the Ohio Chamber of Commerce, Ohio Business Roundtable, the National Federation of Independent Businesses and commercial brokers.

Their bottom-line message was clear: The cost of healthcare is not sustainable, and if costs can’t be better managed, employers are going to find themselves unable to offer healthcare coverage. We had a great panel discussion on healthcare affordability at our Annual Trade Show & Convention in September.

The Commercial Plan Committee also assembled a tremendous new advocacy coalition among members of the business community via local chambers of commerce and the broker community. At the end of 2022, this powerful coalition helped to educate members of the Ohio Senate on why copay accumulator legislation (HB 135) would raise the cost of health insurance for employers and their employees. We are hopeful that this new coalition will help the Commercial Plan Committee members as we finalize our proactive advocacy agenda for 2023!

A sample of our priorities at the Statehouse included:

  • Emergency prescription refills: The General Assembly approved House Bill 37, allowing pharmacists to dispense refills on an emergency basis more than once in a 12-month period — an expansion from previous law. Our work with stakeholders including the Pharmaceutical Care Management Association and the Ohio State Medical Association helped put in limits that ensure medications aren’t dispensed unsafely.
  • “White-bagging”: We worked with the business community, PCMA and AHIP, our national organization, to oppose House Bill 451, which would restrict health plans’ ability to deliver drugs directly to docs — a practice we use to avoid hospitals’ markups of sometimes more than 500% for specialty drugs. This practice, known as “white-bagging,” is an effective tool to keep healthcare costs down.

And in the regulatory environment, OAHP and its members were active on the following important matters:

    In addition, the single Pharmacy Benefit Manager (PBM) implementation was accomplished through tremendous communication and strategic problem-solving to ensure that members’ access to their prescriptions went uninterrupted. OAHP and the plans continue to work diligently every day toward the full implementation of Next Gen starting on Feb. 1, 2023, communicating with stakeholders including the Ohio Children’s Alliance, the Ohio Council of Behavioral Health & Family Services Providers and the Ohio Association of Medical Equipment Services.
  • Mental-health parity: Ohio law requires health plans that cover mental health and substance use disorders to provide coverage that is the same or similar to the coverage they provide for physical health, but many consumers don’t know about the law or don’t know how to access behavioral healthcare. We worked with the Ohio Department of Insurance and many of Ohio’s community behavioral health providers to raise awareness, including creating this Behavioral Health Treatment Road Map.

As always, we worked to keep our industry colleagues informed of law and policy changes and give Ohioans the information they need to make decisions about their health and healthcare coverage.

In one of my favorite projects, we joined with OCALI to present a series of 10 virtual roundtable sessions to help bridge a serious knowledge gap: Too many healthcare providers aren’t properly educated in how to give competent care to people with disabilities. The series, “Improving Outcomes for People With Disabilities,” brought in participants from around the country.

Great partners and collaborators kept the OAHP blog stocked with features on the importance of vaccination, a new law expanding telehealth in Ohio, serving as a COVID-19 youth ambassador, school-based health services, healthcare affordability, the health benefits of joyful play, wellness for healthcare professionals, stopping stigma around addiction and mental illness, and the “family glitch fix” that can help millions of Americans afford coverage on the Affordable Care Act Marketplace.

Finally, we had our most successful OAHP Annual Convention and Trade Show ever in 2022.  We increased our attendance by 26% over 2021, which speaks to the interest in the lineup of tremendous speakers who shared their insights with us at the Convention. We are excited to be looking ahead already to our 2023 Convention on Sept. 26 – 27, 2023, when we will be moving to a new location at the Polaris Hilton Hotel.

We love the work of advocating for affordable healthcare for everyone, and we’re glad you’re on the journey with us.

Stay tuned for more in 2023, and I wish everyone the happiest of holidays and a wonderful new year.