December 11, 2023

2023 Lookback: Celebrating Success and Planning for the Future

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

At OAHP, we entered 2023 fresh off a strong year and with big plans for the new one — keener focus on our work with the business community and commercial plans, a first-ever members’ forum, and our usual robust engagement with the state budget process were just a few highlights.

As we close the year out, I’m so happy to share the many successes we’ve achieved with the help and support of our members, including supporting and affiliate members, and generous sponsors of our work.

We began holding regular meetings with the Commercial Plan Committee and with an advisory group we convened from leaders in the business community. With both groups, we’ve worked to identify areas of common interest and set key policy priorities. I believe that this is where OAHP brings the greatest value to the fight for accessible, affordable health care: Our members and business community allies all have other jobs to do, and OAHP’s job is to establish areas of common interest and enable those communities of interest to have their voices heard at the Statehouse through our policy and advocacy work.

As a prime example, at one of our early business-group meetings, those in attendance heard from Ohio Sen. George Lang, chair of the Business First Caucus and vice-chair of the Insurance Committee, and had the chance to share their concerns with a key legislative leader.

We also connected members with top-notch industry expertise. Those who tuned in to our virtual Executive Forum in April heard Christopher Whaley, a health economist for the RAND Corporation, share findings from RAND’s study on hospital price transparency. Among the eye-openers: In 2020, employers and private insurers overall paid more than twice what Medicare would have paid for the same service in the same hospital, and the discrepancy varied from state to state. We learned how to use the RAND study to determine the cost “hot spots” in Ohio.

Those at the forum also heard from a Harvard economist about how hospital consolidation drives high costs, and from an Indiana state senator and a senior representative of the Indiana business community about that state’s success in enacting legislation to ensure site-neutral payments, one of our top legislative priorities in Ohio.

Speaking of legislative priorities, we celebrated a major win in the 2024-25 budget with the statewide expansion of MyCare, which provides integrated care management for so-called dual-eligibles — those Ohioans eligible for both Medicaid and Medicare. We’ve known since a 29-county MyCare pilot program launched in 2014 that this kind of care coordination leads to better outcomes for patients as well as savings for taxpayers. We’re thrilled to see this good idea grow.

OAHP’s engagement in the budget process yielded other policy achievements, including defeating proposed health care mandates that would have driven up costs without a commensurate benefit. In 2024 we’ll continue to represent the interests of our members on legislative priorities including white-bagging, biomarkers and site of care.

2023 was a watershed year for the Ohio Department of Medicaid (ODM) with the rollout of the Next Generation of Medicaid Managed Care and OAHP was at the center of the work, hosting weekly implementation meetings with our member plans and also between the plans and ODM. I’m confident the feedback provided in those meetings has improved the execution of this critical initiative.

Our ongoing partnership with ODM is a core aspect of the networking and collaboration that I believe is central to our success. With our member Medicaid managed care plans, we worked with the department to create a selection process for awarding grants to community-based public health projects, funded by the plans’ Community Reinvestment initiative. (Stay tuned for an exciting announcement about that soon!)

Another important partner was the Ohio Children’s Hospital Association, with whom we continue to work to determine appropriate quality improvement parameters for children’s health outcomes. This important work will ramp up even more in 2024.

And I was delighted for OAHP to join again with OCALI to present a second edition of Improving Outcomes for People With Disabilities, our series of virtual roundtables designed to educate health care providers on competent care for this population. The 2023 series focused on how the social determinants of health impact disability-related care. In 2024, we will continue this work with OCALI and the Ohio Provider Resource Association, with whom we are hoping to pilot programs to improve the health of people with disabilities and other co-occurring conditions.

Communication is at the core of our mission, and we kept stocked in 2023 with blog posts, white papers and infographics about our work, along with guest blogs by other health care collaborators and thought leaders. If you missed them earlier, check out these materials on diabetes resources for providers, preventing another measles outbreak in central Ohio, how financial planners can help families contain the financial damage of substance use disorder, how food banks can help people at risk of losing Medicaid coverage through redetermination, how housing support for at-risk moms leads to better birth outcomes, a pregnancy risk assessment form that can save babies’ lives, building Ohio’s behavioral health work force, help available through the Ohio Mental Health Insurance Assistance Office, the statewide expansion of MyCare, the promise of Value-Based Care to deliver better health and lower costs, how workplaces can prioritize mental health, health care affordability measures in other states, the 2023 OAHP Pinnacle Awards, a full wrap-up of the 2023 Convention, an alternative payment model based on enhanced home-based care, and how copay coupons drive up health care costs.

Throughout the year, we hosted events both in person and virtual to connect our members with expertise to improve their work and with policymakers whose decisions affect it:

  • Our first-ever Member Forum in March brought our supporting and affiliate members together with guest speakers from ODM and the Ohio Department of Mental Health and Addiction Services. We also moved our annual legislative reception, formerly part of the annual convention in September, to the March event, to allow some important networking and social connection to occur while budget deliberations were going strong.
  • We offered an educational opportunity with Continuing Legal Education credit for the in-house counsel of our members’ plans. Attendees were briefed on the latest legal and regulatory developments affecting health insurance companies and heard presentations on frequently litigated issues among payors and providers, best practices regarding privacy, security and data breaches, and dealing with government agencies and enforcement issues.
  • Our biggest event, September’s Annual Convention & Trade Show, was our most successful ever. A change in venue to the Hilton Columbus Polaris hotel was a big hit with those who attended. We added several new sponsorship opportunities, including a presenting sponsor. We’re extremely grateful to ValueHealth for stepping up to this spot and to the partners who sponsored our first-ever convention special networking event — a bowling party that turned out to be surprisingly competitive and a blast all around.

Overall, OAHP saw fantastic increases in membership in 2023, including more than 20 supporting members and one affiliate member joining or renewing at the premium level.

While the increased revenue is of course essential for us to carry out our mission, the most gratifying aspect of it is the vote of confidence it represents. We work hard to keep our members and the public informed and educated about health care opportunities and challenges in Ohio; the participation and support of so many members, partners and colleagues tells me that work is relevant and valuable.

All of us are grateful for that support and look forward to the best year ever in 2024. I wish everyone a happy holiday season and a happy and healthy new year.