Written by Mary Taylor, Auditor of State
February 20, 2009
At a time when our state budget faces painful cuts, Ohio policymakers are overlooking hundreds of millions in taxpayer dollars that could be saved by implementing Medicaid reform recommendations.
That is what we found in a recent audit we conducted to study the progress made to improve Ohio’s Medicaid program.
Medicaid is the most expensive single item in the state budget and it is extremely important to measure the progress made toward the cost-saving recommendations provided in the 2006 Medicaid performance audit study.
What we discovered was disappointing because only 15 of the original 109 recommendations for Medicaid reform have been implemented. Another 40 recommendations show only partial progress.
The real story is that of 109 recommendations for reform; almost half show no real progress at all. Those 54 missed opportunities add up to at least $302 million in potential annual savings and program improvements that policymakers continue to ignore. Those are taxpayer dollars Ohio could use to address other pressing needs in the state budget.
Medicaid has an enormous impact on the state’s budget but the program is necessary to protect the health and well-being of approximately two million of Ohio’s most vulnerable citizens: low-income families, children, pregnant women, the elderly and people with disabilities. This adds up to almost 16 percent of the state’s population. For these reasons, I have been an outspoken advocate for Medicaid reform.
Since it started in 1968, Ohio’s Medicaid program has grown into a mammoth bureaucracy, costing taxpayers more than $13 billion last year. These costs consume 37 percent – nearly two fifths – of Ohio’s general revenue fund budget.
What’s more, Medicaid’s annual costs keep growing at a rate much faster than state revenues. This creates pressure that keeps taxes higher than they otherwise might be and crowds out the state’s ability to fund other important services like primary, secondary and higher education.
To help address the high costs and inefficiencies in the Medicaid program, a performance audit was conducted that offered 109 recommendations that would help simplify the system making it more efficient and cost effective. These recommendations provided policymakers with a blueprint to reform Medicaid and the opportunity to potentially save Ohio taxpayers hundreds of million of dollars each year. Some progress has been made but unfortunately, many of the money saving recommendations continue to be overlooked.
Our 2008 follow-up to the Medicaid performance audit finds that while a number of important, cost-saving actions have been taken, Medicaid in Ohio remains a complex and expensive bureaucracy.
More than $300 million in taxpayer dollars are left on the table each year because important recommendations for reform are waiting for action. All of this is happening while more Ohioans than ever are depending on Medicaid services.
We cannot afford to let Medicaid reform stall. Ohioans will receive more efficient and effective health care, and millions of taxpayer dollars will be saved each year, if our audit recommendations are followed. Some progress has been made, but Ohio’s policymakers owe it to the citizens of our state to make sure that all recommendations for reform are followed. We can make Medicaid the best program it can be, while making the most efficient use of hard-earned taxpayer dollars, if we just follow the simple roadmaps outlined in each audit.
The 2008 Follow-up Medicaid Performance Audit, as well as the 2006 Medicaid Performance Audit on which it is based, are available at the auditor’s website: www.auditor.state.oh.us