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Provider says bumpy start of My Care Ohio has smoothed out
CINCINNATI (Jeff Hirsh) -- It finally seems to be coming to an end, in September of 2014, the health aide paycheck crisis first investigated a month ago by Local 12 News.
Many home health care aides went without pay for as long as three months after the state of Ohio changed to a new payment system. 82-year-old Willa Wright and her home health care aide Theresa Pharris are kind of like a team. Actually, Pharris does a lot more than that for a client who has diabetes and walks with a cane. But unlike many other home health care aides in Ohio, Thersa Pharris has not missed a paycheck and is not worried.
Pharris works for a large company, Home Care by Blackstone, with 1,200 aides statewide. Unlike independent providers, who work for themselves, the large company has ability to ride out the troubled start of a new payment system.
David Tramontana, CEO of Blackstone Care, said, "In general we're big supporters of the plan. We expected it to be rocky at the beginning, but we've known about it for three years and we just took the time to plan."
The new system called My Care Ohio covers patients like Willa Wright, who get both Medicare and Medicaid. The state used to pay the aides or their employers directly, now it's insurance companies.
"We're nervous about changing how the system worked because our payment flows were predictable with Medicare and Medicaid. And then to have all that go to insurance companies, we had fair reason to be nervous because insurance companies for post-acute providers haven't always been our best friend," said Tramontana.
However, Blackstone has gotten about 80 percent of what it's owed so far and in some cases the payments have actually come early. The head of the company said the old system had to change because it was incredibly expensive for the tax payers and bad for the patients too, with no coordination between Medicare and Medicaid.
"We actually embraced managed care organizations because we saw how broken the system was for what they call dual eligible, folks that are on Medicare and Medicaid," Tramontana said.
As for Willa Wright and Theresa Pharris, there may be a new system in place but the old, good relationship has not changed a bit.
Aetna, one of the two insurance companies handling the program in southwest Ohio, now said all of the backlogged claims have been processed and providers have also been given cash advances if necessary. A company spokesperson also told Local 12 they were working with providers to assure a regular payment schedule in the future.
While late payment problems seem to be letting up in the tri-state area, Local 12 is now hearing of similar problems in Columbus. That's probably because the Columbus roll-out of My Care Ohio started a month after it did around Cincinnati, so the troubles there are just now being felt.
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