Source: Joint Medicaid Oversight Committee Newsletter, October 2022
On October 20, the Joint Medicaid Oversight Committee (JMOC) voted and approved a projected medical inflation rate for the upcoming State Fiscal Year (SFY) 2024-25 Biennium.
The motion to set the rate at 3.3% for SFY 2024 and 3.4% in SFY 2025 was offered by Senator Nickie J. Antonio. The Committee voted (7-1) to approve the JMOC Projected Medical Inflation Rate for the SFY 2024-2025 Biennium.
These rates of growth fall within projections provided by CBIZ Optumas, an actuarial firm contracted by JMOC pursuant to Ohio Revised Code (O.R.C.) §103.414. Under this provision, JMOC must contract with an actuary to determine the projected medical inflation rate for the upcoming fiscal biennium using the same types of classifications and sub-classifications of medical care that the United States Bureau of Labor Statistics uses in determining the inflation rate for medical care in the Consumer Price Index. While CBIZ Optumas is based in Scottsdale, AZ, it is part of CBIZ, Inc. a leading provider of financial, insurance, and advisory services headquartered in Cleveland, OH.
At the Committee Meeting, Steve Schramm, MScHE – Founder and Managing Director of the healthcare consulting and actuarial firm, along with Senior Manager Dan Skinner and Consultant Marshall Dupree – presented on the lower and upper bounds of the projected annualized growth calculated on a per-member per-month (PMPM) basis, for the entire Ohio Medicaid program.
Due to the Public Health Emergency (PHE) and the subsequent freeze on disenrollment still being in effect, the actuaries modeled two scenarios: one with the population mix held constant from calendar year 2021, and another that mixed the population as if the PHE had ended and disenrollment resumed.
For the lower bound, it was projected to be as low as 2.8% in SFY 2024 and 2.6% in SFY 2025. For the upper bound, it was projected to be as high as 4.8% in SFY 2024 and 4.1% in SFY 2023.
Pursuant to O.R.C. §5162.70, JMOC can agree with rates within the actuary’s projections, or set a different projected medical inflation rate for the fiscal biennium if the committee disagrees with the actuary’s projections.
(a) The average annual increase in the CPI medical inflation rate for the most recent three-year period for which the necessary data is available as of the first day of the fiscal biennium, weighted by the most recent year of the three years;
(b) The JMOC projected medical inflation rate for the fiscal biennium.
Additionally, the Medicaid Director shall implement the reforms under this section in accordance with evidence-based strategies that include measurable goals, without making the Medicaid program’s eligibility requirements more restrictive.