SNAP can help Ohio lower Medicaid costs: John R. Corlett

Guest columnist John R. Corlett is president and executive director of The Center for Community Solutions.

A little over 10 years ago, I directed Ohio’s Medicaid program. It was a $12 billion program (it is twice that size now) that financed comprehensive healthcare coverage for more than 2 million Ohioans.

At the time, the program was a part of the Ohio Department of Job and Family Services, which also managed programs such as daycare subsidies, child support, unemployment compensation and the Supplemental Nutrition Assistance Program (SNAP).

One of my top priorities as Medicaid director was to look for ways to slow the growth in Medicaid spending. At the time, I thought my options for slowing spending were limited to three choices: lower reimbursement rates, reduce services and/or cover fewer people.

But what I know now is that one option for slowing spending could have been found on the floor below me, where the staff who managed the SNAP program worked. That is because now we have a better understanding of the link between food insecurity (hunger) and negative health outcomes that result in higher healthcare costs — ultimately paid for by Medicaid.

This was a big miss on my part.

Late last year, a study was published in the Annals of Internal Medicine reporting on a four-year National Institute on Health-funded project in North Carolina that assisted older adults, who were eligible for both Medicaid and Medicare, in applying for SNAP benefits.

Researchers reported fewer hospital and long-term care admissions, as well as emergency room visits, and an estimated Medicaid cost savings of $2,360 per person annually.

To put this in perspective, Ohio has over a half-million people on Medicaid and Medicare, and tens of thousands of them are not enrolled in SNAP — even though they are eligible.

An AARP Foundation analysis found that only 43 percent of eligible older Ohioans were enrolled in SNAP. In fact, older adults are enrolled at a much lower rate than other eligible persons.

Simplify the SNAP application and manage the intersection with Medicaid

Clearly, there is room for improvement. Some help is now on the way, with the Center for Community Solutions successfully pushing for a provision in the state budget to simplify the application process for older adults seeking SNAP benefits in Ohio.

The Ohio Department of Job and Family Services is in the planning phase for implementing these simplified processes.

The Ohio Department of Medicaid is also playing a role. In its most recent re-procurement of its managed-care contracts, the emphasis was clearly on addressing social determinants of health, such as food insecurity.

Going forward, Medicaid insurers are clearly going to be expected to link individuals with needed social services that can alleviate or prevent health challenges.

But some state Medicaid programs are going even further. A report last year from Manatt found that only three states specified SNAP as a program that Medicaid managed-care organizations (MCOs) need to help their members connect to.

They reported that Texas requires its MCOs to make best efforts to establish relationships with SNAP to help facilitate member referrals. North Carolina goes the furthest, requiring MCOs to provide in-person assistance, including filling out and submitting applications for SNAP.

We need to get every eligible older Ohioan enrolled in SNAP

American physician Sidney R Garfield, co-founder of the Kaiser Permanente healthcare system, is reported to have said that “medicine is not health care. Food is health care. Medicine is sick care.”

As the cost of health care continues to rise, state policy makers would be wise to keep this maxim in mind and embrace efforts to get every eligible older Ohioan enrolled in SNAP. It could be the best prescription policy makers ever write.

Readers are invited to submit Opinion page essays on topics of regional or general interest. Send your 500-word essay for consideration to Ann Norman at [email protected]. Essays must include a brief bio and headshot of the writer. Essays rebutting today’s topics are also welcome.