MORE THAN JUST PAYING CLAIMS: HOW OHIO’S HEALTH PLANS SUPPORT A STRONG STATE ECONOMY Kelly O’Reilly, President and CEO, Ohio Association of Health Plan
With health care representing an ever-growing portion of the economy statewide and nationally, managing costs in this vital sector is key to Ohio’s prosperity, even as making health care accessible to as many people as possible is
essential to Ohioans’ well-being. For the Ohio Association of Health Plans (OAHP), the complementary goals of access and affordability are at the heart of our mission. Our 16 member plans provide coverage to approximately 9 million Ohioans via private, commercial plans, and they partner with the state and federal governments to administer public programs such as Medicaid, Medicare and the Health Insurance Exchange. Beyond their importance to public and individual health, the plans are major contributors to the economy, with nearly 20,000 direct employees and an annual payroll of nearly $1.6 billion. They’re good jobs, with an aver- age annual wage of more than $83,000 — well above the average for other insurance industries in Ohio. Ohio’s employers play a major role in coverage, with 54% of Ohio residents covered by a private, employ- er-sponsored plan. Almost all Ohio workers — 89% — work for companies that offer health insurance. More than two-thirds (67%) can choose from two or more plans offered by their companies, and for those with sin- gle coverage, employers pay 77% of the premium. Beside those covered through their employers, 22% of Ohioans are served by Medicaid, 18% by Medicare and 1% by other public programs. Just 5% of Ohioans have no health coverage — an improvement from 2021, when 7% were uninsured. Health plans pay a state tax on premiums collected, contributing $666.7 billion to the state treasury. Ohio’s health insurance market is diverse and competitive, giving people a range of options for coverage to fit their needs. Some of OAHP’s member plans are national carriers; others are Ohio-based or regional. There are full-service plans as well as those that provide administrative support to employers, which assume the financial risk of self-insurance. Health insurance has evolved far beyond simply paying claims. More than actuaries and administrators, health plans employ doctors, nurses, pharmacists, social workers, care managers and community connectors, all in the interest of better engaging patients so that they get the care they need and take the actions required to stay healthy. Traditional payment models, which incentivize more care whether it’s beneficial or not, are giv - ing way to value-based and other alternative payment models that reward good outcomes rather than more procedures. The result? Healthier people and potential cost savings for employers and, in the case of public plans, tax- payers. In just one coverage year (2018-19), estimates are that the state’s Medicaid managed care program saved taxpayers between $4 billion and $5.4 billion. Health insurance done right is a critical part of building a healthy society and economy. OAHP is proud to tell the story of Ohio’s health plans, and we’ll keep advocating for policies that make coverage affordable and accessible to as many Ohioans as possible.
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