Cincinnati Children's Blog

Ohio Budget Bill Puts Children’s Hospitals at Risk

Ohio has the best statewide network of children’s hospitals in the country. Thanks to the high quality, cost effective care at six freestanding children’s hospitals across the state — in Cincinnati, Dayton, Columbus, Akron, Toledo and Cleveland — no child in Ohio is more than a two-hour drive from a flagship hospital. Today, however, we are concerned that provisions in the state budget related to Medicaid reimbursement may weaken our ability to continue to provide the quality health care Ohioans have come to expect from our institutions.

We’re grateful that the Ohio House of Representatives took a step toward resolving these concerns by partially restoring the children’s hospital line item in the state budget. This support is important because children’s hospitals serve a disproportionately high share of Medicaid patients compared to adult hospitals. Building on the current momentum, we look forward to working with the Senate to restore the line item to $6 million, as in the past.

However, we are disappointed that the budget bill passed by the House includes a provision that establishes a legislated advantage for managed care plans in their contract negotiations with hospitals. This provision almost guarantees that the historically low reimbursement rate for services to Medicaid enrollees will be further reduced, harming hospitals and physicians across Ohio and jeopardizing access to healthcare services for many of Ohio’s children.

More than one-third of Ohio’s 3 million children rely on Medicaid for healthcare coverage. For these children, Medicaid is a lifeline, ensuring access to services ranging from routine well-child care to treatment for complex illnesses. Much of this care is provided at children’s hospitals. At Cincinnati Children’s, 43 percent of our patient encounters are with Medicaid enrollees. Currently we experience more than a 20 percent gap between the cost of providing care and the amount we are reimbursed by Medicaid. In 2009 (the most current data available), our Medicaid losses totaled $108 million. That shortfall will increase substantially if the House bill becomes law.

Cincinnati Children’s delivers high quality care for our community’s children, regardless of their ability to pay. Our excellent quality improvement programs, and our collaborations with our sister children’s hospitals across the state, have resulted in better patient outcomes and measureable savings to the Medicaid system. For example, we are documenting fewer hospital visits for asthma, fewer hospital-acquired infections and other improvements that lower healthcare costs.

We recognize the challenge confronting our legislators as they work to address the state’s deficit. Ohio’s six freestanding children’s hospitals are doing our part and are committed to doing more. We look forward to working cooperatively with the Ohio Senate as it deliberates on the budget bill. We’re confident that when our legislators give thoughtful consideration to our nationally renowned quality and cost improvement efforts, as well as our disproportionately high Medicaid burden and resulting Medicaid losses, they will support a budget that provides stability and sustainability for children’s hospitals and preserves the safety net we provide. There is nothing more critical to the future of our state and nation than protecting the health and well-being of our children.

Michael Fisher is President and CEO of Cincinnati Children’s. In 2004 he joined the Cincinnati Children’s Board of Trustees where he strongly advocated for improving child health. Fisher feels that by becoming President and CEO, his sense of commitment, understanding and excitement for Cincinnati Children’s has amplified. 


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