Ohio hospitals are paid for health care services they provide by three categories of payers—commercial insurers, government programs and individual patients. Private insurance coverage is primarily provided through employer-sponsored programs in Ohio. Government payers include Medicare, Medicaid, Veterans Administration, Bureau of Workers Compensation and the military. Patients who have not purchased coverage or applied for coverage through government programs are billed directly for the services provided.
OHA works daily with the private payer community to aggregate in one location the plans’ changes related to COVID-19 testing and claims. Members can log in to view the updates here.
OHA has aggregated COVID-19 financial relief opportunity information to provide an overview of federal and state funding opportunities available to hospitals and health systems through the CARES Act.
As Ohio's population ages, Medicare's role insuring Ohioans 65 and older continues to grow. The federal program also covers certain younger people with disabilities and end-stage renal disease. Read more here on OHA's work with Medicare analysis and policy.
Ohio expanded eligibility to Medicaid in 2014. The program provides health care coverage for Ohio's poor and disabled citizens. Read more here on OHA's work with Medicaid analysis and policy.
Ohio hospitals help fund the state's share of Medicaid. Read more about how the program has reached a tipping point at the current franchise fee rate.
HCAP provides medically necessary free hospital-level care for low-income Ohioans and supplemental payments for hospitals with a disproportionate share of uncompensated care.