Common questions about Ohio Provider Supplement Plan

Discover answers to frequently asked questions about the Ohio Provider Supplement Plan. We aim to clarify common concerns and provide a comprehensive understanding of our innovative healthcare approach.

Frequently asked questions

At Ohio Provider Supplement Plan, we believe in a transparent and effective healthcare system. Our mission, rooted in Washington Court House, Ohio, is to address the challenges within the current system by introducing a new, sustainable model. Explore the questions below to understand our vision and how we strive for better healthcare outcomes.

What's the main takeaway from these answers?
Consider this. Albert Einstein once said that the definition of insanity is doing the same things over and over expecting different results. So even though we know there is no perfect solution, if we keep doing health care like we are, we will still have the same broken system for our grandkids!

How can these costs be reduced so drastically?
Our plan introduces a new model designed to streamline processes and eliminate inefficiencies, leading to significant cost reductions compared to traditional healthcare systems.

Will the insurance system still be making the calls on what is covered?
Our approach seeks to shift decision-making power to providers and patients, reducing the influence of insurance companies on coverage decisions. We aim for a more patient-centric system.

Are these numbers real?

Yes, the projections and potential savings outlined in our plan are based on thorough research and analysis of healthcare economics. We are confident in the viability of our model. They are subjected to change due to countless factors-but still present the best option for lowing health care. See sources and evidence page for more info.

What misunderstandings do you hope to clear up?
We cannot clear up everything. But we hope people will have a clearer picture on how this new system could work. Not just for Ohio, but for the entire nation.

How does this plan benefit providers?
The Ohio Provider Supplement Plan empowers providers with greater autonomy and reduced administrative burdens, allowing them to focus more on patient care rather than navigating complex insurance requirements.

What is the long-term vision for this plan?
Our long-term vision is to establish a sustainable, accessible, and equitable healthcare system that serves as a model for the rest of the nation, providing high-quality care at a reasonable cost.

How can I get more detailed information?

For more detailed information, please explore our "Our Plan" Page where you will find detailed info. along with many other pages you can find at the top of the page.

Why the OPS Plan Works in Ohio

Ohio has about 3 million Medicaid patients but only around 20,000–22,000 medical providers who actively treat Medicaid patients. That means each Medicaid active provider carries roughly 140 patients, far more than the system was designed for.

This imbalance exists because Medicaid pays far below the cost of care. Many providers enroll in Medicaid, but thousands treat zero Medicaid patients because the reimbursement is too low to stay financially stable.

OPS fixes this imbalance.

Medicaid continues paying its normal low rate, but OPS adds a supplemental payment directly to providers using existing Medicaid dollars. Because there are so many more patients than providers, the supplement can be directed straight to the front lines and spread farther to— doctors, clinics, hospitals, and nurses — without increasing total Medicaid spending.

In return, providers agree to lower their base prices, which reduces medical bills for families and decreases cost shifting onto private insurance.

This is the core idea behind OPS: More patients than providers means the supplemental payment can stabilize the entire system by going straight to the people delivering care.

OPS strengthens providers, lowers bills, and keeps Medicaid budget neutral — all by correcting the provider to patient imbalance at the heart of Ohio’s healthcare system.

Will OPS really have enough money to work?

 

Yes. Ohio spends about $34 billion per year on Medicaid (even more now) when combining state and federal funds. Under the OPS model, 55% of that amount is redirected into a dedicated supplemental pool, which equals $18.7 billion. This is a conservative estimate based on today’s spending levels. Independent forecasts from the Ohio Office of Budget and Management and the Legislative Service Commission show Medicaid spending continuing to rise in future years, meaning the OPS pool will grow even larger over time.

OPS does not replace Medicaid, Medicare, private insurance, employer contributions, copays, or deductibles. All of those continue exactly as they do now. The OPS pool simply adds a stable supplemental payment that reduces providers’ dependence on inflated chargemaster prices and high private‑insurance reimbursement rates. When providers have predictable supplemental income, insurers can negotiate lower rates, which is what ultimately drives down premiums for families and employers.

In short, the OPS plan uses a realistic portion of money Ohio is already spending, and future projections show even more funding becoming available. That makes OPS financially strong enough to stabilize providers, improve transparency, and create downward pressure on premiums without raising taxes or expanding Medicaid’s budget.

Rethinking healthcare for a better future

We invite you to learn more about the Ohio Provider Supplement Plan and how we are committed to revolutionizing healthcare. Join us in building a more effective and sustainable system for everyone.

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