Care Management

Seven years later, Connecticut Medicaid still saving taxpayers money

Download the report As with most health care in Connecticut, Medicaid spending was rising quickly before 2012 growing by almost half over the prior four years. But in 2012, Connecticut made a remarkable and unique move — Medicaid switched from a capitated payment model using private insurers to a care coordination-focused, self-insured payment model. Since…

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Mixed results from great study on Medicaid behavioral health interventions

Yesterday’s MAPOC Complex Care Committee meeting focused on results of an adult high behavioral health need member initiative by Beacon, Medicaid’s behavioral health administrator. The program serves high utilizers of hospital services with behavioral health needs providing intensive care management by teams of clinicians and peer specialists. Medicaid members with high behavioral health needs were…

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PCMH Plus Year 1 Performance and Savings Results: Increased state costs but little evidence of impact on quality

Read the full report This month, Connecticut Medicaid announced the first year performance of PCMH Plus[1], their controversial new shared savings program[2] compared to the prior year. Under shared savings, if health systems (ACOs) are able to lower the cost of their members’ care, they receive a bonus equal to half those savings. PCMH Plus…

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Advocates get no answers to questions about HUSKY experiment

Last month, a group of independent consumer advocates, the Medicaid Study Group, sent questions to DSS about the impact of PCMH Plus, their new $10.8 million experimental program of shared savings in HUSKY. Advocates have been concerned about PCMH Plus’s potential to deny needed care, raise costs in the program, and erase hard-won progress. Questions…

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31 ways to save on healthcare in Connecticut’s budget

Connecticut’s state budget is facing future deficits and health spending is a large share of the budget. The state now spends $3.8 billion between Medicaid and the state employee health plan to cover about a million state residents. Health care spending outside the state budget is also growing. Connecticut has the sixth highest per capita…

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Rest of US catching up with CT – Medicaid managed care doesn’t work

Two Health Affairs blog posts highlight the disappointments states are having with their capitated Medicaid managed care programs. Managed care across the US is growing fast, making big profits for private insurance companies, promising improved health outcomes and lowering costs. But CT found exactly the opposite effect when we shifted away from capitated managed care…

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Committee develops care plan best practices recommendations for Medicaid

The Complex Care Committee of CT’s Medicaid Council has made recommendations to DSS for careplans in the Medicaid program. The importance of effective care plans has arisen often throughout the committee’s work diving deep into barriers to care for Medicaid members with complex health needs. Effective care plans ensure that people are driving decisions about…

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CTNJ: Advocates must inform consumers of risks when the state won’t

This week, independent advocates launched, a campaign to give HUSKY members balanced information about an experimental, new payment model expanding across the program. PCMH Plus has risks for consumers along with possible benefits, but HUSKY members aren’t aware of them or that they have the right to opt-out of the new payment model. Read more

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