PCCM

Medicaid update: Quality was rising through 2016, raising concerns about PCMH+

Friday’s MAPOC meeting focused on Medicaid quality and access information from CHNCT, DSS’s administrative contractor for the program. Across the 12 (of over 100) quality measures chosen, there was modest but sustained improvement from 2014 through 2016. However community health center performance consistently lags behind other PMCH practices across the quality measures. Of particular concern…

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Connecticut’s Medicaid redesign update– Pros and Cons

  Connecticut’s Medicaid program has earned national recognition for combining improved access to high quality care with an impressive record of cost control. Shifting the program from a financial risk payment model to care coordination through person-centered medical homes (PCMHs) four years ago is widely credited with that success. Last year the administration began developing…

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Advocates’ guide to underservice recommendations

SIM is seeking to radically transform our state’s $30 billion health system and has chosen a shared savings payment model for those reforms. Advocates are concerned about incentives to deny necessary care under the new payment model, as happened in the past. SIM’s Equity and Access Council was charged with developing protections to limit and…

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CT’s Medicaid success: Access and quality are up, costs are down

Since 2012, when CT’s Medicaid program shifted from a capitated payment model to a self-insured model based on care coordination, the program has enjoyed significant improvements in quality, access and cost control, as predicted. A new analysis finds that the number of providers participating the in the program is up 32%, person-centered medical homes are up…

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Medicaid PCMH update

Today’s Care Management Committee meeting (formerly the PCCM Committee) in Hartford was frustrating. DSS and their consultants outlined their final plan for CT Medicaid’s person-centered medical home (PCMH) transformation. Unfortunately the final plan is not substantially different than the original proposal which raised concerns among advocates. Most contentious was DSS’ refusal to match consumers and…

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Courant OP-ED raises concerns about Medicaid PCMH proposal

An Opinion piece in today’s Hartford Courant by Sheldon Toubman of New Haven legal aid outlines many problems with DSS’ proposal for person-centered medical homes. PCMHs have been used by payers, including many other state Medicaid programs and CT’s state employee plan, to improve the effectiveness of health care, reduce duplications and errors and rein…

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State chooses CHN to run Medicaid

The administration announced that they will be negotiating with Community Health Network to administer the entire state Medicaid program as of January 1st. Based on the state’s community health centers, CHN has been a participating managed care provider for HUSKY since its inception sixteen years ago. The managed care program will expand beyond the current…

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CT Health Policy Project comments on DSS proposal for Medicaid person-centered medical homes

To implement the administration’s directive to develop person/patient-centered medical homes for every Medicaid consumer, DSS has proposed a payment model very different from other successful state programs. CTHPP has submitted comments on the proposal including concerns about reliance on retrospective enhanced fee-for-service and P4P payments, the lack of risk adjustment, opaque incentives, and a weak…

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Medicaid Council update

Friday’s Council meeting was mixed. DSS described their process for developing person-centered medical homes — a far better name. Their provider advisory group will be guiding the department in choosing which PCMH standards providers will have to meet, how they will be paid and the outcomes they will be measured against. Doctors are well-represented (a…

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