Smart Savings

Comment open on leading healthcare value pricing methodology

The Institute for Clinical and Economic Review (ICER) is seeking public input on their methodology to their development of benchmark prices for tests, treatments, drugs and innovations based on their value. ICER, an independent non-profit research institute, is the key source for value-based assessments. Their reports are used by the VA, Medicare, Medicaid, commercial plans…

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Better, safer ideas to support primary care in Connecticut

Download the report Primary care is the foundation of the health system. It is, or should be, patients’ first interaction with the healthcare system for non-urgent issues. There is strong evidence that care coordination linked to primary care practices, such as patient-centered medical homes (PCMHs), foster improved health while lowering costs.[i] Areas with more primary…

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Medicaid’s Care Management program is saving lives and money, but state paying twice and savings may be going to PCMH+ ACOs

Last week, the Complex Care Committee of the Medicaid oversight council heard from CHNCT, the nonprofit that, among other things, administers our state’s Intensive Care Management (ICM) program. ICM is available to Medicaid members with complex health needs and, typically, high health costs. The ICM program includes regional teams providing comprehensive assessment and care planning,…

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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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CTNJ: Public Health has a Free Rider Problem

Public health is the best deal on the planet. Connecticut spends only $29 per person, less than most states, on public health but $9,859 on healthcare services, more than most states. But Connecticut expects our under-funded public health system to solve this intractable health problem while all the savings go to the inefficient healthcare system…

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