Smart Savings

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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ICER seeking new members of comparative effectiveness panel

The Institute for Clinical and Economic Review (ICER) has opened nominations for their New England Comparative Effectiveness Public Advisory Council. The council, one of three in the US, is composed of leading clinicians, patient and public representatives, methodologists, and health economists. The group meets three times each year to consider ICER effectiveness reports on the…

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Health Affairs: CHC, Inc. eConsult program saved on specialty care and improved access

This month’s Health Affairs includes a study on the effectiveness of eConsults for Medicaid members needing specialty care. Specialty referrals are rising, especially for Medicaid members, who often experience challenges getting that care. In response to this barrier for their patients, in 2011 Connecticut’s CHC, Inc. created a system to link primary and specialty care…

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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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Another reason to be glad HUSKY fired managed care

New favorite quote – “If you have a dumb incentive system, you get dumb outcomes.” Charlie Munger, quoted by 46brooklyn A new analysis by 46brooklyn highlights the extra costs to Medicaid managed care programs of drug industry middlemen. Ohio’s Medicaid program pays $224 extra in markups to Pharmacy Benefit Managers (PBMs) hired by managed care…

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