Medicaid update: hints of new data and promises of more, call center wait times still long, but behavioral health progress

There was good and bad news at Friday’s Medicaid council meeting. Call center wait times are down to 85 minutes but more callers are giving up. There are signs of hope in fixing the new transportation problem and DSS has imposed sanctions (maybe a connection there), but concerns remain. But in good news, we heard from Beacon about the success of their behavioral health program. More providers are participating in Medicaid improving access to care, particularly for autism services. Fewer kids are stuck in inpatient psychiatric hospitals because community services aren’t available and readmissions are down. Providers are getting support and training. But challenges remain in capacity for autism services, medication assisted treatment, respite and crisis stabilization. Beacon’s analysis of CT’s Medicaid data is impressive. We received information about the overall program that we’ve never gotten from DSS including racial/ethnic profiles, homelessness, prevalence rates for diabetes, opioid use, and diabetes, co-occuring medical and behavioral health diagnoses, average cost per member, and total dental and pharmacy costs. Outcome measures data (HEDIS rates) were not as clear. Data and analysis should never be shared only as Powerpoint slides. It was reported that information on the enhanced care coordination program for high-cost, high-need members is coming and is encouraging.

Concerns were again raised that DSS’s rush to move almost 200,000 members into PCMH + means they lose access to Beacon’s Intensive Care Management Program. DSS acknowledged this loss and stated that that was always their intention. DSS claims that the ACOs are providing the same level of services and promised we will eventually see data that confirms equivalent performance in access to care and outcomes  through the ACOs – that members’ welfare has not been compromised in the pursuit of generating savings. Advocates are eagerly awaiting that data and evidence.

The meeting ended with very moving video testimony by Vincent about the difference Beacon’s behavioral health care management has meant in his life and health.