Medicaid MCOs and quality, access – What the evidence says
Governor Lamont is reportedly considering a plan to have private insurance managed care plans (MCOs) run Connecticut’s Medicaid program.
Do MCOs improve quality or access to care in state Medicaid programs? We looked into the evidence.
In a word, No.
From the literature:
The evidence does not support Medicaid MCOs improving either access to healthcare services or the quality of care provided to members.
According to MACPAC, Medicaid’s federal oversight commission, the National Conference of State Legislators, and the National Association of Medicaid Directors, despite many studies, independent evidence does not support MCO promises to improve access or the quality of healthcare for members. Syntheses of independent, peer-reviewed studies also do not find evidence of improved quality or access.
Quality of care in Connecticut Medicaid is much better across dozens of measures than most states, which have MCOs. Just one study published this year found the rates of early-stage cancer diagnosis and survival among Medicaid members were substantially better in Connecticut, without MCOs, than in New Jersey, a demographically comparable state that still has MCOs. Rates were comparable between the states until 2012, but when Connecticut removed MCOs from our Medicaid program our rates steadily improved. New Jersey Medicaid’s rates did not change.
Go to the full report for all the evidence
Visit NoHuskyMCOs.org for updates, more evidence, the history of MCOs in HUSKY, talking points, a slide deck, sign onto a petition to the Governor, and other ways to get your voice heard. We’ll be adding to it regularly. NoHuskyMCOs is sponsored by the CT Health Policy Project.