Care Management
Advocates’ guide to underservice recommendations
Connecticut’s State Innovation Model (SIM) is seeking to radically transform our state’s $30 billion health system by aligning incentives to build value. SIM 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…
Read MoreAdvocates’ 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…
Read MoreWebinar online – Caring for high-need patients – Lessons for CT
Evidence is growing that we cannot fix our health care system without addressing the needs of the small number of patients with very complex and costly health problems. Connecticut can learn from other programs across the US as we build reforms for our state and our Medicaid program. On this week’s webinar we heard from…
Read MoreCSG/ERC Hopkins tour highlights patient safety, care coordination and cancer innovations
Yesterday’s off-site trip to Johns Hopkins from the CSG/ERC annual meeting was impressive. We heard about out of the box thinking by a clinical scientist that led to a breakthrough in treating lung cancer – that very low, but longer term doses of chemotherapy drugs worked better than full doses in shrinking tumors and helped…
Read MoreMedicaid Council update
Friday’s Medicaid Oversight Council meeting focused on the success of the Intensive Care Management Program. The program provides the most fragile Medicaid consumers with team-based, patient-centered care starting with a comprehensive assessment of what consumers need, both health and other supports, strengths and barriers. The team supports the consumer in setting their own goals and…
Read MorePCCM/HUSKY Primary Care now on Facebook
The effort to move PCCM forward in Connecticut is taking a new turn – yes, we are joining Facebook! Type in “HUSKY Primary Care” on Facebook. The goal of this new group is to get people on or interested in HUSKY to talk about the exciting new option of PCCM/HUSKY Primary Care, with each other…
Read MoreDSS outlines options to move HUSKY away from capitation – or not
At yesterday’s Medicaid Care Management Oversight Council (formerly known as the Medicaid Managed Care Council), DSS outlined three policy options to restructure HUSKY’s financing. The options were a response to direction in the latest budget to move HUSKY from a fully insured, capitated system to a self-insured, ASO model; the budget included approximately $75 million…
Read MorePCCM Update
At yesterday’s Appropriations’ Human Services Subcommittee meeting, DSS reported on progress toward implementing a pilot Primary Care Case Management program for HUSKY. DSS has been busy researching other states’ PCCM programs, including a January trip to MA to hear from several states’ about best practices and collecting PCCM provider contracts. DSS generously invited this advocate…
Read MoreGovernor’s proposal to cut interpreters faces opposition
An article on ctnewsjunkie.com reports on Friday’s press conference by legislators opposing Governor Rell’s proposal to cut $4.7 million for medical interpreters in Medicaid. At last week’s Medicaid Managed Care Council, CT Voices for Children presented on the very high and growing rate of costly emergency room visits by Medicaid Managed Care/HUSKY patients. 38% of…
Read MoreOver 40 million Americans missed needed health care services due to cost
18.6% of American adults did not receive needed medical care in 2005 because they could not afford it, according to a new report by the CDC. 25 million did not get needed dental care, over 18 million missed needed prescriptions and over 15 million did not get medical care they needed because of cost. 6%…
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