Care Management
Connecticut hospital systems vary in reducing low-value care
A new report published in JAMA Internal Medicine on low-value care provided to Medicare beneficiaries at the health system level offers actionable tools to improve effective care on the ground. Healthcare services that provide little or no health benefit, may harm patients, increase costs, and waste resources are low-value. Examples include prostate specific antigen testing…
Read MoreGood and bad Medicaid PCMH, PCMH Plus updates
At today’s MAPOC Care Management Committee, we learned that Medicaid’s successful Patient-Centered Medical Home (PCMH) program is growing and keeping up with higher enrollment due to COVID. In disappointing news, we also learned that the controversial PCMH Plus program has fewer care managers than expected and only 36% of ACO member advisory committees have any…
Read MoreOHS committee considering dumbing down successful PCMH standards
Among other troubling plans, the Office of Health Strategy’s Primary Care Subgroup is considering four options to certify high-performing primary care practices for higher levels of reimbursement. The committee is deciding how to double spending on primary care while simultaneously capping healthcare cost growth. At their meeting this week, the committee of mainly primary care…
Read MoreNew Medicaid homelessness prevention program shows promise
Starting August 1st, Medicaid members at risk of homelessness will have access to housing support services and subsidies through the new CHESS program. The program is designed to address upstream problems to prevent future problems and improve overall health. Described at today’s MAPOC meeting, the plan expects to serve about 850 Medicaid members with care…
Read MoreGovernor’s consultant report recommendations for Medicaid savings are baseless
It’s not in the headlines but the biggest source of potential savings, $200 million, proposed by the Governor’s controversial report from Boston Consulting Group (BCG) to save money in state government to is to go back to failed Medicaid financial risk models. There are two problems with the proposal. First, the financial risk models don’t…
Read MoreConnecticut Medicaid costs stable but rising physician and clinic spending threaten progress
Download the report Since switching from managed care organizations in 2012 to focus on care management, Connecticut Medicaid spending has stabilized while enrollment has expanded significantly, according to the state’s latest financial report. Medicaid now covers one in four state residents. However, physician and clinic spending increases are eroding early progress in controlling costs. Medicaid…
Read MoreCT Medicaid eligibility and service decisions benefit members but also the state budget
It may be counter-intuitive but, despite our high incomes, Connecticut’s generosity in eligibility and provider rates means the federal government provides more support to our program than other states. Medicaid is jointly funded, and administered, by both federal and state governments. Federal funding is highest to states with the lowest per capita incomes. As a…
Read MoreCT suicide prevention planning to save lives
Like the rest of the nation, deaths by suicide were rising in Connecticut even before the pandemic, according to the State of Connecticut Suicide Prevention Plan for 2020 – 2025. One in three Connecticut residents have reported signs of depressive and/or anxiety disorder during the pandemic. The newly released plan offers data-driven recommendations to prevent…
Read MoreUS safe injection sites could save lives and save cities up to $4.35 million each year
Allowing safe sites for injecting opioids in the US would save lives and lower healthcare spending significantly for affected communities, according to ICER’s latest draft evidence report. In 2018, opioid overdoses killed 948 Connecticut residents and there are signals that the rate has risen during the pandemic. Supervised injection facilities (SFIs) are part of a…
Read MoreHalf of current COVID hospital admissions are Medicaid members
Connecticut Medicaid has taken a serious hit from COVID. At Friday’s Medical Assistance Program Oversight Council meeting, we learned that while hospitalizations went up, outpatient and physician care went down. In May outpatient care spending was down 51% from last year and physician care was down 36%. Those numbers have risen somewhat but are still…
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