Care Management
CTNJ: COVID Response Offers Opportunities for Connecticut’s Future Healthcare System
The pandemic has been tragic in both lives lost and economic damage, especially to low wage workers. Our already flawed healthcare system has been seriously disrupted. Insurer profits are up, hospitals are losing money, and Connecticut healthcare jobs in April were down 28,400 from the year before. As the pandemic winds down, the recovery offers…
Read MoreShare your ideas to support Connecticut health care coordination, access, and quality
The state is rushing to implement an expensive Health Information Exchange to access $48 million before a federal deadline. The state Office of Health Strategy (OHS) is moving forward very quickly despite concerns raised by consumers and providers about selling access to identifiable patient records to insurers and ACOs, privacy rights, the capacity of the…
Read MorePCMH (no Plus) program continues to grow and improve care
At MAPOC’s Care Management Committee meeting Wednesday, the state provided the latest numbers from the successful Person-Centered Medical Home program. PCMHs are primary care practices that coordinate care for patients, offer expanded hours, and address population health needs. The program continues to grow, adding 52 primary care providers and seven new sites of care in…
Read MoreCommunity health centers still struggle with ED visits
As in the past, Medicaid patients of Connecticut’s community health centers are far more likely to visit an ED than other Medicaid patients, according to a presentation by CHNCT at Friday’s Medicaid Council meeting. While rates have decreased a bit, the very large gap in ED use rate between clinic patients and other Patient-Centered Medical…
Read MoreSurvey finds CT ACOs planning services for high need members
Similar to national results, a new survey of Connecticut Accountable Care Organizations for MAPOC’s Complex Care Committee by the CT Health Policy Project finds that most are using multiple methods to identify high need members. But they are still working on implementing effective programs to address the needs. Many of their plans follow best practices…
Read MoreCTNJ Analysis: When Making Things Better Makes Things Worse: Algorithms, Data and Racial Bias
Unintended consequences are old news; so why are we surprised every time it happens? Computer programs developed to target care management services to people with serious complex conditions were meant to make important health decisions based on data but instead favored White patients over sicker Black patients. Read more
Read MoreCT Medicaid child checkup rates jumped when HMOs were fired
Well-child screenings increased twelve percent for HUSKY children between FY 2001 and FY 2012, according to a new report from the Government Accounting Office. While correlation is not causation, it is important to note that on January 1, 2012 Connecticut Medicaid payment shifted from capitation through private managed care companies to our current managed fee-for-service…
Read MoreHousing community explores successful CT collaborations to promote health
Over 300 Connecticut affordable housing stakeholders joined Governor Lamont and other speakers at the Affordable Housing Alliance’s 30th annual conference last week. The Governor explained his focus on affordable housing by relating a conversation with a young bus rider in New Haven who’d been homeless as a child. With help from housing care managers, he…
Read MoreState approves controversial New Haven primary care move
Friday, the state Office of Health Strategy gave final approval Yale-New Haven’s application to move primary care for over 25,000 low income consumers out of neighborhoods and shift them to the Cornell Scott and Fairhaven health centers for payment purposes. Under the final agreement patients would still be cared for by the same YNHH primary…
Read MorePCMH + risk scores suggest possible gaming or worse; Advocates call on DSS to delay expansion to protect members and taxpayers
A new analysis of PCMH + members’ risk scores finds unexplained increases compared to the control/comparison group that could signal ACO gaming of the system for financial gain and/or, far worse, a decline in the health of members in the program. PCMH Plus, a controversial new payment model, allows ACO (large health systems) to share…
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