Care Management
Survey 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…
Read MoreCoincidence? CT spends little on primary care, and we have high ED, preventable hospitalization rates
A new analysis finds that Connecticut, at only 3.5% of our health care dollars spent on primary care, is last among 29 states studied. Not surprisingly, we also rank among the highest in ED visits, all hospitalizations, and in avoidable hospitalizations. The US average is 5.6% of health care spending devoted to primary care, well…
Read MoreNew tool makes Medicaid business case for CT to address obesity
Twenty nine percent of Connecticut children ages 5 to 17 are overweight or obese, according to the Department of Public Health. That number jumps to 47.8% for children living in households with annual incomes between $25,000 to 50,000. Many, maybe most, of these children qualify for Medicaid. Only 13.1% of Connecticut high school students eat…
Read MorePCMHs in CT – not the “shiny new toy” anymore but moving forward improving care, controlling costs
Ten years ago, patient-centered medical homes (PCMHs) were exotic in Connecticut. PCMHs are one of the best documented innovations to improve health. PCMHs are primary care practices that help keep people well by assessing needs, coordinating care, and giving people the skills and resources to maintain their own health. As a nurse managers told me,…
Read MoreNew PCMH + plans overlook past problems
Wednesday DSS and Mercer unveiled their thinking about plans for Wave 3 of PCMH Plus, Medicaid’s controversial shared savings program. Results from PCMH Plus’s first year, Wave 1, were disappointing with increased state costs and little evidence of improvement in quality. Based on the problems identified in Wave 1, advocates made recommendations to fix those…
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