HUSKY
Medicaid update: PCMH+ limping along, bad news for HUSKY parents, and Medicare cuts loom
PCMH+, CT Medicaid’s experimental move back into financial risk that now impacts just over 100,000 people, survived the budget cuts – sort of. The PCMH+ budget was cut from $500,000 (state costs) last year to $300,000 this year, but the SIM federal grant has been devoting a lot of resources to the initiative. We have…
Read MoreCT Medicaid only state to earn A+ for access to HepC drugs
A new report finds that CT’s Medicaid program leads the US in access to new Hepatitis C medications. Hepatitis C affects 3.5 million Americans and causes more deaths than any other infectious disease. CT Medicaid imposes no liver damage, sobriety or prescriber restrictions to HepC drug access that are common in other states. The report…
Read MoreIndependent advocates seek answers about Medicaid experiment
The Medicaid Study Group, a collaboration of CT independent consumer advocates, sent a list of critical questions about PCMH+ to DSS yesterday. PCMH+ is Medicaid’s controversial new payment experiment affecting over 100,000 people and scheduled for a massive expansion next year. Advocates have submitted questions in writing because we have not been able to ask questions…
Read MoreState CHIP program that covers 17,331 CT children at risk without federal action
MACPAC estimates that, without federal extension of funding for the CHIP program, CT will run out of funds in February. Our state CHIP program, also called HUSKY Part B, provided subsidized coverage 17,133 children as of August 1st. Created by Congress in 1997, the CHIP program has provided coverage to 3.67 million children across the…
Read MoreQuality challenges remain in CT Medicaid PCMHs
Also at Friday’s meeting, DSS reported on a selection of quality results from 2015, highlighting concerns. The results compared quality measures for patients receiving care from private practice and community health center Patient-Centered Medical Homes. In other programs, PCMHs have improved quality performance over non-PCMH practices. There remains a lot of room for improvement. Only…
Read MoreDéjà vu at Medicaid Council meeting
Friday’s Medicaid Council meeting focused on the controversialPCMH+ shared savings program reminding many observers of years of rosy DSS presentations about the very similar, failed HUSKY MCO program. PCMH+ started six months ago with 137,000 members. The concept is to give Accountable Care Organizations (large health systems) a reason to lower the total cost of…
Read MoreAdvocates document concerns with PCMH+ implementation
The Medicaid Study Group, a coalition of independent consumer advocates, have published an update on CT Medicaid’s new payment reform experiment, PCMH+, fact sheet and report. The program started January 1st with 137,037 members. Under the new shared saving payment model, large health systems (called ACOs in other states and programs), get half the health care savings…
Read MoreReport estimates AHCA would cut $5.9 billion in Medicaid funds to CT
Connecticut would lose $5.9 billion in Medicaid funding from 2019 to 2028 under the American Health Care Act passed by the House last month, according to a new report from the Urban Institute and the Robert Wood Johnson Foundation. Connecticut would likely not be in a position to fill that funding gap with state funds.…
Read MoreNew data finds CT leads nation in lowering Medicaid costs
New data from CMS actuaries finds that Medicaid per capita health care spending dropped 5.7% from 2010 to 2014, better than any other state. Of note, in 2012 CT Medicaid shifted away from capitated managed care organizations to run Medicaid. Unfortunately, the rest of the CT’s market is not performing as well as Medicaid –…
Read MoreMedicaid update – administrative conversion drives up call wait times
Friday’s Medicaid oversight council meeting focused on DSS’s conversion to ImpactCT, a new IT system to handle eligibility and enrollment. The hope is that moving more administrative functions online will streamline the process and reduce errors. Unfortunately, implementing the system is pulling staff away from their desks for 9 days of training, causing a sharp…
Read More