HUSKY
Medicaid Council update – PCMH + and national Medicaid proposals
Friday’s MAPOC meeting started with an update about the shared savings experiment that covers 137,037 members and started January 1st. Contracts have been finalized with nine ACOs. enrollment % of total NEMG/Yale 7,509 5.5% St. Vincent’s 18,086 13.2% Fairhaven HC 7,811 5.7% Cornell Scott-Hill HC 13,781 10.1% Generations Family HC 8,000 5.8% Southwest CHC…
Read MoreAdvocates ask DSS yet again for a robust evaluation of risky experiment before expanding
Twenty-three independent advocates sent a letter today again urging the state to conduct common sense evaluation of the first wave of a risky new program before expanding the program, as promised. Advocates have learned that the planned evaluation will not be available until 2 months after the RFP for the second wave is finalized and released. In addition, current…
Read MoreGovernor proposes new health reform planning agency, and more cuts to HUSKY parents
The Governor’s state budget proposal, released today, includes $5.8 million in rearranged funding and staff for a new Office of Health Strategy, effective July 2018, to “enhance coordination and consolidate accountability for the implementation of the state’s health care reform strategies.” The office will combine OHCA (formerly a separate agency, but now part of DPH…
Read MoreComplex Care Committee hears about serious problems with new technology for home health visits
Friday’s meeting of MAPOC’s Complex Care Committee focused on problems with DSS’s new Electronic Verification System to ensure accountability in provision of home care to Medicaid members. Implementation of the troubled, costly, mandated system began January 1st and is scheduled to be completed February 1st. All stakeholders, including consumer advocates and home health agencies, repeated…
Read MorePCMH + evaluation plans – weak review and too late to matter
Wednesday DSS unveiled their initial plans to evaluate PCMH +, the new experimental HUSKY shared savings program that just started January 1st with 160,000 members. HUSKY’s previous experience with financial risk was a universally acknowledged failure. Contrary to promises for a meaningful evaluation of the program before moving another 200,000 members into the program next…
Read MoreBusting Medicaid spending myths
Despite best efforts by legislators, advocates, and state officials, persistent myths remain about the success of Connecticut’s Medicaid program. It’s understandable – before the shift five years ago away from private insurers to care coordination, costs were out of control, but things are very different now. We’ve looked under the hood, drilled down into details,…
Read MoreDSS plans for high-cost, high-need members focuses on behavioral health
At yesterday’s online MAPOC Complex Care Committee meeting, DSS described their innovation plan to address the needs of high-cost, high-need Medicaid members. (meeting video and slides) The project was made possible by a technical assistance grant from the National Governor’s Association. Five agencies and the Medicaid Administrative Service Organizations, CHNCT and Beacon Health, have worked…
Read MoreTroubling Cabinet vote for downside risk on Medicaid and state employees, but there will be a public hearing
In a 13 to 4 vote Tuesday, the Health Care Cabinet voted to impose the controversial downside risk payment model on CT’s Medicaid and state employee plans. DSS, OPM, DPH and the only consumer advocate at the meeting all voted against the option (votes are listed below). Deep concerns have been raised about downside…
Read MoreMedicaid Council weighs in on Health Care Cabinet reform proposal
Last week’s Medicaid Council meeting focused on the controversial Strawman proposal for reforming CT’s health care system and the implications for Medicaid. We reviewed continuing progress in the program improving quality and access while controlling costs. State spending on the program is down, despite strong enrollment growth, and per person costs are stable saving the…
Read MoreSetting the Record Straight on Broken Promises, Now Let’s Move On
Medicaid advocates and providers have been talking a lot about the administration’s policy reversal with a troubling decision to consider downside risk as a payment model for Medicaid. A main source of concern is that stakeholders had clear and repeated promises from the administration not to implement downside risk in Medicaid. Click here to thrash through…
Read More