HUSKY
Administration agrees to more time to design Medicaid reform
Monday the administration announced that they will delay the redesign of CT’s Medicaid program by at least six months. In a letter sent last week by twenty one independent consumers advocates, concerns were raised about the rush back into a risky financial model that could cost increase state costs. Advocates were particularly concerned about jeopardizing…
Read MoreIndependent advocates call for more study on Medicaid payment shift
A letter signed by twenty one independent consumer advocates calls on the state to halt the SIM-driven Medicaid’s rush into a return to shared savings, a risky payment model. Dozens of issues remain to be addressed to protect the 770,000 people who rely on the program before the deadline of October 5th. The rush is…
Read MoreShared savings math doesn’t add up, CCIP plans could undermine Medicaid
A new brief outlines the risk to taxpayers from Medicaid shared savings increasing health costs, as SIM is pressing. About half of Medicare ACOs spent more money on health care for members under shared savings last year. If Connecticut’s ACOs perform in Medicaid shared savings as they did for Medicare, CT taxpayers could lose as much…
Read MoreCTNJ Op-Ed: Let’s Halt the Rush to Risky Medicaid Experiment
Today’s CT News Junkie includes an opinion piece urging caution and more time for thoughtful deliberation in moving 200,000 HUSKY members into a very new, untested payment model that is costing more for Medicare. CT’s Medicaid program is a success story – improving quality, increasing providers, and lowering costs – but that success is fragile.…
Read MoreAdvocates’ Medicaid Study Group offers recommendations for Medicaid shared savings reform
Over a dozen Connecticut independent consumer advocates representing diverse populations and issue areas spent the last several months diving deep into Medicaid shared savings and today released recommendations for our state’s program. The Medicaid Study Group formed early in 2015 in response to a request from the Co-Chairs of the Medicaid Council’s Care Management Committee to…
Read More$103 million in new budget cuts Medicaid, mental health services
On Friday, the administration announced $103 million new budget cuts in response to lagging revenues. The biggest cut is $63.5 million in Medicaid, reportedly focused on hospitals. Community providers raised concerns about the impact of the cuts, including $7.4 million in behavioral health funding and $5 million from services for people with developmental disabilities,…
Read MoreACOs not saving for Medicare, model could cost CT Medicaid almost $100m/year
CMS’s vast shared savings experiment for Medicare has disappointed again in its second year. The plan was to encourage providers to assemble into health care systems, called Accountable Care Organizations (ACOs), to coordinate care and keep people well. The incentive was that the systems share half (or more) of the resulting savings. The only problem…
Read MoreAdvocates support SIM underservice, cherry picking protections
Connecticut’s SIM plan acknowledges that risks of inappropriate under-treatment and cherry-picking are higher in new shared savings payment models. Advocates were successful in getting a provision included in the SIM final plan that prohibits payment of shared savings to provider networks that systematically deny needed care or cherry pick patients to generate those savings. The…
Read MoreIssue Brief: Attribution and Why It Matters
A new brief describes attribution, a key component of payment reform. Attribution done wrong in a shared savings payment model can create incentive to cherry pick out less lucrative or difficult patients and disrupt existing provider-patient relationships. Attribution is the process of defining the population that a provider network is responsible for managing under a…
Read MoreAdvocates’ guide to underservice recommendations
Connecticut’s State Innovation Model (SIM) is seeking to radically transform our state’s $30 billion health system by aligning incentives to build value. SIM has chosen a shared savings payment model for those reforms. Advocates are concerned about incentives to deny necessary care under the new payment model, as happened in the past. SIM’s Equity and…
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