HUSKY
Medicaid Council update
Friday’s Medicaid Council meeting featured DSS Commissioner Bremby’s comprehensive, long overdue client services system overhaul. To say the current systems are outdated is a massive understatement – fragmented, ancient, paper-based, and under-resourced. DSS’ plans for the future are as good as the current system is bad. Phone and online systems will be integrated, information for…
Read MoreMedicaid Council meeting
The news from Friday’s Medicaid Council meeting was that there was no news. Unlike previous HUSKY transitions, the shift from three capitated HMOs to only one entity, Community Health Network (CHN), running the program was uneventful. There had been concerns that many providers previously participating in the HMO networks were not enrolled in regular Medicaid,…
Read MoreMedicaid PCMH update
Today’s Care Management Committee meeting (formerly the PCCM Committee) in Hartford was frustrating. DSS and their consultants outlined their final plan for CT Medicaid’s person-centered medical home (PCMH) transformation. Unfortunately the final plan is not substantially different than the original proposal which raised concerns among advocates. Most contentious was DSS’ refusal to match consumers and…
Read MoreCourant OP-ED raises concerns about Medicaid PCMH proposal
An Opinion piece in today’s Hartford Courant by Sheldon Toubman of New Haven legal aid outlines many problems with DSS’ proposal for person-centered medical homes. PCMHs have been used by payers, including many other state Medicaid programs and CT’s state employee plan, to improve the effectiveness of health care, reduce duplications and errors and rein…
Read MoreState chooses CHN to run Medicaid
The administration announced that they will be negotiating with Community Health Network to administer the entire state Medicaid program as of January 1st. Based on the state’s community health centers, CHN has been a participating managed care provider for HUSKY since its inception sixteen years ago. The managed care program will expand beyond the current…
Read MoreCT Health Policy Project comments on DSS proposal for Medicaid person-centered medical homes
To implement the administration’s directive to develop person/patient-centered medical homes for every Medicaid consumer, DSS has proposed a payment model very different from other successful state programs. CTHPP has submitted comments on the proposal including concerns about reliance on retrospective enhanced fee-for-service and P4P payments, the lack of risk adjustment, opaque incentives, and a weak…
Read MoreMedicaid Council update
Friday’s Council meeting was mixed. DSS described their process for developing person-centered medical homes — a far better name. Their provider advisory group will be guiding the department in choosing which PCMH standards providers will have to meet, how they will be paid and the outcomes they will be measured against. Doctors are well-represented (a…
Read MoreComments on federal ACO proposal, Changing Face of Medicaid
CMS has issued the proposed rule under national health reform to implement Accountable Care Organizations (ACOs) for Medicare beneficiaries. ACOs are a new way of paying for health care, moving away from fee-for-service to paying for value. An ACO is a network of health care providers spanning the care spectrum paid to provide for all…
Read MoreFixing Medicaid: Healing CT’s Largest Health Care Program
Access to care in CT’s public programs has always been a struggle; it is difficult to find a provider who takes Medicaid. In 2008 CT significantly raised Medicaid payment rates but a report by the CT Health Policy Project before, during and after the increase found that physician participation in the program didn’t improve. With…
Read MoreDSS implementer bill allows agency to cut benefits without legislative approval
Section 116 of SB 1240, passed by the Senate yesterday, would allow DSS to cut benefits provided to consumers in the LIA program, formerly known as SAGA. Cuts could include, but is not limited to, office and hospital visits, therapy services, medical equipment and supplies, medications, non-emergency medical transportation, and home care. If unchanged, the…
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