Medicaid
CTNJ: Analysis – Clinic plan could hit state budget, raise patient costs, increase barriers to access
Last week the state Office of Health Strategy held a public hearing on a plan to transfer 28,500 mostly Medicaid patients, now served by three Yale-New Haven (YNHH) neighborhood primary care clinics, to a new site on Long Wharf owned by YNHH. But in a twist that could cost the state millions, those patients will…
Read MorePublic hearing on controversial YNHH primary care plan this week
The state Office of Health Strategy (formerly OHCA) will be holding a CON public hearing next Wednesday November 28th at 3pm at the Parish House at Betsy Ross Arts Magnet School, 150 Kimberly Ave., New Haven, CT 06519. Yale-New Haven Hospital, together with New Haven’s two community health centers, Fairhaven and Cornell Scott Hill Health…
Read MoreDisability advocates register serious concerns with SIM primary care capitation plan
On Friday, thirty consumers and advocates for people with disabilities sent a letter to Vicki Veltri and Mark Schaefer, CT’s SIM officials, expressing their concerns with SIM’s proposal to capitate primary care for everyone in CT. The signers are concerned about the potential to deny needed care, especially for people with complex medical conditions. Capitation…
Read MorePCMH+ quality reports surprisingly underwhelming
At the MAPOC and Care Management committee meetings we finally received the promised quality evaluation of PCMH +’s first year. PCMH+ is DSS’s experimental new payment program that now covers 165,432 HUSKY members. We only received information on the 13 mainly process measures. These measures were chosen as basis for shared savings payments, not for…
Read MoreCT hospitals report $1.6 billion in community benefits, but most of that is claims of Medicaid underpayment
Yesterday’s Healthcare Cabinet meeting focused on CT nonprofit hospital community benefit reports to the IRS. Last year, CT hospitals claimed $1.6 billion in community benefits, but over half of that (57%) are claims of Medicaid underpayment. Charity care provided to patients unable to pay for their services constituted 21% of total charity care; health professional…
Read MoreAdvocates get no answers to questions about HUSKY experiment
Last month, a group of independent consumer advocates, the Medicaid Study Group, sent questions to DSS about the impact of PCMH Plus, their new $10.8 million experimental program of shared savings in HUSKY. Advocates have been concerned about PCMH Plus’s potential to deny needed care, raise costs in the program, and erase hard-won progress. Questions…
Read MoreMedicaid update: LTSS working to keep people out of nursing homes, hospitals
Friday’s Medicaid Council meeting focused on rebalancing long term services and supports allowing more members to stay at home, if they choose, and improve quality of life. Recipients of LTSS services comprise 6% of Medicaid members but 43% of costs. On average community-based care is less costly. The comprehensive strategy that began with a 2013…
Read MoreAnother reason to be glad HUSKY fired managed care
New favorite quote – “If you have a dumb incentive system, you get dumb outcomes.” Charlie Munger, quoted by 46brooklyn A new analysis by 46brooklyn highlights the extra costs to Medicaid managed care programs of drug industry middlemen. Ohio’s Medicaid program pays $224 extra in markups to Pharmacy Benefit Managers (PBMs) hired by managed care…
Read MoreMedicaid update: Enrollment numbers coming finally, highlighting progress
Friday’s Medicaid Council meeting focused on enrollment numbers and reviewing achievements in the program. DSS outlined challenges that have delayed reporting enrollment numbers for two years and their new system for reporting the numbers. Rather than getting enrollment reports on paper as in the past, DSS is posting the data on CT Open Data. Visitors…
Read MoreConnecticut’s uninsured rate up, reversing four-year trend
New numbers from the US Census Bureau report that 194,000 or 5.5% of Connecticut residents were uninsured last year. That number is up 22,000 from the year before when the uninsured rate was 4.9%. The new data breaks a trend of fewer uninsured that began with implementation of coverage expansions under the Affordable Care Act…
Read More