Medicaid
Health in the News – long term care insurance, mandates, and Medicaid inpatient admissions up
Interest in the CLASS Act, part of national health reform, has focused attention on long term care insurance. All sides agree that something needs to be done, but is federally sponsored insurance sustainable? Issues around mandated insurance benefits are heating up again. Federal standards for the essential benefits package are being developed that may or…
Read MorePainless way to save $40 million in HUSKY
Our new policymaker issue brief outlines how moving HUSKY to self-insurance should save the state at least $40 million, without any changes in access to care. In 2008, under the PHIP/ASO model medical costs were actually lower than under HMO capitation the next year. Because the shift to self-insurance was sudden DSS was in a…
Read MoreThe final word – HUSKY ASO cost less than HMOs – or it should have
At Friday’s Medicaid Oversight Council meeting Mercer actuaries gave us the final comparison of the costs of the HUSKY program under the ASO/PHIP arrangement compared to the costs under capitated HMOs. We learned that in 2008 during the PHIP period, when the Governor removed any financial risk from the HMOs and the program ran as…
Read MoreNew report confirms that uninsured are NOT the reason for ER overcrowding, Medicaid is
Six out of seven ER visits to CT hospitals did not require hospital admission between 2006 and 2009, according to a new report by the Office of Health Care Access. Almost half were for non-urgent problems. Uninsured patients accounted for only one in eight ER non-admit visits, virtually the same as their proportion in the…
Read MoreCost cutting commission final proposals
The state Commission on Enhancing Agency Outcomes issued its final recommendations to save money in the state budget including over $145 million from health care spending. Proposals include more efficient Medicaid drug purchasing, drug recycling, preventing falls, and reducing the number of nursing home beds in the state and re-balancing long term care to emphasize…
Read MoreMedicaid Council update
Financial numbers released at Friday’s Medicaid Care Management Oversight Council meeting highlighted the need for more sophisticated accountability or, even better, moving the program to a self-insured ASO model and removing any HMO incentives to game the system. The Council first heard about Aetna’s underwhelming and vague performance improvement programs; Aetna’s quality performance for members…
Read MoreOLR reports on major issues for 2011
The Office of Legislative Research’s annual list of issues likely to be addressed in the coming session includes: · Considering alternatives to HMOs for the troubled HUSKY, including statewide PCCM · Reconsidering last year’s budget requirement that HUSKY move from the current capitated HMO-based model to a self-insured ASO model, as is common to most…
Read MoreState panel recommends $140 million in health care budget savings
Over half the recommended budget proposals for state budget savings from the Commission on Enhancing Agency Outcomes focus on health care spending. The savings center on prescription spending in Medicaid and moving nursing home residents to assisted living. The Commission is Co-Chaired by Sen. Gayle Slossberg and Rep. James Spallone. Ellen Andrews
Read MoreAdvocates ask CMS to intervene in HUSKY rate reductions
Two years ago, the state increased payment rates to providers in the Medicaid fee-for-service program and required that the HUSKY HMOs pay providers at least fee-for-service rates within the managed care program. The change in HMO contracts to require higher rates was included in the program’s federal waiver and capitation rates paid to plans were…
Read MoreFrom the consumer helpline: Medicaid consumers being charged
Two calls just this morning came from consumers covered by Medicaid being charged by hospitals. One was a mother on HUSKY Part A charged $281 by a hospital for services she already received. But the first call was from a man on Medicaid who was told by the hospital that they would not schedule the…
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