Medicaid
CT’s Medicare patient centered medical home application — bad and good news
Unfortunately, CMS did not approve CT’s application to include Medicare in our patient-centered medical home plans for state employees and Medicaid. If it helps, we are in good company – Massachusetts and Maryland, states with sophisticated reform efforts – also did not get approved. But the good news is that the partners are all interested…
Read MoreState Supreme Court to decide if widows are responsible for nursing home bills
The New Haven Advocate reports that the CT State Supreme Court is considering a case that could have a devastating impact on CT’s 28,000 nursing home patients and their families. The case involves who should pay the $60,795.32 nursing home bill of a man who died two years ago. The nursing home, Wilton Meadows, is…
Read MoreHUSKY HMOs made $19 million profits last year; families paid $323.16 to HMO profits
At the very end of yesterday’s Medicaid Care Management Oversight Council meeting, DSS reported that the HUSKY HMOs made $18.8 million in profits on the program during 2009. This profit is on top of their administrative costs. Aetna made most of that profit — $14 million – despite having only one fourth of total enrollment.…
Read MoreNew Orleans health care – five years after Katrina
Yesterday, the NASHP conference in New Orleans started with a plenary session on the state of health care in the city. Things were not great before Katrina – the city was at the bottom of national list for health care access and outcomes. 80% of the housing stock was lost; health care institutions were devastated.…
Read MoreConversion to risk corridors in HUSKY seems less likely
As reported by Christine Stuart at CT News Junkie, in a meeting yesterday the Executive Committee of the Medicaid Managed Care Council considered HUSKY financing options outlined by DSS at the last Council meeting. The budget passed earlier this year includes $76 million in savings to move HUSKY from the current capitated system to a…
Read MoreWill Charter Oak survive?
An interesting story by Arielle Levin Becker at the CT Mirror asks whether Charter Oak will survive after Governor Rell leaves office. The best thing about Charter Oak is that people with pre-existing conditions are not excluded from coverage; under national health reform, that exclusion will be prohibited in all health insurance in 2014. It…
Read MorePCCM/HUSKY Primary Care now on Facebook
The effort to move PCCM forward in Connecticut is taking a new turn – yes, we are joining Facebook! Type in “HUSKY Primary Care” on Facebook. The goal of this new group is to get people on or interested in HUSKY to talk about the exciting new option of PCCM/HUSKY Primary Care, with each other…
Read MoreDSS outlines options to move HUSKY away from capitation – or not
At yesterday’s Medicaid Care Management Oversight Council (formerly known as the Medicaid Managed Care Council), DSS outlined three policy options to restructure HUSKY’s financing. The options were a response to direction in the latest budget to move HUSKY from a fully insured, capitated system to a self-insured, ASO model; the budget included approximately $75 million…
Read MoreEnhanced Medicaid match funding moving through Senate
The Senate has reached a deal on an extension of the enhanced Medicaid matching funds that most states had already counted on in budgets. CT’s current year budget included $266 million in expected funding which was scaled back to $199 as part of the deal. However, states were concerned that none of the funding would…
Read More150,000 coming into already troubled Medicaid program
Finally attention is being paid to probably the largest impact of national reform – an estimated 150,000 people in CT will become eligible for Medicaid/HUSKY; an increase of 38% over current levels. Any reader of this blog knows how HUSKY has struggled since its inception. A secret shopper survey found only one in four listed…
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