Medicare
CTNJ: ACOs may be the new HMOs, And they need a watchdog
Care for a growing number of Connecticut residents is being directed by an Accountable Care Organization (ACO) and very few patients know it. Read more
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 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 MoreConnecticut Medicare ACOs overspent by $45 million in 2016
Data from CMS show that in 2016 Connecticut’s Accountable Care Organizations (ACOs) together spent $45 million more on care for Medicare beneficiaries above risk-adjusted benchmark spending levels. ACOs are networks of providers across the continuum that coordinate care for people and receive a share of the savings they generate. All of Connecticut’s Medicare ACOs only…
Read MoreCT one of only four states that require Medigap plans to cover members when they need it
In all but four states, including CT, seniors on Medicare can be denied Medigap coverage at anytime according to a new analysis by the Kaiser Family Foundation. Federal law only requires a one-time, six-month Medigap plan open enrollment period that begins when beneficiaries originally sign up for Medicare. But states can go farther to protect…
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