PCCM
Medicaid 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 MoreConnecticut patient-centered medical home first adopters
Transforming a busy medical practice into a patient-centered medical home (PCMH) can be daunting but the benefits are worth it, according to a report by CTHPP intern Kim Kushner. With 113 NCQA recognized patient centered medical homes, CT is far behind surrounding states. Kim interviewed a solo practitioner, a safety net community health center and…
Read MoreMedicaid Council update
Today’s Medicaid Council meeting was overwhelming – DSS has made a lot of very detailed decisions about how to structure and finance the Integrated Care Organization (ICO) proposal for dual eligibles and outlined them in 45 complex slides at the meeting which were not made available at the time. After the meeting, Comm. Bremby stated…
Read MorePCCM update
There is good news and bad news from the Medicaid Council’s PCCM committee meeting last Friday. The good news is that the department has agreed to revise the PCCM evaluation to be a constructive tool to move the program forward. PCCM program plans unfortunately are not as hopeful. There are no current plans to expand…
Read MoreMedicaid Council update
At Friday’s Medicaid Care Management Oversight Council meeting the Dental Health Partnership reported on a remarkable secret shopper survey of the program. They found that callers were able to schedule appointments with 88% of offices called; the average wait time for an appointment was 11.2 days. Not bad. But rather than sit on their laurels,…
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