PCCM
News roundup
Hospital mergers accelerate Hartford Courant Hospitals working to reduce readmissions CT Mirror HUSKY improving with PCCM CT Health I-Team CT hospitals’ contribution to the economy CT News Junkie CT physicians’ contribution to the economy Hartford Business Journal Brokers’ role in health reform CT Mirror
Read MoreMedicaid Council and PCCM updates
At Friday morning’s Medicaid Council meeting we heard from Mercer about their HUSKY quality review project. The authors pointed out that most of the measures were about paperwork, not outcome-based, and of limited usefulness. For example, the study measured the reading level of member handbooks but not whether any members actually received or used them.…
Read MoreSales call illustrates the benefits of PCCM and a new way of doing business in Medicaid
I had a call yesterday that illustrates the power and potential of CT Medicaid’s new self-insured PCCM model. A representative from a national medical service company wanted to learn more about business opportunities in our state under the new arrangement. They provide medical supplies for people with a common chronic condition and have non-clinical technicians…
Read MoreMedicaid self-insurance/ASO planning meeting
Friday DSS met with advocates, providers, state agency representatives, and potential bidders to collect input on the RFP for an administrative services organization (ASO) contract for all 600,000 state Medicaid members. In a shift of policy, the Malloy administration announced three weeks ago that the state would be moving to a self-insured ASO model for…
Read MoreMedicaid Council update
Today’s meeting started with an entertaining LOB intruder alert drill by the Capitol Police. DSS described shift to ASO for Charter Oak, HUSKY A and B, low income adults and all other Medicaid clients. The goal is to create dynamic, innovative local systems of care and support that are rewarded for providing better value over…
Read MoreGovernor’s budget proposal out
Governor Malloy’s first budget proposal, released today, includes tough choices for health care consumers but also some very good news. New copays for Medicaid services will likely reduce both appropriate and inappropriate utilization, but all Medicaid members will be able to access important tobacco cessation treatment. Reductions in benefits for low income adults are concerning…
Read MoreState moving to ASO and PCCM for all Medicaid consumers
At a press conference today, Lieutenant Governor Nancy Wyman and OPM Secretary Ben Barnes announced that CT’s Medicaid program will move to a self-insured administrative services organization (ASO) model effective Jan. 1, 2012. An RFP is expected to be released next month. The state will also expand the current PCCM/patient-centered medical home program statewide as…
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 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…
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