PCCM
Comments 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,…
Read MoreNews 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…
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