PCCM
OLR reports on major issues for 2011
The Office of Legislative Research’s annual list of issues likely to be addressed in the coming session includes: · Considering alternatives to HMOs for the troubled HUSKY, including statewide PCCM · Reconsidering last year’s budget requirement that HUSKY move from the current capitated HMO-based model to a self-insured ASO model, as is common to most…
Read MoreMore state health policy in New Orleans
Yesterday, I finished up at the NASHP conference hearing the latest from VT’s Blueprint for Health and a panel on how FQHCs are stepping up to provide coordinated care and patient-centered medical homes (PCMHs). VT is planning to expand their Blueprint PCMH program to the entire state in three years. Primary care practices certified as…
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 MoreMedicaid Managed Care Council Update
First, at Friday’s meeting the Council decided to meet in August (on Friday the 13th) – we rarely do that – because of the many challenges and opportunities facing the program. At the meeting, DSS reported that they have sent a letter to CMS seeking guidance about how to move HUSKY from the current, controversial…
Read MorePatient-Centered Medical Home updates
There are several opportunities in the new federal health reform act for CT to embrace, and fund, patient-centered medical homes. Currently, CT has no (zero) medical homes certified by NCQA, the national accrediting body. The SustiNet patient-centered medical home committee is considering the options and how they fit with Connecticut’s unique health care environment. At…
Read MoreMedicaid Managed Care Council update
We ran out of time at Friday’s Council meeting, so we will devote the entire June meeting to discussing how the state plans to implement the new budget provision to self-insure the HUSKY/SAGA/Charter Oak program. Some of the decision points are whether to keep the program capitated but without financial risk (not sure how that…
Read MoreMedicaid Managed Care Council update
Friday’s Council meeting was relatively uneventful. We started with a wonderful outreach video by CT’s Healthy Start programs describing the important work they do supporting at-risk pregnant women and connecting them to the care they need to ensure healthy births. (Advocates think it would be a good idea to start every Council meeting with babies…
Read MoreNew OLR report finds PCCM succeeds, saves money in other states
A new report by the legislative Office of Legislative Research outlines enrollment, savings and impact on hospital visits in states that have implemented Primary Care Case Management (PCCM). PCCM is a different way of running Medicaid managed care plans (HUSKY in CT) used in thirty states. PCCM does not involve HMOs, but rather rests on…
Read MorePCCM Subcommittee update
At today’s PCCM subcommittee of the Medicaid Managed Care Council, DSS unveiled their plans for the Mercer evaluation of the program to be completed by July 1st. Advocates raised many concerns including: · The inability to get any meaningful information on health outcomes with only 200 members on average over the last year · A…
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