PCCM
Governor’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…
Read MoreOLR 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 More