Mixed results from great study on Medicaid behavioral health interventions

Yesterday’s MAPOC Complex Care Committee meeting focused on results of an adult high behavioral health need member initiative by Beacon, Medicaid’s behavioral health administrator. The program serves high utilizers of hospital services with behavioral health needs providing intensive care management by teams of clinicians and peer specialists. Medicaid members with high behavioral health needs were…

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Medicaid update: Quality improving but lots of work to do

Friday’s Medicaid Council meeting focused on quality performance in the program. The good news – ED visits and readmissions continue dropping across the program, although community health centers’ performance remains a problem Well-child visit and lead screening rates are higher than the national average Routine care is increasing and inpatient care is decreasing The bad…

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Comments to DSS opposing increase in PCMH Plus funding for program that didn’t improve quality and increased state costs

Read the full comments Thank you for this opportunity to oppose this amendment to add an additional $600,000 to the growing costs of PCMH Plus, the experimental new Medicaid shared savings program. The state cannot afford to spend more on this program that, in 2017 its first year, did not improve the quality of care…

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CTNJ: Public Health has a Free Rider Problem

Public health is the best deal on the planet. Connecticut spends only $29 per person, less than most states, on public health but $9,859 on healthcare services, more than most states. But Connecticut expects our under-funded public health system to solve this intractable health problem while all the savings go to the inefficient healthcare system…

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CT up to third healthiest state this year

According to America’s Health Ranking, Connecticut is the third healthiest state in the union this year, up from fifth last year. We are doing far better than our 13th ranking in 1992 but down from 2nd in 2008 and 2006. The ranking by the United Health Foundation has compared states on 34 health indicators since…

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PCMH Plus Year 1 Performance and Savings Results: Increased state costs but little evidence of impact on quality

Read the full report This month, Connecticut Medicaid announced the first year performance of PCMH Plus[1], their controversial new shared savings program[2] compared to the prior year. Under shared savings, if health systems (ACOs) are able to lower the cost of their members’ care, they receive a bonus equal to half those savings. PCMH Plus…

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New data mapping tool gives changes in uninsured rates by CT town

The CT Data Collaborative has entered new Census data into a mapping tool that gives, among other metrics, the percent of uninsured residents by town or Census tract over time. Two maps compare five-year uninsured rates by town/census tract from 2008-2012 to 2013 to 2017. The uninsured rate in most municipalities dropped between those time…

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ICER seeking new members of comparative effectiveness panel

The Institute for Clinical and Economic Review (ICER) has opened nominations for their New England Comparative Effectiveness Public Advisory Council. The council, one of three in the US, is composed of leading clinicians, patient and public representatives, methodologists, and health economists. The group meets three times each year to consider ICER effectiveness reports on the…

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PCMH+ quality reports surprisingly underwhelming

At the MAPOC and Care Management committee meetings we finally received the promised quality evaluation of PCMH +’s first year. PCMH+ is DSS’s experimental new payment program that now covers 165,432 HUSKY members. We only received information on the 13 mainly process measures. These measures were chosen as basis for shared savings payments, not for…

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CT hospitals report $1.6 billion in community benefits, but most of that is claims of Medicaid underpayment

Yesterday’s Healthcare Cabinet meeting focused on CT nonprofit hospital community benefit reports to the IRS. Last year, CT hospitals claimed $1.6 billion in community benefits, but over half of that (57%) are claims of Medicaid underpayment. Charity care provided to patients unable to pay for their services constituted 21% of total charity care; health professional…

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