DSS gets input for Medicaid landscape survey
At last week’s MAPOC meeting, DSS announced they will be hiring a consultant to survey the Medicaid landscape assessing options for improvement, including MCOs. Advocates, legislators, and other stakeholders have publicly registered their opposition to returning the failed MCO model to our successful HUSKY program. At the meeting DSS requested input on the criteria consultants will use to evaluate the options. While the consultants will make recommendations, the final decision will be by the state.
Yesterday the CT Health Policy Project and Disability Rights CT gave DSS our input. Both sets of input refer to areas that were serious problems when HUSKY was run by MCOs before 2012. Concerns include administrative costs, data reporting, burdens on providers, sufficient provider rates and timely payments, and access to care measures.
Proposed criteria from one or both organizations include:
- Can members opt-out?
- Full public transparency – contracts, performance measures, spending
- Access and quality of care for underserved communities
- Not disclosing specific performance metrics ahead of time so venders can’t manipulate accountability
- What is the exit strategy if the option fails? It took 16 terrible, very very long years to fix the MCO failure last time.
- Are the options supported by independent, strong evidence of success toward Connecticut’s goals and challenges?
- Where will savings be invested – by venders and the state?
- Impact on DSS staff and potential cuts
- Can we cap profits and executive salaries, as for nursing homes?
- How to implement innovations in a long contract environment
- Likelihood of resistance to each option by providers, advocates, and members
- Venders should be subject to Freedom of Information laws
- Risks of underservice and cherry-picking in the payment model or program design
- Maximize patient choice of all Medicaid-participating providers
- Integration with transportation contractor and other services
- Impact on ICM and PCMH programs that are working – Do No Harm
- Informed consent — will members hear about ALL treatment options – not just the cheap ones
- How the option supports health-related social needs