Former Medicaid official offers options to improve the program and a warning
Recently retired from DSS, Steven Colangelo answered the state’s invitation for recommendations to improve HUSKY. He worked at DSS more than 31 years, 10 in Medicaid, focused on the quality of care. His tenure crossed numerous state administrations and seismic shifts in Medicaid policy at the federal level.
Steven opposes current state plans to return to MCOs. He worked at DSS when HUSKY was under MCOs and the shift to our national model managed non-MCO model that has successfully improved access and quality of care, while saving billions of taxpayer dollars.
According to Steve, “The MCO years (the last iteration in place in 2008) were marked by chaos, confusion and lack of proper oversight. State staff struggle[ed] to monitor the MCOs’ activities. There were problems with spotty provider networks that were often erroneous, contradictory medical policies, computer files riddled with inconsistencies and a general lack of cohesion to target certain disease states and health equity issues.”
Steve’s other recommendations include:
- Step up transparency by posting quality measures in a reasonable timeframe. There has been a significant delay in DSS measure reporting compared to earlier administrations. Steve notes that public reporting allows partners to collaborate with the state to improve care and “timely data is the only way to improve outcomes above a glacial pace.”
- Following CMS’s years-long urging and the example of other states, DSS should measure health outcomes for members qualifying for both Medicaid and Medicare – the most fragile, and expensive, population
- Update quality measures
- Contract with a Certified External Quality Review Organization, as other states do, to expand quality improvement capacity
- Improve monitoring for health conditions by sharing data with DPH, allowing both agencies to look upstream and prevent health problems. Other states have these data-sharing arrangements that have “moved the quality needle dramatically.”
- Do not reward providers cited for financial malfeasance with more business and expand fraud detection capacity
- Extend Medicaid’s exceptional care management services to all members. They all deserve improved quality of care and taxpayer deserve the savings.