At Wednesday’s BHP Oversight Council meeting, DSS reported HUSKY MCO enrollment numbers in Middlesex County, the first to go “on-line” back to managed care plans. Voluntary enrollment in the MCOs started Sept. 1st; at the end of November it will be mandatory. Of Blue Care members, 170 (41%) chose Aetna Better Health, 28 chose AmeriChoice (7%) and 218 (52%) chose CHN. Of traditional Medicaid members, 18 (25%) chose Aetna, 1 (1%) chose AmeriChoice and 54 (74%) chose CHN. It is important to remember these are very early numbers and provider networks are still skeletal.
DSS and DCF also reported on BHP finances ($109 million in FY 08), and access numbers. Access was broken out by children vs. adults, and by outpatient services, intermediate care, home-based services (which have increased significantly) and emergency mobile psychiatric services. We also received detailed information on inpatient care – the numbers of admissions is up but length of stay is down. While we have far to go, inpatient days in discharge delay for children (children ready to leave the hospital, waiting for an appropriate treatment setting) is down from 37% in the last quarter of 2007 to 26% in the second quarter of 08, coming closer to national averages. The Council is reviewing DSS’ plans for using targeted new funding to reduce length of stays in psychiatric residential treatment facilities, with more focused treatment and reducing delay days.
Significant concerns were raised about DSS’ plans for mental health and substance abuse services under Charter Oak. Services are limited and costs to consumers could be substantial. The effect of medical debt on patients’ financial health, serving as a disincentive to needed follow up care, and that Charter Oak could be ineligible for free bed assistance because they have insurance, in some cases, they may be worse off with Charter Oak than uninsured.