State moving to ASO and PCCM for all Medicaid consumers

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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 soon as possible to serve as an option for every Medicaid member. Under this model, the state will directly pay all medical costs of care for all Medicaid clients including HUSKY Parts A and B, Low Income Adults (formerly the SAGA program), Charter Oak, seniors and people with disabilities. PCCM patient-centered medical homes will provide consumers with all their primary care, personalized care management, help accessing needed specialty care and expanded service hours reducing the need for ER visits. Patients will have help navigating an increasingly hostile health care environment and get tools and support to manage their own health. Beyond savings millions of dollars, the shift will allow the state to track exactly where tax dollars are going and improve accountability. The new system puts CT in a better position to access opportunities under national health reform, including the health home option that will reimburse the state 90% of the care coordination costs for patients with chronic conditions.
Ellen Andrews