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To implement the administration’s directive to develop person/patient-centered medical homes for every Medicaid consumer, DSS has proposed a payment model very different from other successful state programs. CTHPP has submitted comments on the proposal including concerns about reliance on retrospective enhanced fee-for-service and P4P payments, the lack of risk adjustment, opaque incentives, and a weak attribution system. For example, under an enhanced fee-for-service arrangement, a provider would have an incentive to bring a healthy child who had recovered from a routine infection back into the office to get paid for care management costs making the child take time from school, a parent time off from work, exposing the child to a waiting room full of sick children, incurring transportation costs, and taking up a slot on the schedule of a busy primary care practice. To read our concerns, click here for comments.
Ellen Andrews