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CT Medicaid’s plan for payment reform marked a milestone last week with release of the RFPfor provider networks and community health centers to participate. Most of the independent consumer advocates’ Medicaid Study Group recommendations are included, but not all. Pros include protective attribution, no downside risk, smart quality incentives to reward improvement, re-investing savings in quality, makes the questionable CCIP plan voluntary for networks, PCMH support, requires formal consumer advisory oversight in the governance structure, and strong language prohibiting payment of savings generated by inappropriate underservice. The RFP reflects the Care Management Committee’s concerns about shared savings’s potential to encourage underservice by including policies to prevent the problem and a yet-to-be-developed robust monitoring system. The bidder’s conference this week was well-attended by community health centers and private ACOs with lots of specific questions. Proposals are due July 26thfor a contract start date of Jan. 1st of next year. There is still a great deal of work to do.