Care Management

SIM primary care capitation proposal gets another tepid reception

This week, SIM presented to the Healthcare Cabinet their proposal to capitate primary care, initially for Medicare members, but eventually for all state residents. The proposal is to move primary care to capitated “bundles” – one for basic primary care services and a voluntary, supplemental payment for expanded activities such as infrastructure and HIT and…

Read More

PCMH+ update: discussions ongoing to fix problems

At yesterday’s MAPOC Care Management Committee meeting, DSS and Mercer reported on their plans for PCMH+, the controversial shared savings Medicaid program. A workgroup has been meeting at DSS to drill down on what didn’t work. DSS has lobbied the Governor to include a new Wave 3 to update the current program in his budget…

Read More

Seven years later, Connecticut Medicaid still saving taxpayers money

Download the report As with most health care in Connecticut, Medicaid spending was rising quickly before 2012 growing by almost half over the prior four years. But in 2012, Connecticut made a remarkable and unique move — Medicaid switched from a capitated payment model using private insurers to a care coordination-focused, self-insured payment model. Since…

Read More

Mixed results from great study on Medicaid behavioral health interventions

Yesterday’s MAPOC Complex Care Committee meeting focused on results of an adult high behavioral health need member initiative by Beacon, Medicaid’s behavioral health administrator. The program serves high utilizers of hospital services with behavioral health needs providing intensive care management by teams of clinicians and peer specialists. Medicaid members with high behavioral health needs were…

Read More

PCMH Plus Year 1 Performance and Savings Results: Increased state costs but little evidence of impact on quality

Read the full report This month, Connecticut Medicaid announced the first year performance of PCMH Plus[1], their controversial new shared savings program[2] compared to the prior year. Under shared savings, if health systems (ACOs) are able to lower the cost of their members’ care, they receive a bonus equal to half those savings. PCMH Plus…

Read More

Advocates get no answers to questions about HUSKY experiment

Last month, a group of independent consumer advocates, the Medicaid Study Group, sent questions to DSS about the impact of PCMH Plus, their new $10.8 million experimental program of shared savings in HUSKY. Advocates have been concerned about PCMH Plus’s potential to deny needed care, raise costs in the program, and erase hard-won progress. Questions…

Read More

31 ways to save on healthcare in Connecticut’s budget

Connecticut’s state budget is facing future deficits and health spending is a large share of the budget. The state now spends $3.8 billion between Medicaid and the state employee health plan to cover about a million state residents. Health care spending outside the state budget is also growing. Connecticut has the sixth highest per capita…

Read More
Processing...
Thank you! Your subscription has been confirmed. You'll hear from us soon.
ErrorHere