Care Management

New PCMH + plans overlook past problems

Wednesday DSS and Mercer unveiled their thinking about plans for Wave 3 of PCMH Plus, Medicaid’s controversial shared savings program. Results from PCMH Plus’s first year, Wave 1, were disappointing with increased state costs and little evidence of improvement in quality. Based on the problems identified in Wave 1, advocates made recommendations to fix those…

Read More

Advocates offer recommendations for Medicaid shared savings future

The first year of Connecticut Medicaid’s PCMH Plus experiment in shared savings was disappointing. The program cost the state at least $1.3 million extra tax dollars and quality did not improve compared to Medicaid members outside the program. Every Accountable Care Organization (ACO), regardless of savings or quality improvement, was rewarded with a payment. The…

Read More

Better, safer ideas to support primary care in Connecticut

Download the report Primary care is the foundation of the health system. It is, or should be, patients’ first interaction with the healthcare system for non-urgent issues. There is strong evidence that care coordination linked to primary care practices, such as patient-centered medical homes (PCMHs), foster improved health while lowering costs.[i] Areas with more primary…

Read More

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