Managed care proposal for seniors and people with disabilities

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DSS has issued an RFQ to provide managed care to 26,000 Medicaid only recipients who are Aged, Blind or Disabled. Those people are now covered under the fee-for-service program. No one disputes that this population could use some care management, especially the 26,000 consumers who struggle to access care in a dysfunctional system. However, rather than open the bidding up broadly to get the best entity with the most experience and the best record of success in this challenging work, DSS has chosen to limit the bidding to only the three HMOs that now run the HUSKY program. This is very concerning given the trouble the HUSKY program has encountered; problems that have only grown worse over the last decade. For background on the HUSKY program, click here, here, here and here. The good news is that the new arrangement will not be capitated, however the HMOs’ care management payments will be subject to a 10% withhold released based on meeting “certain performance targets in areas such as quality, utilization and cost.” HMO letters of intent are due next Thursday and full responses by February 8th.
Ellen Andrews