Search results for: cost cap
Advocates’ letter urges delay of SIM plans for Medicaid
Fifteen independent advocates sent a letter to the administration yesterday expressing deep concerns with SIM’s Community and Clinical Integration Plan (CCIP) for Medicaid. Advocates are concerned that CCIP will undermine hard-won progress in our state’s Medicaid program that has improved access to high quality care while controlling costs. In contrast to successful programs in other states, SIM…
Read MoreHealth Care Cabinet – RI, MA reforms reviewed, hospitals’ response to price presentation
Today’s Health Care Cabinet meeting was as fascinating as last month’s. We heard again from the consultants working with the Cabinet to develop a plan to reform CT’s health care system. This time they focused on reforms in Rhode Island and Massachusetts. Rhode Island is also facing hospital consolidation, but with more geographic overlap than…
Read MoreMedicaid update – plans to “transition” 17,688 HUSKY parents off the program, serious SIM/CCIP problems jeopardize Medicaid redesign
Friday’s Medicaid Council meeting focused on implementation of last year’sbudget provision that will end coverage for 17,688 HUSKY parents on July 31stof this year. DSS reported on efforts to assure that people still eligible for Medicaid in other categories do not lose coverage. Of the 1,215 parents who lost coverage last year due to the…
Read MoreGovernor’s budget proposal – it could be way worse
Today the Governor announced his proposed budget for the coming fiscal year that starts July 1st. The very, very good news is that Medicaid is largely untouched – no new cuts to providers, no more people losing coverage, and minimal service limits (orthodontia). This is smart because current reforms in the program are working to…
Read MoreBenefits of sponsoring out-of-state trips for policymakers
A new Health Affairs blog highlights the benefits of learning trips for state health policymakers working on systemic change. The author, President of New Jersey’s Nicholson Foundation, notes that out-of-state trips are very effective in fostering new perspectives on problems and finding innovative solutions. “The Nicholson Foundation is dedicated to addressing the complex needs of…
Read MoreArticle finds Medicaid managed care offers mixed results
Echoing CT’s experience, researchers writing in the Journal of Managed Care & Specialty Pharmacy found little evidence that states’ rush to move Medicaid members into risk-based commercial managed care plans has saved money or improved quality. Currently half of all Medicaid members nationally are enrolled in these plans. States moving to commercial managed care…
Read MoreHow CT can save $1 billion
Per person costs in CT’s Medicaid program fell, actually went down, by 5.9% last year. If the rest of CT’s state budget could match that performance, we would have a $1 billion surplus. Following is my list for how we could spend it (this was fun). · Reverse the HUSKY parents cut · Reverse the…
Read MoreMedicaid still saving $ hundreds of millions
Four years after shifting from managed care organizations to a care-management focused program, CT’s Medicaid program continues providing significant relief to the tight state budget. At today’s Medicaid Council meeting we learned that per person spending was down 5.9% from FY 2014 to 2015, saving the state $360 million just last year compared to no…
Read MoreCT health reform progress up slightly this month
CT’s progress toward health reform inched up this month to 25.7%, ending a four month decline. New Medicaid numbers confirmed that per person costs continue to decline, long after the initial savings from switching away from capitated insurers. The continued progress suggests that structural changes like patient-centered medical homes, quality incentives and intensive care management…
Read MoreAnthem, Aetna and CIGNA have 82.5% of CT health insurance enrollment
As always, this year’s managed care report card from CT’s Insurance Dept. is fascinating. Anthem has 44% of total enrollment. Anthem is seeking to buy CIGNA for $54 billion; together they have 64% of CT enrollment. Aetna has 18.5% of enrollment, ConnectiCare has 9.2%, and Oxford/United Health Care has 6.8%. Enrollment is very low…
Read More