Search results for: cost cap
Insurance Committee to hear exchange active purchasing bill
The legislature’s Insurance and Real Estate Committee has raised SB-596, An Act Concerning the Duties of the CT Health Insurance Exchange, and will hold a public hearing on the bill Thursday. SB-596 requires the CT Health Insurance Exchange to actively purchase health coverage for the estimated one in ten state residents who will purchase health…
Read MoreCT hospitals among worst in Medicare performance payments
CT’s hospitals are the lowest among all 50 states in earning Medicare quality payments starting this month – only hospitals in DC performed worse. Medicare’s value-based purchasing program will tie a portion of hospitals’ payments to the quality of care they deliver. Only 4 of CT’s 29 acute care hospitals will receive a quality bonus;…
Read MoreMedicaid Council meeting clears up misinformation on HUSKY parents fate under ACA
The CT Health Insurance Exchange staff’s presentation to the Medicaid Council Friday described the “opportunity” under the Affordable Care Act for significant state savings by shifting HUSKY parents into the exchange. They described subsidized premiums ($45 to $243/month), some caps on out of pocket costs, and a list of covered services. However, with questioning from…
Read MoreHUSKY B saves $4 million in switch from HMOs
As advocates predicted, it appears the shift from capitated managed care to self-insurance saved the HUSKY Part B program $4 million in lower medical costs in the first six months. (The numbers are still tentative, as there may be some outstanding claims from the first half of the year, but they are not expected to…
Read MoreFascinating presentation at Health Care Cabinet
Today’s Cabinet meeting featured a presentation by Capitol District Physicians Health Plan, an Albany-based, nonprofit, physician-led health plan, that is succeeding in the triple goals of reducing costs, improving quality of care and addressing population health. Their CEO, a cardiologist, and VP of Underwriting described the innovations that led to their success including patient-centered medical…
Read MoreDual eligible payment reform update
Advocates have raised concerns about DSS’ plans to re-engineer CT’s Medicaid pilot program for dual eligibles, people eligible for both Medicare and Medicaid. Last year HHS granted CT $1 million to plan this initiative. DSS intends to assign consumers to “health neighborhoods” – contractual networks of providers to cover the care continuum that will coordinate…
Read MoreState chooses CHN to run Medicaid
The administration announced that they will be negotiating with Community Health Network to administer the entire state Medicaid program as of January 1st. Based on the state’s community health centers, CHN has been a participating managed care provider for HUSKY since its inception sixteen years ago. The managed care program will expand beyond the current…
Read MoreMedicaid Council update
At Friday’s Medicaid Care Management Oversight Council meeting the Dental Health Partnership reported on a remarkable secret shopper survey of the program. They found that callers were able to schedule appointments with 88% of offices called; the average wait time for an appointment was 11.2 days. Not bad. But rather than sit on their laurels,…
Read MoreMedicaid Council update
Today’s meeting started with an entertaining LOB intruder alert drill by the Capitol Police. DSS described shift to ASO for Charter Oak, HUSKY A and B, low income adults and all other Medicaid clients. The goal is to create dynamic, innovative local systems of care and support that are rewarded for providing better value over…
Read MorePainless way to save $40 million in HUSKY
Our new policymaker issue brief outlines how moving HUSKY to self-insurance should save the state at least $40 million, without any changes in access to care. In 2008, under the PHIP/ASO model medical costs were actually lower than under HMO capitation the next year. Because the shift to self-insurance was sudden DSS was in a…
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