Search results for: cost cap
Medicaid Managed Care Council update
Friday’s Council meeting focused mainly on plans for the $50 million temporary high risk pool opportunity created by national health reform. DSS joined the CT Insurance Dept. and the Health Reinsurance Association (HRA) to describe their plans. They intend to piggyback on the current high risk pool administered by HRA which was created in 1976…
Read MoreMedicaid Managed Care Council update
We ran out of time at Friday’s Council meeting, so we will devote the entire June meeting to discussing how the state plans to implement the new budget provision to self-insure the HUSKY/SAGA/Charter Oak program. Some of the decision points are whether to keep the program capitated but without financial risk (not sure how that…
Read MorePCCM forum highlights DSS barriers to implementation
Friday the Appropriations Committee heard about DSS’ lack of progress in implementing the PCCM option for HUSKY passed into law three years ago. The panel included Dr. Patrick Alvino, a pediatrician practicing in Branford, who would like to participate but because PCCM is not statewide he and his 2,000 patients do not have the option.…
Read MoreGovernor’s budget proposal – lots of cuts and a plan to reform HUSKY HMOs
In her budget proposal released yesterday, the Governor proposed shifting the current HUSKY HMOs away from capitation back to a non-risk arrangement. For a few months in early 2008, the Governor ordered a similar switch from capitation to an Administrative Services Organization (ASO)-model, in which the HMOs administered the program for DSS but passed all…
Read MoreObesity and Tobacco Forum
The CT Public Policy Institute held a forum at the Capitol yesterday on the scope of obesity and tobacco issues in our state and what policymakers can do to improve health and lower costs. 16% of CT adults currently smoke, below the US average of 21%. Smoking kills more people than AIDS plus alcohol plus…
Read MoreManaged care proposal for seniors and people with disabilities
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…
Read MoreObesity and tobacco forum
The CT Public Health Policy Institute will hold a breakfast forum on overweight and obesity in CT and tobacco use and smoking in CT Tuesday Jan. 19th from 8 am to noon in Room 2A of the Legislative Office Building. The forum will include presentations with background, cost analysis and consequences of the problems followed…
Read MoreMedical home and PCCM meetings
Yesterday’s organizational meeting of the SustiNet Patient-Centered Medical Home Advisory Committee was very encouraging. There is a lot of energy across stakeholder groups, especially among providers and payers. We are soliciting input on who/what groups to consult for input and what issues to consider. Suggestions include business coalitions, NCQA, medical homes from other states, consumer…
Read MoreNASHP pre-conference on payment reform
Today’s pre-conference meeting to the National Academy of State Health Policy’s annual conference took on the elephant in the health policy room – how to align incentives among payers, providers and consumers to reward quality and efficiency. Health care is a very fragmented, very large business and it doesn’t turn on a dime. But a…
Read MoreFamilies report on how national health reform will benefit CT consumers
A new report by Families USA outlines how national health reform proposals will improve health care for CT consumers from current law. Issues include coverage for pre-existing conditions, premiums based on gender and health status, expanding options for coverage, affordable premiums and out of pocket costs for families and small businesses, annual and lifetime caps…
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