Quality challenges remain in CT Medicaid PCMHs

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Also at Friday’s meeting, DSS reported on a selection of quality results from 2015, highlighting concerns. The results compared quality measures for patients receiving care from private practice and community health center Patient-Centered Medical Homes. In other programs, PCMHs have improved quality performance over non-PCMH practices. There remains a lot of room for improvement. Only 23.9% of children ages 1 to 17 are getting behavioral health screenings in private PCMHs (they all should be), but it’s even worse at community health centers (10.2%). Emergency department visits are still too high but are 35% higher for community health center PCMH patients. Less than half of patients in both private (47.3%) and community health center (38.6%) PCMHs are getting follow up within seven days of discharge from the hospital. The trend isn’t encouraging — between 2014 and 2015, almost as many measures worsened as improved. Following past trends, quality at community health centers is lower than at private practice PCMHs for all but one of twelve measures listed. CT Medicaid has a great deal of work to do, but unfortunately PCMH+ and its administrative burdens, lack of evaluation, and unhelpful financial incentives to stint on care will make it much harder.