State closes the record on risky YNHH, CHC plans for New Haven primary care

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Friday, the Office of Health Strategy closed the record on Yale New-Haven’s application to

shift care for 28,500 mainly low-income New Haven area residents to a new site, far from neighborhoods and to shift Medicaid billing for those patients to the two community health centers “for increased reimbursement through the FQHC enhanced Medicaid rate structure” raising costs to the state by millions. OHCA asked three sets of questions about the proposal. Today, the CT Health Policy Project sent a letter urging the state not to approve the application until there are clear protections for patients, taxpayers and the community in place.

Advocates, providers and community members have raised serious concerns about the plan that have only grown over time. There is new evidence about lower levels of care quality at community health centers, including New Haven’s clinics, especially higher ED visit rates. Tenuous plans for a hardship fund to assist uninsured patients to pay high rates charged by clinics are limited and will keep patients from appointments, especially for management of chronic conditions. Plans to assist patients travelling to the new, distant clinic site are ill-defined. There are deep concerns about less access to medications which are critical to treating infections, addictions, mental health and cardiac conditions, among others. There are no answers to questions about how the applicants intend to increase the number of patients that providers see each day. Concerns about information and access to family planning services are serious. Undefined extra costs to a tight state budget could cause cuts in eligibility and provider rates, undermining Medicaid’s success.