Monday, October 12, 2015

NJ conference on Medicaid ACOs – deep commitment to applying lessons learned

A CT contingent ventured to NJ last week for their 4th Annual Medicaid Payment Reform Summit. The conference was sponsored by the QI Collaborative which is working with the state and private foundations to support accountable care in NJ’s Medicaid program. We heard from Jeff Brenner of the Camden Coalition about their impressive results in serving high-need, high-cost consumers through intensive and culturally appropriate outreach, robust provider collaboration, and strong links to social services. We heard about other effective high-cost, high-need programs from Baltimore, Boston, and New York. We heard from three ACOs that were certified for NJ’s Medicaid program and one that wasn’t but is still working toward accountable care. We heard from Jurgen Unutzer from the Univ. of Washington about what works, and what doesn’t, to effectively integrate behavioral health into primary care. A panel talked about technology innovations that can support effective payment and delivery reforms. Fascinating information from people really doing the work.  NJ is well ahead of CT in designing thoughtful Medicaid reforms. We learned a lot.

Thursday, October 8, 2015

CT Medicaid spending down 4.2% from FY 14 to FY 15

Happily CT’s Medicaid program is bucking the state budget trend. State spending on CT’s Medicaid program fell 4.2% between state fiscal year (FY) 2014 and 2015, largely due to higher federal reimbursements, according to an analysis by the Office of State Comptroller. Between FYs 2009 and 2015, Medicaid averaged 4.1% annual increases, lower than the state employee health plan at 4.4% and state retiree health insurance at 5.5%. According to the report, almost half of Medicaid spending goes to hospitals (28%) and to drugs (18%). Between FY 2014 and 2015, hospital spending dropped by 1.5% while pharmacy spending grew by almost 40%. The report points out that Medicaid “can have a growth rate that is consistent with or even below general medical inflation and still consume one of the largest dollar shares of the budget.”

Wednesday, October 7, 2015

CT MFP program success featured in Health Affairs

An article in this month’s Health Affairs describes CT Medicaid’s successful Money Follows the Person program. The study by UConn and DSS authors found that participants transitioning from institutional care to community settings reported better quality of life and life satisfaction that continued well after the transition. Some needed to return to the hospital or ER for a time, but only 14% returned to institutional care. Researchers were able to identify new predictors of re-institutionalization that will help improve the program and prevent the need for institutional care.

Tuesday, October 6, 2015

Administration agrees to more time to design Medicaid reform

Monday the administration announced that they will delay the redesign of CT’s Medicaid program by at least six months. In a letter sent last week by twenty one independent consumers advocates, concerns were raised about the rush back into a risky financial model that could cost increase state costs. Advocates were particularly concerned about jeopardizing recent quality, access and cost control gains in the program. 

Friday, October 2, 2015

October web quiz: Potential CT impact of the Cadillac tax

Test your knowledge of Connecticut employer health plans that may be subject to the ACA’s Cadillac tax. Take the October CT Health Policy Webquiz.

Thursday, October 1, 2015

CT health reform progress down 4th month in a row

Unfortunately CT’s progress toward health reform is down again this month to 25.6%, dropping for the fourth month in a row. Medicaid’s rushed return to a risky financial model and recent provider cuts led the concerns. However Medicaid officials continue to consult with stakeholders in the design. Higher premiums on CT’s health insurance exchange added to the troubles along with SIM’s imprudent plans for community resources that are undermining Medicaid’s progress. The CT health reform progress meter is part of the CT Health Reform Dashboard.

Tuesday, September 29, 2015

Independent advocates call for more study on Medicaid payment shift

A letter signed by twenty one independent consumer advocates calls on the state to halt the SIM-driven Medicaid’s rush into a return to shared savings, a risky payment model. Dozens of issues remain to be addressed to protect the 770,000 people who rely on the program before the deadline of October 5th. The rush is being driven by the needs of CT’s small SIM grant, which pales in comparison to state spending on Medicaid. Advocates are concerned that the return to financial risk, this time placed on provider networks, could jeopardize quality improvements, gains in provider participation and effective cost control. Based on Medicare’s experience with the shared savings, Medicaid costs for the state would increase rather than save. Current state budget shortfalls have already prompted $64 million in provider cuts and dropping 20,000 working parents from the program.