Courant OP-ED raises concerns about Medicaid PCMH proposal

An Opinion piece in today’s Hartford Courant by Sheldon Toubman of New Haven legal aid outlines many problems with DSS’ proposal for person-centered medical homes. PCMHs have been used by payers, including many other state Medicaid programs and CT’s state employee plan, to improve the effectiveness of health care, reduce duplications and errors and rein in skyrocketing costs. However, DSS’s proposal varies significantly from best practices identified in other states. The current PCCM program, used by a majority of states, provides a set amount of funding to providers upfront to encourage investment in care coordination. DSS’s proposal asks primary care practices, on very thin margins, to pony up with the potential for funding/reimbursement later. It also builds on the current fee-for-service system that has been blamed for over-utilization that drives up costs. Most funders are moving away from fee-for-service payments.
Ellen Andrews