Tuesday, January 15, 2013

Medicaid Council new site and meeting update

The Medicaid Oversight Council has a new, comprehensive website. It is now easy to find the calendar for the Council and its many committees, presentations, quarterly reports, agendas, minutes, legislation, and program information. A huge step forward in transparency and sharing information that can improve health. Many many thanks to Council staff. Last week’s Council meeting was relatively uneventful. Concerns were raised about the state’s decision to stop person-centered medical home bonus payments to community health centers. Part of the deficit mitigation plan passed in December, the cut was news to advocates, clinics and many legislators. It is not specified in the bill that passed. At the meeting we learned that it was negotiated by leadership in both Houses and the Governor and was shared with Senate Democrats. Medicaid now has 851 total practices included in the PCMH program – some fully accredited and some on the glide path to certification. DSS described their plans to raise Medicaid primary care rates to Medicare levels for services provided by physicians and some providers working under the supervision of a physician. Under the ACA, the cost of those increases are fully paid by the federal government for two years; the state is considering the future costs of sustaining those rate increases beyond 2014. The rate increases are expected to begin in July, retroactive to Jan. 1st. Because CT Medicaid rates are already well above other states and very close to Medicare levels on average, physicians in our state are not expected to see a large increase. DSS also outlined broad plans to reform hospital payments toward value-based purchasing. Immediate plans include updating inpatient payments to DRGs (as are used in Medicare to better reflect patient acuity) and update the complex current outpatient coding system to a universal system. Eventually DSS plans to move to paying for episodes of care, following many other payers. In other news, we learned that only about half of children covered by Medicaid in either 2010 or 2011 received an initial or periodic screening; about half received dental care as well.