Tuesday, September 30, 2014

Investigators highlight problems in Medicaid managed care nationally – but through collaborative effort CT is a success story

Getting a lot of national attention, a new report by federal investigators highlights significant problems in accessing Medicaid care, largely through private managed care plans, as millions of Americans enter the program. However, through collaborative effort, Connecticut serves as an exception to that trend. The report outlines a lack of access or quality standards across states, and even worse monitoring or enforcement of the few standards that exist. Connecticut used to have this problem. But two years ago the administration shifted to a self-administered, care coordination-based system and we have largely reversed the problem. Since the shift quality of care is up, 32% more providers participate, and per person costs are down. In a survey of providers, advocates also outlined the system’s challenges, and identified best practices from other states and systems. Over the last two years DSS has addressed the report’s issues, one by one -- improving operations, transparency and stability. Connecticut Medicaid is a success story – both in outcomes and demonstrating the power of collaboration; other states should take notice.