Monday the
Lieutenant
Governor responded to a
letter
sent earlier this month signed by twenty independent consumer advocates and
providers raising concerns about SIM’s plans for Medicaid. In her letter, the
Lieutenant Governor agreed that CT’s Medicaid program has become a national
model of success, improving access to care, raising quality and controlling
costs. Those achievements resulted from our transition three years ago from
financial risk models to care coordination – through person-centered medical
homes and intensive care management. Advocates are concerned that SIM’s rushed
return to financial risk models will unravel those achievements. Data systems
and policies are not ready to carefully monitor financial incentives in de
facto downside risk arrangements, or to identify and correct under-service
driven by the new incentives. The advocates’ letter urges the administration to
learn the lessons of the spectacular HUSKY MCO failure and consider
well-tested,
better options that have greater potential to improve quality, coordinate
care and further control costs.
In her letter, the Lieutenant Governor understands our
concerns and has agreed to delay implementation of the new Medicaid plan by six
months. That is a good start; hopefully it will be sufficient to protect people
and hard-won progress. In any event, the advocates remain committed to work
constructively with the administration toward the common goal of developing a
value-based program.
