Monday, March 21, 2016
Wall Street Journal article celebrates CT Medicaid success after move away from private insurers
Wall Street Journal highlighted CT Medicaid’s success controlling costs and improving care by bucking the usual trend. Four years ago CT moved away from private insurers to run the program ourselves – and that has made all the difference. “’Been there, done that and it didn’t work,” says Robert Zavoski, a pediatrician and medical director for the Husky system.” The WSJ article by Melinda Beck notes that the total cost of care per member per month dropped from $718 to $670 from 2012 to last year, participating providers are up 7% and fewer members are forced to get care in an ER. CT’s administrative costs are down to 5%, far better than the 12% typical of private Medicaid managed care plans. The keys to success are clear, actionable data (which we could never get from the health plans) and person-centered medical homes (that actually manage and coordinate care centered on the member). The article features Dr. Barbara Ziogas, a pediatrician, and Marlene Donahue, a foster mother to children with complex medical needs. Both say the system now works far better for both members and providers on the ground.