Connecticut’s Medicaid
program has earned national recognition for combining improved access to high
quality care with an impressive record of cost control. Shifting the program
from a financial risk payment model to care coordination through
person-centered medical homes (PCMHs) four years ago is widely credited with
that success. Last year the administration began developing a new, ambitious
reform plan, Medicaid Quality Improvement and Shared Savings Program (MQISSP)
committed to build on and support the success of the PCMH program. The goals of
MQISSP are to “improve health and
satisfaction outcomes for Medicaid beneficiaries”.
Under MQISSP, the state intends to contract with competitively
selected networks of providers, both
Federally Qualified Health Centers and advanced networks (i.e.
Accountable Care Organizations). Networks will coordinate person-centered care
among a continuum of providers and community resources. Networks will share in
the resulting savings in the total cost of care for their attributed members if
they meet quality standards. Over the last year, the Department of Social
Services (DSS) has worked with the Care Management Committee of Connecticut’s
legislative Medical Assistance Program Oversight Council to develop the
program. The Care Management Committee includes legislators, providers,
consultants, and consumer advocates. As of April 2016, that process is largely
complete and drafting has begun on the MQISSP application for networks.
Among fourteen major
issues decided to date, most are very positive (pros) and will support the
goals of improved quality and satisfaction. But three are problematic For more information, read
the CT Health Policy Project brief.
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