CT Medicaid’s plan for payment reform marked a milestone
last week with release of the RFP
for provider networks and community health centers to participate. Most of the
independent consumer advocates’ Medicaid
Study Group recommendations are included, but
not all. Pros include protective attribution, no downside risk, smart
quality incentives to reward improvement, re-investing savings in quality,
makes the questionable CCIP plan voluntary for networks, PCMH support, requires
formal consumer advisory oversight in the governance structure, and strong
language prohibiting payment of savings generated by inappropriate
underservice. The RFP reflects the Care Management Committee’s concerns about
shared savings’s potential to encourage underservice by including policies to
prevent the problem and a yet-to-be-developed robust monitoring system. The
bidder’s conference this week was well-attended by community health centers and
private ACOs with lots of specific questions. Proposals are due July 26th
for a contract start date of Jan. 1st of next year. There is still a
great deal of work to do.