Also at Friday’s meeting, DSS reported on a selection of
quality results from 2015, highlighting concerns. The results compared quality
measures for patients receiving care from private practice and community health
center Patient-Centered Medical Homes. In other programs, PCMHs have improved
quality performance over non-PCMH practices. There remains a lot of room for
improvement. Only 23.9% of children ages 1 to 17 are getting behavioral health
screenings in private PCMHs (they all should be), but it’s even worse at
community health centers (10.2%). Emergency department visits are still too high
but are 35% higher for community health center PCMH patients. Less than half of
patients in both private (47.3%) and community health center (38.6%) PCMHs are
getting follow up within seven days of discharge from the hospital. The trend
isn’t encouraging -- between 2014 and 2015, almost as many measures worsened as
improved. Following past trends, quality at community health centers is lower
than at private practice PCMHs for all but one of twelve measures listed. CT
Medicaid has a great deal of work to do, but unfortunately PCMH+ and its
administrative burdens, lack of evaluation, and unhelpful financial incentives
to stint on care will make it much harder.
