Medicaid Council update – very good news on PCMHs

At today’s Medicaid Council meeting we heard an impressive presentation by DSS and CHNCT, Medicaid’s administrative services organization, about the success of person-centered medical homes (PCMHs) in CT’s program. At the end of the year 211,206 Medicaid consumers were being cared for in a PCMH – about one in three CT Medicaid recipients. 65% of all NCQA certified PCMH providers are participating in the Medicaid program. Quality of care in PCMHs is higher than in non-PCMH practices on 9 of 11 measures including adolescent well care rates, diabetes care, and avoiding ED visits. Quality bonuses went out to high performing practices in 2013, with more to come this year, in addition to higher payment rates for all PCMHs. Consumers report better satisfaction with care, better access to specialists and providers more willing to listen. EPSDT rates are higher in PCMHs and practices are largely very satisfied with the support they are getting from the state in achieving and maintaining PCMH certification.

In another presentation, CT Voices for Children reported on continuity of coverage in HUSKY. The most important finding is that continuity is higher in HUSKY Part A (no family costs) than in Part B (with costs for families). In fact, gaps in coverage are more common for children in higher cost bands of HUSKY Part B, suggesting that costs to families are the barrier to staying in the program. This has troubling implications for coverage in CT’s health insurance exchange, where coverage costs can be very high.