CTNJ: ACOs may be the new HMOs, and they need a watchdog
Care for a growing number of Connecticut residents is being directed by an Accountable Care Organization (ACO) and very few patients know it.
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PCMH+ update: discussions ongoing to fix problems
At MAPOC’s Care Management Committee meeting, DSS and Mercer reported on their plans for PCMH+, the controversial shared savings Medicaid program. A workgroup has been meeting at DSS to drill down on what didn’t work. DSS has lobbied the Governor to include a new Wave 3 to update the current program in his budget proposal, as well as an even more controversial plan to include dual eligibles, the most fragile Medicaid population, in the program as well.
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SIM primary care capitation proposal gets another tepid reception
This week, SIM presented to the Healthcare Cabinet their proposal to capitate primary care, initially for Medicare members, but eventually for all state residents. This is not SIM’s first shot at selling this proposal to stakeholders. It’s not going well.
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YNHH answers latest questions about controversial primary care proposal
Monday Yale-New Haven Health System and their community health center partners answered the latest set of questions from the state Office of Health Strategy (formerly OHCA) to their controversial plan to move primary care services for 28,000 low-income New Haven residents out of the current neighborhood sites to Long Wharf.
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What We’re Reading
Pharma lobbyists flooded Maryland to block a drug-pricing bill. Opponents pushed back – and won.STAT – The story behind the story of how a group of consumer advocates and legislators were able to prevail over Pharma’s considerable resources to get a bill passed to push back on sky high drug prices and protect consumers and taxpayers. A must read.
Suicide risk grew after Missouri Medicaid kids shifted to managed care, hospitals sayKaiser Health News -- According to Missouri hospitals, suicides increased and lengths of stay dropped after thousands of children with mental illnesses were transferred from traditional Medicaid into for-profit managed care companies. More reason to be happy CT moved away from Medicaid managed care seven years ago.
The US Healthcare Cost CrisisGallup
Almost half (45%) of American adults worry that a major health event could result in bankruptcy and Americans borrowed $88 billion last year to pay for healthcare, according to a new Gallup poll. 61% of Americans would choose a freeze in health costs over a 10% increase in their incomes. While the burdens fall on both Democrats and Republicans, perceptions of the quality of the US health system vary substantially. But neither are optimistic that political leaders can solve the problem.
Behavioral health: Research on healthcare costs of untreated conditions is limitedGAO
Only 30% of the 56.8 million American adults with behavioral health conditions accessed care in the last year. Reasons include cost, stigma and access challenges such as not knowing where to get care. While most studies indicate that untreated conditions lead to other costs, we don’t know how much.
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