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Connecticut Medicaid ‘best in nation for curbing per-enrollee cost trend’

This is a press release, presented in the format in which it was sent:

Medicaid in general tracks lower than private insurance and Medicare in latest federal comparative data reported in Health Affairs magazine

A new cross-state comparison of Medicaid, Medicare and private insurance spending, published by Health Affairs and based on federal data, shows that Connecticut’s Medicaid program led the nation in controlling cost trends, when measured per enrollee during the 2010-14 reporting period.

Connecticut is reported as having reduced its per-person spending by a greater percentage (5.7%) than any other state in the country.  Overall, Medicaid tracked lower nationally than both private health insurance and Medicare in the cost trend comparisons.

The comparative data is the latest available from the federal Centers for Medicare and Medicaid Services. [Please scroll down to see two-page data chart from Health Affairs’ June 2017 issue.]

Commissioner Roderick L. Bremby of the Department of Social Services (DSS), administering agency for Connecticut Medicaid, said the leading cost trends can be attributed in part to various innovations in Medicaid service delivery.

“The numbers demonstrate the cost-effectiveness of Medicaid in general, and the position of Connecticut as a national leader within Medicaid,” Commissioner Bremby said.  “Further, the comparison to per-enrollee cost trends in Medicare and private health coverage clearly shows that Medicaid is an efficient investment of public funding in support of positive health outcomes.”

Among the key factors:

  • Connecticut was the first state in the country to implement early expansion of Medicaid eligibility under the Affordable Care Act.  Currently, about 217,000 adults without minor children are covered in this portion of Medicaid.
  • Trends in expansion states like Connecticut may have benefitted from participation by large numbers of relatively low-cost, younger individuals.
  • In January 2012, as a result of an early initiative by the Malloy-Wyman Administration, Connecticut HUSKY Health (Medicaid and Children’s Health Insurance Program) entered the final stage of becoming a self-insured, managed fee-for-service program by migrating its medical services from capitated managed care to a model under which services are managed in partnership with statewide Administrative Services Organizations (ASOs).

 

“Starting in 2012, DSS and partners began to implement important new care delivery interventions – ASO-based Intensive Care Coordination (ICM), Person-Centered Medical Homes, health homes for individuals with behavioral health conditions,” said Kate McEvoy, DSS health services director and state Medicaid director.  “These advances have made extraordinary contributions toward more person-centered, goal-driven, holistic coordination of services and supports for individuals with complex needs.  Quality has demonstrably improved, as documented by a range of measures.  Self-reported care experience has also markedly improved.”

DSS has also supported practice transformation through free multi-disciplinary coaching as well as tools and supports for providers (ICM, standardized statewide coverage and utilization management guidelines, timely payment).

Finally, DSS has built in ‘value-based’ payment strategies that initially focused on pay-for-performance (PCMH enhanced fee-for-service payments and performance and year-over-year improvement payments) and have developed to include the inaugural use of ‘upside-only’ shared savings arrangements, under which entities that achieve benchmarks on identified quality measures will share in savings that are achieved.

“As Medicaid-related policy, funding and legislative action continues at the national and state levels, it will remain important for government and stakeholders to continue to carefully evaluate the impact of policy strategies on quality, care experience and cost,” Commissioner Bremby said.

The information in the below chart, which represents the latest publicly available CMS data for all states, is one important indicator of progress.

Commissioner Bremby emphasized the crucial advances represented by the Affordable Care Act (also known as Obamacare), and expressed his thanks and support to Governor Dannel P. Malloy, Lieutenant Governor Nancy Wyman and Connecticut’s Congressional delegation for their active roles in fighting repeal efforts in Washington that would decimate Medicaid.

 

 

 

The data featured in the table comparing states is from the State Health Expenditure Accounts, produced by the CMS Office of the Actuary, a consistent and comprehensive source that allows for analysis of state-specific trends over time.

11 comments

Bryan Meek July 15, 2017 at 10:42 am

So our Medicaid is the best but it still costs almost $3k more than private plans. Also we have 217,000 adults without children taking the benefit at over $8000 or roughly 1.6 billion dollars, when private plans would save $600 million. And this is the system our legislative leaders want to keep.

John Levin July 15, 2017 at 10:46 am

One of the great things about Obamacare (there are many) is that for the first time EVER, the working poor have access to health insurance. Previously, employers of low wage workers had no obligation to offer health insurance to their workers, even if it was offered to company officers. Some businesses did so because the owners recognized a moral obligation or the officers recognized a business benefit. Under Obamacare, all business with 50 or more employees were required to offer the same health insurance to all employees. This resulted in millions of american workers being offered health insurance for the first time ever, although many businesses responded to the requirement by keeping their staffing levels below 50, or in many cases, such as with WalMart and Ulta Salon, restricting employee work hours so that many employees would be classified as part time and not subject to the Obamacare insurance requirement.

In addition, under Obamacare, Medicaid eligibility was expanded, in any state that elected to do so (31 states have so far, including Connecticut), to include low wage workers and their families if the family income level was up to 138% of the federal poverty level. This allowed low wage workers (in those 31 states) to gain access to Medicaid, even if their employer offered them insurance (which would be a more expensive plan than Medicaid), or they worked for an employer that had fewer than 50 workers. This has been a huge benefit for generally hard working but very low income Americans, and one that I am very proud to support through my taxes. It is what a reasonable and compassionate nation does for their people, especially a wealthy nation like ours.

Isabelle Hargrove July 15, 2017 at 12:13 pm

I am sure many readers will just glance at the few first paragraphs of this propaganda press release and walk away thinking that Medicaid is more cost effective than private insurance. But, unsurprisingly to the rest of us and in true government form, it is grossly more expensive per person. Now imagine what single-payer would look like? Actually, don’t imagine, go look at the taxes in the numerous large countries with diverse populations who opted for such systems. No, thank you.

anna russo July 15, 2017 at 2:59 pm

One of the great things about Obamacare (there are many) is that for the first time EVER, the working poor have access to health insurance.

Yeah, at the taxpayers expense….

anna russo July 15, 2017 at 3:01 pm

@John Levin
“and one that I am very proud to support through my taxes.”

Then, please, pay my share and I’ll support the organizations that I want to endorse.

Didn’t think so…

Dawn July 17, 2017 at 7:20 am

And let us not forget that the appointment that cost the non-insured $200 cost the Medicaid and private insured participant $20. How can good doctors survive without becoming a robot with no actual time spent getting to know a patient and their needs.

Peter Franz July 17, 2017 at 8:03 am

Do people actually think that when the working poor get ill, and go to the emergency room because they have no insurance. . . that they don’t wind up paying for it? Much more for it?

This is a complex topic, and “I don’t want to pay for other’s insurance” is the kind of foolish head-in-the-sand attitude that sees the USA pay the most for healthcare in the modern world. . . with amongst the worst outcomes.

The longer we pretend we can point fingers at each other instead of realize what other nations have already learned, we will continue to finish last.

anna russo July 18, 2017 at 12:54 pm

@Peter, so it’s foolish not to care for your own self? Take responsibility for your own self?

Are you one of those people that it is a god given right to have insurance? That it’s right up there with the right to life, liberty and happiness? Don’t think so.

Bryan Meek July 18, 2017 at 2:07 pm

@Peter. Please then explain why ER visits are up after Obamacare? The problem with Obamacare and other programs is that they completely ignore the laws of supply and demand. Doctors are retiring and refusing new patients at record levels thanks to this failed legislation. It would have cost a fraction to insure the 15 million people without insurance than does Obamacare, which upended the entire industry and put states like ours on a path to bankruptcy.

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