Connecticut Moves Away From Private Insurers to Administer Medicaid Program
Source: WSJ
At a time when most states are paying private insurers to provide health care for their Medicaid recipients, Connecticut says it has saved money and improved care by going the opposite way. In 2012, Connecticut fired the companies that were running Husky, as its Medicaid system is known, and returned to a more traditional “fee-for-service” arrangement where the state reimburses doctors and hospitals directly.
State officials, physicians and patient advocates have welcomed the move: Average cost per patient, per month, is down from $718 in mid-2012 to $670 last year, according to state data. The number of doctors willing to treat Medicaid patients is up 7% and as a result fewer patients are using emergency rooms for routine care.
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States have turned to managed care as a way to control spending, particularly those that expanded Medicaid under the Affordable Care Act. Health plans say they can provide better, more-coordinated care and save states money—some $6.4 billion this year, according to an estimate prepared for the Association for Community Affiliated Plans, which represents nonprofit health plans in 26 states.
Other reports say managed care’s record with Medicaid has been mixed. With some exceptions, a county-by-county study by the nonpartisan Urban Institute last year found no evidence that greater reliance on managed care cut costs, but it did increase the likelihood of ER visits, difficulty seeing specialists, and unmet need for prescription drugs.
Read more: http://www.wsj.com/articles/connecticut-moves-away-from-private-insurers-to-administer-medicaid-program-1458325696
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