Over the coming weeks this blog will highlight a key feature of Medicaid and the individual states that administer Medicaid and CHIP leading up the the program’s 50th anniversary (July 30th). Hopefully, you’ll learn some interesting facts about Medicaid and each of the 51 state programs.
Basics: Husky Health, Connecticut’s Medicaid program, covers 726,253 lives
Medicaid managed care is on the rise at the moment, with predictions that as many as 75% of Medicaid beneficiaries may be served by a managed care plan this year. Connecticut is interesting because in 2012, the state brought the program back in-house after 15 years of contracting with managed care organizations.
The CT Department of Social Services now manages beneficiaries using an Administrative Services Organization (ASO) model. One very interesting rationale that Connecticut gave for their shift was the issue of high utilizers – 4% of their beneficiaries accounted for 49% of costs (this is very consistent with national trends). Managing this group well is key to improving health outcomes and reducing preventable costs. When the high utilizers were spread across three managed care plans, it was hard for the state to know who they were or how they were doing. By bringing all the beneficiaries into one pool, it’s possible to get a clearer picture of the high utilizers – and to improve the delivery system so that it can serve them better.