PCMH Plus and Changes to Husky Medical Care: What You Should Know

by Coalition for People

At the June meeting of the Coalition for People, Ellen Andrews of the CT Health Policy Project gave a presentation of some very important changes to HUSKY Health. She also introduced the work of the CT Health Policy Project, whose purpose is to ensure there is affordable healthcare for everyone in the state.

Since 2012 HMOs have not been involved in Connecticut’s Medicaid program. Primary care providers work directly with patients. It saves money and people get more care.

PCMH Plus is a new program; Person-Centered Medical Home Plus or PCMH+ provides person-centered, comprehensive and coordinated care to HUSKY Health members. Advocates are concerned it jeopardizes the progress made since 2012. It will allow medical practices to get back 50% of the money they save the Medicaid program. It incentivizes less care which can be achieved by eliminating duplicate tests and improving care to keep people out of the hospital. Savings can also be generated by denial of needed services, not following through and not referring people to specialists. These practices will save the state money and 50% of the savings will get kicked back to the medical practices. Patients can be “cherry-picked” and patients needing high-cost care can be dumped from their providers’ practice.

Patients have the choice to opt-out of PCMH+ and nothing will change with their current care. In fact, if people do not opt-out of PCMH+, they will lose access to Intensive Care Management, a program to help people with complex conditions. Many people who are covered by HUSKY Health don’t know about this program and what their options are. For more information, check the website at PCMHPlusFacts.org.

The next meeting of the Coalition for People is Wednesday, Sept. 19, 2 p.m. in the community room (lower level) of the Fair Haven LIbrary, 182 Grand Ave. All are welcome to attend.