April 7, 2011

GOVERNOR MALLOY: $1 MILLION FEDERAL GRANT TO IMPROVE PATIENT CARE IN MEDICAID, MEDICARE

Connecticut Wins Award to Pilot New Form of Health Care Coordination for Older Adults, People with Disabilities

(HARTFORD, CT) - Governor Dannel P. Malloy today welcomed a $1 million federal grant to help Connecticut pioneer a coordinated system of care for elders and adults with disabilities covered by both Medicaid and Medicare - a group that now consumes the highest amount of taxpayer health care dollars.

"I am pleased and grateful that the federal Centers for Medicare and Medicaid Services has recognized the quality of Connecticut's proposal to provide better care to tens of thousands of our most frail and chronically ill citizens, while easing costs to taxpayers," Governor Malloy said.

The so-called 'dual eligible' population - people poor enough to qualify for Medicaid and who also have Medicare because of age or disability - accounts for over $2 billion in Connecticut's Medicaid expenditures.

"We are on track to bring innovative solutions to bear on a problem that has driven up health care costs disproportionately," Governor Malloy said. "In essence, our poorest and most vulnerable citizens have been 'on their own' in the health care system. Their medical costs have been covered but lack of coordinated care for various conditions and procedures can lead to redundant care, unnecessary costs and fragmented accountability between the state and federal governments."

Individuals who are dually-eligible for Medicare and Medicaid represent about 19% of Connecticut's Medicaid beneficiaries and 19% of the Medicare population. However, they account for 58% of state Medicaid expenditures and 25% of Medicare's expenditures.

Approximately 60% of dually-eligible beneficiaries are over 65, and 40% have disabilities or are chronically ill. Medicaid spending per dually-eligible individual in Connecticut is nearly twice the national average ($27,619, compared to $15,900 nationally), and Medicare spending per dually-eligible enrollee with a disability is $25,902, compared to $14,755 nationally). Medicaid is funded jointly by the state and federal governments, while Medicare is federally-funded.

Under Connecticut's winning proposal in the State Demonstrations to Integrate Care for Dual Eligible Individuals federal grant program, the Department of Social Services (DSS) will contract with 'integrated care organizations,' or ICOs, to coordinate medical care at the local level.

"This approach is designed to create accountability for the delivery of health care services and long-term care support," said Jeannette DeJesús, Deputy Commissioner of the Department of Public Health and Special Advisor to the Governor on Health Care Reform. "The goal is to bring improvements in coordination of care and health outcomes, while increasing cost-efficiency for taxpayers."

The grant proposal was written primarily by Mark Schaefer, Director of Medical Care Administration at DSS.

"We greatly appreciate the support and encouragement of Governor Malloy as we develop the integrated care organization model for Connecticut," Dr. Schaefer said. "Interested legislators, providers and the advocacy community made an enormous contribution to the design of this new service model, which has great potential to improve the quality of care and, with it, health outcomes for about 120,000 low-income enrollees of Medicaid and Medicare. ICOs will be a focus of local care coordination for all providers who touch the lives of our clients, ranging from the primary care physician to the specialist, hospital or skilled nursing facility.

Roderick L. Bremby, who took office this week as Commissioner of DSS, said the timing of the federal grant award coincides nicely with the Malloy/Wyman Administration's multi-level initiative to improve public health coverage, while tackling burgeoning costs in Medicaid. "On Tuesday, DSS issued a major request for proposals in support of the administration's restructuring initiative, and we are on track to implement these significant changes by January 2012," Commissioner Bremby said.

On February 8, Lt. Governor Nancy Wyman and Office of Policy and Management Secretary Ben Barnes announced the change in health care administration to improve coordination of medical benefits and outcomes under Medicaid in general, including the HUSKY Plan and the Charter Oak Health Plan for uninsured adults. Managed health care services will be replaced by an 'administrative services organization' structure.

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For Immediate Release: April 7, 2011

Contact: David Dearborn
Department of Social Services
David.Dearborn@ct.gov
860-424-5024 (office)
860-301-8383 (cell)

Twitter: @GovMalloyOffice

Facebook: Office of Governor Dannel P. Malloy