Connecticut Department of Social Services Requests Provider Input for Legislatively Required Medicaid Report

As required by Section 17 of Public Act 23-171, An Act Protecting Patients And Prohibiting Unnecessary Health Care Costs, the Connecticut Department of Social Services (DSS) is preparing to submit to the Medical Assistance Program Oversight Council (MAPOC) a recommended strategy to reform the state’s Medicaid program.  The HUSKY Health Report is due no later than January 1, 2025. 

DSS is required to consult with the Connecticut Hospital Association (CHA), hospitals, and other providers to inform community-based prevention policies and wellness, care delivery, and financing strategies.  Connecticut hospitals and health systems were invited by DSS to participate in a listening session on Tuesday, October 8, during which stakeholders were encouraged to provide input on how to achieve the six goals set forth in the statute, including:

1. Improve healthcare access and outcomes
2. Increase adoption of interventions to support improved access to preventive care services
3. Identify and address social, economic, and environmental drivers of health to advance long-term preventive health and healthcare outcomes
4. Explore innovative financing reforms that support high-quality care, promote integration of primary, preventive, and behavioral healthcare, and address health-related social needs and long-term preventive outcomes
5. Improve collaboration and coordination among healthcare providers and cross-sector community partners
6. Improve Medicaid reimbursement and performance to achieve a sustainable healthcare delivery system and improve healthcare affordability for all

Hospital and health system leaders stressed that addressing Medicaid underpayment must be a pillar of reform efforts.  For years, the Office of Health Strategy (OHS) has calculated a Medicaid payment-to-cost ratio that shows hospitals are reimbursed about 60 to 65 cents on the dollar for care provided to Medicaid patients.  That shortfall places an enormous burden on hospitals, which in turn is borne by the employers and employees who cover these uncompensated costs in their annual premiums, threatening the affordability of commercial health insurance.

Additionally, hospitals and health systems emphasized that cross-sector community partnerships are key to driving long-term improvements in social, economic, and environmental influencers of health.  It is through these collaborations that hospitals and communities work together to improve the health of the community and help prevent chronic conditions. 

Providers explained that an innovative financing model will be needed to achieve the statute’s health equity goals, particularly by increasing Medicaid payment, investing in cross-sector community health partnerships, and sharing 100% of the savings that result from the work of hospitals, their community partners, and primary care.

DSS is also accepting written public comments through Friday, October 25 via e-mail to Public.Comment.DSS@ct.gov.