Advocacy

Reimagining Medicaid

Caring for the Health of Our Communities

Redesigning the Medicaid program to invest in local communities is key to a healthier future.

Connecticut’s low Medicaid reimbursement rates inhibit access to care, drive up patient costs, and strain healthcare providers. At the same time, residents and communities across the state are struggling to prevent and manage chronic disease and improve health. The Medicaid program can and should work better for the patients and communities it supports.

Increasing Medicaid reimbursement rates across the healthcare continuum and adopting payment reforms that direct funds to community health improvements will remove barriers to care, advance health equity, and enhance healthcare affordability for all Connecticut patients.

What if… Medicaid was designed to not only focus on immediate medical needs but to address the root-cause issues that drive poor health and health disparities?

Connecticut hospitals have joined with a coalition of community partners to advocate for reforms that reimagine Medicaid. A central aim of these reforms is to invest in initiatives that prevent chronic disease and improve community well-being. Addressing social, economic, and environmental drivers of health — like stable employment, housing security, environmental safety, and access to nutritious food — fosters healthier families for generations to come.

Housing

Nutrition

Economic Mobility

Transportation

Environment

Neighborhood Safety

Multi-Sector Health Partnerships Address Root-Cause, Upstream Drivers of Health

Connecticut hospitals and health systems, in collaboration with community partners, have developed a comprehensive framework to achieve these goals by strengthening and expanding multi-sector health partnerships. This framework builds on efforts already underway to develop and implement innovative programs that connect individuals and families throughout the state with vital resources and services.

New Financing and Regional Accountability Model

Connecticut hospitals and health systems are proposing to make adjustments to the hospital tax program to support substantial improvements in reimbursement and new investments in a broad range of community health initiatives supported by multi-sector health partnerships.

A major feature of this redesign is measuring and rewarding improvements in healthcare outcomes and long term prevention outcomes, including lower rates of chronic disease and behavioral health conditions. A central principle of this reform is to reinvest 100% of the resulting savings to further strengthen the care delivery system and to expand the scope and scale of community-led health and well-being initiatives.

Three Cornerstones to Medicaid Redesign

Address Medicaid hospital underpayment: Increase reimbursement so that payments cover the cost of providing care and provide for annual trend updates that keep pace with the rising cost of care.
Engage multi-sector health partnerships: Build on community partnerships to co-design ways to best use Medicaid funds to create community-directed investments that reward positive health outcomes.
Establish a regional investment and accountability financing model: Establish a financing and accountability framework that provides substantial and sustained new investment funding for the work of hospitals and the multi-sector health partnerships in which they participate.