While the deadly coronavirus seems to be subsiding in Connecticut for now, its impact on nursing homes has not. More than 6,700 beds are empty, and it may take many months of financial struggle before occupancy climbs back to pre-pandemic levels. Of the approximately 200 nursing homes in Connecticut that receive payments from Medicaid, the government health insurance program for low-income people, only 15 were 70% or less occupied in January, according to the Connecticut Health Investigative Team’s analysis of state data. By August, almost five times as many facilities saw occupancy drop to that level or less. While the statewide average decline was 15%, the number of residents in 19 nursing homes has plummeted to 55% and below since January.
Health insurance coverage might be more accessible and affordable in Connecticut if the state applied for certain Affordable Care Act and Medicaid waivers, according to advocates who say the options should be explored. Two waivers in particular—Affordable Care Act (ACA) Section 1332 and Medicaid Section 1115—would let the state disregard certain federal requirements, possibly lowering health care costs for some individuals, according to a policy brief commissioned by the Universal Health Care Foundation of Connecticut and the Connecticut Health Foundation. “What we need to do in Connecticut is really think about … how could we creatively, imaginatively, innovatively use waivers to expand coverage to quality care and really help improve health,” said Frances Padilla, president of Meriden-based Universal Health Care Foundation of Connecticut. “We haven’t had that conversation yet in Connecticut.”
The ACA waiver isn’t available until 2017 but the Medicaid waiver is already being used by dozens of other states to lower costs, she said. “It allows a state to get past some of the requirements of Medicaid and do some things that are innovative,” she said of the Medicaid waiver.
Plans are underway to provide thousands of individuals under age 21 with autism spectrum disorder (ASD) with home-based interventions and other services through the state’s Medicaid program beginning Jan. 1. “This is absolutely huge,” said Jennifer Bogin, director of Autism Spectrum Services for the Connecticut Department of Developmental Services (DDS). “Many children already get quality programming during the school day. But it’s rare when that programming is brought into the home.
The use of nationally certified medical homes to coordinate the care of Connecticut’s Medicaid patients has led to improved quality, a 2 percent cut in per person costs, and a 32 percent increase in the number of participating providers during an 18-month period. The news comes as the state moves forward with plans to jumpstart the medical home movement in Connecticut with an expanded “Glide Path” program that would assist all practices – not just those that accept Medicaid patients – working to become medical homes. The program, still under development, would require practices to meet national standards. The state initiative has shed light on the challenges facing Connecticut’s medical homes, including the costs of implementing an electronic medical record and care coordination strategies. Experts say medical homes can improve quality, cut costs and reduce health inequities among all patients, not only those in the state’s Medicaid program.