Development of a Medicaid Managed Care Report Card in the State of Connecticut

Background: Like many states, Connecticut does not currently have a systematic way for Medicaid enrollees to select a suitable plan based on managed care performance indicators. In Connecticut, Medicaid is divided into two broad programs based on income: the HUSKY A program serving low-income working families and children; and the HUSKY B program serving uninsured children in families with incomes greater than 185% FPL. Under each plan, managed care organizations (MCOs) provide services; four MCOs in the HUSKY A program and three MCOs in the HUSKY B. HUSKY A members can change plans monthly, and on average, about 1.5-2% of members do so. While plan change enables members to seek plans that better meet their needs, it also creates instability and disrupts continuity of care. A ‘lock-in' provision for HUSKY A is planned for 2007, which makes access to quality indicators for plans particularly important. HUSKY B started ‘locking-in' members in 1998. Following the lead of other states, Connecticut hopes to develop a managed care report card to better inform consumers, providers, and legislators with meaningful data about the performance of Connecticut's Medicaid MCOs. Methods: Analyze Medicaid report cards used in other states; and through key informant interviews and secondary data analysis, conduct analysis of needs of Connecticut's Medicaid population. Outcome: A best practice report on essential indicators and policy to implement a Medicaid report card, presented to the Connecticut Medicaid Managed Care Council. This study also has implications for other states examining the applicability of a report card mechanism.