Tuesday, September 2, 2014

CT Mirror calculator figures insurance costs for 2015

A cool new calculator from CT Mirror allows visitors to compute coverage costs across health plans with just a few clicks. It is way too much fun to play with. The tool is part of the Mirror’s new Health Care Users Guide. Highly recommended.

Friday, August 29, 2014

New SIM summary online – consumer concerns remain

The administration’s federal SIM application for $64 million is finished. As the plan and application developed, consumer advocates sent five letters signed by dozens of independent advocates voicing concerns including weak consumer protections, incentives to deny necessary appropriate care, the need for nationally recognized standards, and the lack of independent voices in the process. Some of our concerns were incorporated, but many remain. An update on the application is online, including where the money would go if awarded, the fate of consumer interests, and what still needs to be done. 

Thursday, August 28, 2014

New to Book Club: Fixing Health Care Inside & Out

Our latest addition to the CT Health Policy Project Book Club offers very concrete guidance for practices and policymakers working to improve quality and access to care, while holding the line on skyrocketing health care costs. From the Harvard Business Review, Fixing Health Care Inside & Out is a great compendium of health care innovations that focus on improving quality and ensuring that precious, scarce resources are maximized. Helpful lessons that work from the real world include overcoming turf battles in building teams, organizing around consumers’ needs rather than medical specialties, effectively using peer pressure to improve performance, and ensuring that shiny new (expensive) technologies are used appropriately. Authors also describe how the structure of the current system (fee-for-service and beyond) can sabotage great new, simple, efficient ideas.

Tuesday, August 26, 2014

Join a tweet chat on CT’s SIM plan Wednesday

A community of CT social media health advocates hold regular tweetchats with the hashtag #hcsmct. A tweetchat is a public Twitter conversation, generally with a regular schedule, connecting people with common interests. Including the hashtag #hcsmct in tweets during the chat allows visitors to follow and participate in the discussion. Join us this Wednesday, Aug. 27th at 3pm to discuss CT’s SIM plans for health care innovation. @cthealthnotes will be moderating – my first time, so be patient.

Monday, August 25, 2014

CT state employee plan premiums 25% more than US average

According to a new report, CT state employee plan premiums averaged $1,199 per employee last year, the 9th highest rate among states. State employees with single coverage paid 11% of premium on average, compared to 25% of all CT employee plans. Families averaged 15% of premiums for state employees compared to 32.7% for all CT families. The average actuarial value of CT state employee coverage was 98%, higher than any other state or the highest 90% platinum level for health insurance exchange coverage.

Friday, August 22, 2014

SIM administrators seeking planning consultants should avoid prior mistakes

State SIM administrators are soliciting bids for a new set of consultants to guide the implementation process. Given the problems with the SIM final plan development process, advocates offer these recommendations. This time:
  • ·      Use an transparent, objective process that is open to all qualified applicants
  • ·      Avoid any perceptions of political and other conflicts
  • ·      Require a familiarity with CT’s health system and history, or at least a willingness to learn
  • ·      Require strong, broad research skills
  • ·      Require the consultants to be open to and respectful of all stakeholder ideas and perspectives
  • ·      Prohibit biases toward pre-conceived payment or other theoretical models that conflict with CT realities
  • ·      Select for strong listening skills, both to committee members and the much larger wisdom of the stakeholders crowd, avoid perception that all the answers reside in any small committee
  • ·      Select for a record of respectfully engaging that wisdom and incorporating it into implementation to engage everyone in making SIM work
  • ·      Select for consensus-building skills over rhetoric
Advocates look forward to contributing to SIM’s implementation and ensuring a success that benefits every state resident.

Thursday, August 21, 2014

CMS stopped reimbursing CT for new Medicaid eligibles in January

CT News Junkie reported today that CMS halted reimbursements for the newly eligible Medicaid members as of January 1st. The first quarter payment the state missed was $249 million, but the second quarter amount could be more as enrollment grew under the ACA expansion starting January 1st. According to DSS’s financial reports, the state’s expected federal MLIA amount for May alone is $126 million. This follows smaller but related issues reported in June concerning Medicaid reimbursement for DMHAS services. The state expects to have the problem resolved by the end of the year but concerns have been raised about the state’s cash levels to ensure payments to providers and other state spending.