Friday, October 31, 2014
A clip from Crowd Control, a new National Geographic channel show, puts innovative thinking to work solving problems. This clip highlights a novel idea to trick New Yorkers into taking the stairs instead of an escalator. Notice that no one knows they are exercising or doing “the right thing” – they are just having fun. This clip addresses the problem of stopping people from illegally parking in disabled spaces. Crowd Control is the latest project of Daniel Pink, author of Drive – one of my favorite books.
Thursday, October 30, 2014
November 12th Trinity College will host a day-long conference on The Contraception Mandate – Religious Liberty & Health Care. Marc D. Stern, General Counsel for the American Jewish Committee and Member of the Bar of the U.S. Supreme Court, will be the keynote speaker. After lunch, three breakout sessions on related topics—Religiously Affiliated Organizations and Health Care, Legal Issues Pertaining to Women's Health Care, and Connecticut Regulations and the Contraceptive Mandate—will be held. The conference is free, but registration is required for lunch.
Wednesday, October 29, 2014
A study by Health Pocket averaging unsubsidized insurance premiums both on and off the exchange found that for 23 year olds, CT’s average premiums this year were the 11th highest among states, 12% higher than the US average. For 30 year olds, CT also ranks 11th highest with premiums 13% higher than the US average, and 8th highest for 63 year olds at 16% higher than the US average. Between 2013 and 2014 monthly premiums, averaged on and off exchanges rose for both men and women and all ages studied, but increases were not the same. American men age 30 experienced 78.2% average increases, but premiums for American men age 63 rose only 22.7% on average. The ACA limited the difference in premiums charged by age effective this year. The difference in premiums between CT residents age 23 and age 63 changed from 300% in 2013 to 195% this year. Federal subsidies, available only to insurance purchased in the exchange, limit monthly insurance premiums for people with qualifying incomes.
Friday, October 24, 2014
Join Bob Berenson, MD of the Urban Institute for a CTHPP webinar November 18th at 1pm as he explains health care payment reform options. Dr. Berenson has long health policy experience, both inside and outside government. He served as Director of Medicare Payment Policy at CMS. His work focuses on quality measurement/improvement and Medicare shared savings. In the webinar Dr. Berenson will focus particularly on shared savings models as CT is considering for both the Medicaid/Medicare health neighborhood pilots and the much more ambitious SIM plan. Click here to register for the Nov. 18th webinar.
Wednesday, October 22, 2014
2014 Medicaid Managed Care Congress this week in Washington heard about CT’s impressive success in bucking trends moving from the common capitated MCO model to a patient-centered care coordination-based ASO model. The Project was honored to participate and share CT’s secrets to success including our study on barriers to provider participation, quality improvements, rising provider participation, and stable per member costs despite significant enrollment growth. I also shared how CT is not resting our laurels, but is building on that success to develop health neighborhoods to coordinate care, improve quality and control costs for CT’s dually eligible residents. There was a lot of interest in the data demonstrating our success, and the policymaking process we used to get there. We also heard excting success stories from other states, including NY’s impressive data systems and early shared savings lessons from Oregon and Louisiana.
Friday, October 17, 2014
annual consumer report card on health insurers. In its 9th year, the report card compares managed care plans offered in CT across 15 categories of performance including number of providers by county, controlling high blood pressure, cancer screening rates, prenatal care, and drug spending. An incredible resource, the report also includes enrollment numbers by plan, NCQA quality ratings, worksheets for consumers to compare plans on important features, and very useful customer service contact info.
Wednesday, October 15, 2014
At last night’s SIM Practice Transformation committee meeting, consumer advocates were able to halt erosion of national standards for patient-centered medical homes (PCMHs). Following research and best practices and resisting misinformation, in June the committee voted to use nationally recognized NCQA standards for PCMHs in SIM. NCQA-recognized PCMHs are the foundation of CT Medicaid’s remarkable success in lowering costs, improving quality and engaging new providers in the program. Unfortunately, there have been more recent efforts in the committee to erode that decision. Last night’s meeting was frustrating to watch as much policymaking was based on misleading anecdotes, random conversations, and lack of understanding of health policies – thankfully advocates did their homework and cited published research to make their case. Eventually SIM staff reaffirmed that NCQA standards will be the “framework” and “backbone” for PCMH standard setting in SIM. It is important to note that Massachusetts has reportedly reversed their decision to create state-specific PCMH standards.
The committee also heard from AmeriCares Free Clinics that provide coordinated, high quality care to thousands of uninsured low-income state residents left out of ACA expansions. AmeriCares would like to earn PCMH status to further improve the quality of their care, despite the fact that they do not bill to payers and will not be rewarded financially. AmeriCares asked to be included in the SIM glide path providing technical assistance to earning PCMH status, despite the fact that they do not bill to Medicaid. Staff agreed to keep open the possibility for free clinics to apply for the funding, but priority will still go to the large Medicaid shared savings networks.