CT drops back to a C on health reform

This month Connecticut health care thought leaders gave our state a C on health reform, erasing the C+ bump in last month’s survey. Connecticut also earned a C for effort. Patient-centered medical homes join Medicaid as the bright spots, earning a B and C+, respectively. Medicaid is the only area that received any A grades from thoughtleaders. Educating the Public earned the worst grade – a C/D, closely followed by Public Education and Health Insurance Market Reform. Suggestions to improve Connecticut’s progress echoed last month’s themes -- engaging consumers and small businesses in policymaking, smarter policymaking, urgency, and a call for collaboration. For more, go to the CT Health Reform Dashboard at www.cthealthreform.org.

Fascinating presentation at Health Care Cabinet

Today’s Cabinet meeting featured a presentation by Capitol District Physicians Health Plan, an Albany-based, nonprofit, physician-led health plan, that is succeeding in the triple goals of reducing costs, improving quality of care and addressing population health. Their CEO, a cardiologist, and VP of Underwriting described the innovations that led to their success including patient-centered medical homes, partial capitation for primary care providers (including risk adjustment and increased fees in the calculations), wellness programs, investments in technology, and worksite population health programs. They have integrated care management, data analysis and population health into the practices they support with additional staff at the practice site. The keys to their success seem to be significant sophistication in health policy/data, physician leadership and the connection with employers. CT could learn a lot from them. Hopefully future Cabinet meetings will include more presentations like this one.

Medicare/Medicaid dual eligible reform plan update

On Friday, the Medicaid Council passed the recommendations of the Complex Care Subcommittee on DSS’s application for an integrated care demonstration program for people eligible for both Medicaid and Medicare. The committee recommended that the Council endorse DSS’ application with the condition that providers be rewarded based on performance on quality measures; the amount they receive may be reduced if they do not also produce savings for their enrollees by an amount or percentage to be determined. The rewards are in addition DSS opposed the recommendation arguing that rewarding only providers who both generate savings and reach performance standards is the best way to ensure the program generates savings. The recommendation passed unanimously with two abstentions. Public comments on the application are being accepted until May 24th.

Exchange fix bill dies in Senate

The bill to bring the CT Health Insurance Exchange into compliance with federal regulations died on the Senate calendar last night as the session ended. The bill would have added two consumer and two small business representatives to the Board’s membership and given the State Health Care Advocate a vote. Currently there are no voting members representing consumers and three Board members have insurance industry backgrounds. The bill passed two committees and passed the House unanimously but was never called in the Senate. The administration has defended their appointments and the composition of the current Board. Board members are appointed by the Governor and legislative leadership. Thankfully one current member, appointed by House Republicans, is a small business owner.

CT Health Reform Dashboard – CT up to 12.1%

CT has jumped ahead in progress in health reform to 12.1% of the tasks completed, according to the May CT Health Reform Dashboard. This is up from 10.8% last month. While we are closing in on the major January 1, 2014 deadline for many reforms, much remains to be done. At this rate, it will take 5.6 years to achieve reform. The dashboard can be found at www.cthealthreform.org.

Risk is all about perception, and that shapes health decisions

Making good decisions, about our health and everything else, revolves around perceptions of risk, according to speakers at yesterday’s annual Donaghue Foundation conference. David Ropeik, author of How Risky Is It Really? Why Our Fears Don’t Always Match the Facts, and Brian Zikmund-Fisher, Professor of Health Behavior and Health Education at the University of Michigan, delivered a great deal of evidence that our perceptions of risk are not necessarily tied to the realities. How risk is communicated can be as important as the numbers. Thankfully, the science of how to convey risk information in a useful and meaningful way is constantly improving. Fascinating conference, yet again, leaving us with lots to think about and use in our work.

May web quiz – Medicaid eligible CT residents under national reform

Test your knowledge about the CT residents who will become eligible for Medicaid in 2014 under national health reform. Take the May CT Health Policy Webquiz.