Friday, December 19, 2014

CT News Junkie Op-ED – learning from mistakes in HIT

A new opinion piece in CT News Junkie focuses on the need for CT to develop a functional health information system, that respects consumers’ privacy, is crucial to patient safety, improving quality, controlling costs and thoughtful reform. The merciful demise this year of HITE-CT, a quasi-public entity charged by the state with doing just that, offers some lessons.

Thursday, December 18, 2014

SIM update

CMMI announced Tuesday that Connecticut was among eleven states whose SIM application was approved. CT expects to receive $45 million over four years to support reform.

The SIM Health IT Council will hold its first meeting today at 1pm at the LOB. Commissioner Bremby of DSS,  which has been given responsibility for developing an Health IT plan for the state, presented on the state’s plans at the last SIM steering committee meeting. The ambitious but thoughtful plan includes infrastructure, risk profiling, a consent registry, and other critical pieces to create a functional system for CT.

The SIM workforce council has been placed on hold. Only one of the three original workforce proposals was included in the final SIM applications. UConn will no longer be leading that effort.

The Chartis Group has been chosen as consultants to support the work of the Equity & Access Committee to develop a system of underservice monitoring. The Committee will meet with the consultants for the first time tonight at 6pm in Rocky Hill.

Monday, December 15, 2014

Medicaid update

The Medicaid Council workgroup developing quality measures to use in reforming Medicaid’s payment system has held a couple of meetings – one very constructive, the first not so much. The first meeting was hastily called, dominated by SIM representatives, and contentious. However, the comforting bottom line from that meeting was that DSS will make the final decisions about how payment reform is structured for Medicaid. The second meeting was more friendly and productive, with better representation by Medicaid stakeholders and committee members who’ve worked over the years to improve the program. At the second meeting we worked through an impressive list of quality measures already being used by the program including typical quality measures, consumer and provider satisfaction surveys, and provider profiling. The committee explored what is now being measured, how that data is used, and is soliciting additions to fill gaps.

In Friday’s Medicaid Council meeting we watched a new You Tube video from DSS highlighting the program’s recent progress in improving access to quality care and controlling costs. The video is part of the department’s efforts to better communicate policy decisions and accomplishments. We also heard more about the extensive array of available Long Term Supports and Services that allow fragile people to live in their communities while saving the program money. We also heard an update on the enrollment dashboard and consultants the department is hiring to help improve processes.

Thursday, December 11, 2014

CT fourth healthiest state

In this year’s report, America’s Health Rankings finds CT residents are healthier than residents of all but three other states, up from 7th in the last two years. Our strengths include a very low smoking rate, low teen birth rate, and a high rate of dental visits. Our challenges are a very troubling high rate of avoidable hospitalizations, high rate of binge drinking, disparities based on educational attainment, and insufficient sleep.

Tuesday, December 9, 2014

Consumer Advisory Board considers ethics policies

In today’s meeting, the Consumer Advisory Board (CAB) discussed proposed ethics standards to ensure that anyone who makes decisions about funding from SIM not benefit from that funding. According to Connecticut’s Public Officials and State Employees Guide to the Code of Ethics, a substantial conflict of interest exists when “a public official, his or her spouse, a dependent child, or a business with which he or she is associated will derive a direct monetary gain or suffer a direct monetary loss by virtue of his or her official activity.” The guide further states “A public official or state employee must abstain from taking official action on the matter that presents a substantial conflict for them, his or her immediate family, or any associated business.” Under the SIM proposal approved by the SIM Steering Committee, the CAB proposes to fund community organizations and other potential contractors. The proposed language for adoption by the CAB requires transparent and open procurement processes, members, their families or businesses they are associated with are prohibited from bidding on or accepting funds that are directed by or on behalf of the CAB or SIM, and a revolving door provision that extends the provision for one year after the member’s appointment ends. Members expressed support for the concept and avoiding even a perception of conflicted interests. Some suggested following generally weaker non-profit Board standards that often only require that the member with the conflict recuse himself or herself from voting on the application of their business or organization. This allows situations, as happened at the AccessHealthCT Board, where a member argued and voted for weak standards and opposed active purchasing, resigned from the Board, and subsequently went to work for an insurer that intends to participate in the exchange under the weak standards and without facing negotiation with the state to keep rates affordable. The CAB asked for more clarification on whether they are required to follow the Code of Ethics. But at least one member offered that the CAB should adopt the ethics code standards anyway and err on the side of caution.

Monday, December 8, 2014

CT hospitals made $597 million profit last year

A new analysis of CT’s 29 acute care hospital finances by C-HIT found that while operating profits were down last year to $333.6 million from $513.6 m last year, overall profits were still $597 million due to an increase in investment and other income. The annual OHCA report found that just under half (48%) of total CT hospital revenue was from public sources – Medicaid and Medicare. At 3.15% CT hospitals’ average operating profit margin was above margins for many other US industries such as continuing care/assisted living facilities (-1.0%), electronics/appliance stores (1.5%), highway/street/bridge construction (2.2%) and groceries (2.3%). Non-operating margins were still higher than non-operating margin at 2.5%; combined CT hospitals achieved an aggregate 5.64% profit last year. Five of CT’s 29 acute care hospitals lost money last year, while 10 reported higher profits than the year before. Three of the five with negative margins are part of larger networks. Of note is Windham Hospital’s performance, losing money for the last five years despite their affiliation with Hartford Health Care Corp., while the hospital achieved profits for each of the four years preceding that affiliation.

Click here for the full OHCA report.