Monday, November 30, 2009
Friday, November 27, 2009
Wednesday, November 25, 2009
Sadly, there are alternatives that could save the state money as well as improve health care. We have offered thirteen of them.
In an unprecedented arrangement, United is not merging with Health Net (which is leaving CT), but simply buying all their information about us. They can then choose which of us, possibly based on our health status, they will offer to insure. They can also decide what they will charge us. United could more than triple their share of CT’s health insurance market; studies have found that less competitive markets lead to higher premiums for everyone. CT’s health insurance market is already too concentrated and we are at high risk for anti-trust concerns. Also, consumers who are lucky enough to be defaulted into a United policy may have to change doctors and medications. United’s provider panel is sparse in areas of the state and they have a different formulary than HealthNet. Also, as a matter of privacy, United will now have sensitive personal health information on about 200,000 state residents that we never consented to share with them. Health Net is now under investigation for losing a hard drive with Medical claims data. I also pointed out that all those 200,000 HealthNet members already had the choice of insuring with United and rejected it. To default them into a plan they already rejected is not doing them any favor.
For two hours, United’s own lawyers were able to ask their own executives and consultants softball questions extolling the virtues of the proposal. Then CID staff asked technical questions for another hour. Interestingly, United happened to have a large chart display just to respond to one of the CID staff questions. Then we had our turn at the podium. The CT State Medical Society, the Office of Health Care Advocate, the Center for Medicare Advocacy, the American Medical Society, the Patient Advocacy Institute, Middlesex Professional Services and the CT Health Policy Project all testified in opposition. We got very few questions. Then the United witnesses were asked softball questions by CID staff allowing them to rebut any of our concerns (I’m told lawyers call that rehabilitating the witness). One of those questions to the insurer asked whether actual workers in a small business have a role in choosing the insurance plans offered. United, as experts on small businesses like ours, answered that only owners have that choice. I guess that means that consumers really don’t have a voice in choosing health plans, only employers. (In our small group the opposite is the case, but I wasn’t given an opportunity to say that). We were only allowed to submit any written comments for a few hours, however United was given until 4pm the next day to submit anything they choose.
Democracy in action.
Saturday, November 21, 2009
Friday, November 20, 2009
Thursday, November 19, 2009
Unfortunately, the meeting of the Medicaid Managed Care Council’s PCCM Subcommittee that followed did not go as well. DSS has refused to remove the irrelevant and intimidating Freedom of Information clause in PCCM provider contracts. As one provider in the room put it – the first time a provider gets a request or a subpoena, that will be the end of the program. It is important to note that providers participating in HMOs are not required to sign similar contract language. DSS also continues to refuse to devote any resources to marketing PCCM, despite the overwhelming marketing allowed by the HMOs, paid for out of tax dollars. DSS estimated that the HMOs were spending 1% of the cap rates on marketing, which is roughly $7 million/year. Marketing activities by HMOs, approved by DSS, and paid for out of tax dollars, include free ice cream and haircuts to sign up with an HMO, a banner behind an airplane at a community festival, gifts, radio and billboard advertising, and raffles for school uniforms and supplies. DSS noted that when they talk to providers about signing up for PCCM, they also encourage them to sign up for the HUSKY HMOs and Charter Oak. It is unclear whether providers understand that they can sign up for just PCCM or if they believe they have to also sign contracts with the HMOs. DSS also announced that they will hire Mercer to conduct an evaluation of PCCM to be done by July. However, they acknowledged that the very small enrollment in the program so far makes it nearly impossible to make valid statements about how well the program is doing in providing care, reducing costs, or improving quality. Mercer was the DSS contractor that approved the 24% HMO rate increases for the HUSKY HMOs, which were called into question by the Comptroller’s independent audit, and derives a great deal of their business from managed care plans, in CT and nationally.
In the meantime, advocates are working without any tax dollars to market PCCM to both providers and consumers in New Haven and Hartford in anticipation of the program’s roll out there January 1st. We have an army of volunteers and energetic students mailing and calling providers, practice managers, community organizations and consumers. We are holding two forums open to anyone interested, and eligible to join, the program. By far the largest obstacle we are encountering is skepticism about DSS’s commitment to the program and a strong distrust of the state. If you are considering PCCM, for more information click here.
Wednesday, November 18, 2009
Tuesday, November 17, 2009
Monday, November 16, 2009
Although it was on the agenda, PCCM wasn’t discussed at the meeting, again.
Friday, November 13, 2009
At the Health Care Workforce Task Force meeting yesterday afternoon, the group finalized a list of groups we will reach out to for input and recommendations. The next meetings of the task force will be early next year with these groups. There was interest in mapping providers across the state geographically, tracking not only numbers of providers but patient access to care, particularly for Medicaid and HUSKY, including the public health workforce in our deliberations, how technology can help improve training, and measures to address skyrocketing prescription drug costs. The task force agreed to ask for a joint meeting with the Allied Health Workforce Policy Board which has been working for several years to identify and address areas of need. Chancellor Mark Herzog provided the task force with a compilation of the allied health and nursing programs at each of CT’s community colleges. Decisions about what programs to offer is driven by community demand, market forces, and constraints on state funding. Nursing is the most expensive program to offer.
Thursday, November 12, 2009
Tuesday, November 10, 2009
Monday, November 9, 2009
Friday, November 6, 2009
Thursday, November 5, 2009
Wednesday, November 4, 2009
Tuesday, November 3, 2009
A researcher has found that people who are politically active are happier than disengaged citizens who can’t name the Vice-President. Protesters are more optimistic and socially connected. And there is some evidence that it isn’t just an association; that getting people to think like activists makes score higher on “vitality.” Aristotle apparently stated the same thing, although it’s not likely he did a controlled experiment. Personally, I think at a certain point there are diminishing returns.
Monday, November 2, 2009
Nov. 4 from 9 to 11:30am in Enfield at the St. Francis Care Building, 7 Elm Street
Nov. 4 from 11:30am to 1pm in Danbury at the Tarrywile Park & Mansion, 70 Southern Blvd.
Nov. 16 from 11am to 1pm in Hartford at the Village for Families & Children
For more information call (860) 263-2172 or (877) 552-8247 or email firstname.lastname@example.org