Tuesday, June 28, 2011

Webinar: NCQA Patient centered medical home standards update

Join us for a webinar Monday July 25th at 2pm to hear about NCQA’s updated standards for practices seeking recognition as patient-centered medical homes. The new standards emphasize organizing care around the patient and include integration of behavioral health care and care management, a standardized patient experience survey, and ensuring that patients and their families are involved in quality improvement. The standards also reinforce federal regulations on meaningful use of health information technology. To register for the webinar, go to https://www1.gotomeeting.com/register/796189832.

Friday, June 10, 2011


Staff of the CT Health Policy Project will be out of the office until June 27th. See you then.

Tuesday, June 7, 2011

Comments on federal ACO proposal, Changing Face of Medicaid

CMS has issued the proposed rule under national health reform to implement Accountable Care Organizations (ACOs) for Medicare beneficiaries. ACOs are a new way of paying for health care, moving away from fee-for-service to paying for value. An ACO is a network of health care providers spanning the care spectrum paid to provide for all the needs of their patients. The proposed rule has been controversial for many reasons, but a less noticed provision includes an erosion of patient privacy protections. The proposal would allow CMS and providers to share sensitive medical information unless the patient chooses to opt-out of the system. The proposed opt-out process is unrealistic and would be very difficult for many Medicare beneficiaries to access. Unfortunately, it is very likely that the first time many patients learn that their information is being shared will be after a breach. The CT Health Policy Project submitted comments to CMS yesterday opposing this provision of the proposed rule.

Slides on the extensive changes coming to CT’s Medicaid program are online. The slides were part of a talk for the Community Health Center Association of CT’s board member conference this weekend.
Ellen Andrews

Thursday, June 2, 2011

Health insurance exchange bill passes Senate

Yesterday the Senate passed SB 921 creating the Connecticut Health Insurance Exchange. The Exchange, authorized under the Affordable Care Act (ACA), will create a standardized, understandable marketplace for consumers and small businesses to purchase health insurance. The Exchange must be operational by 2014 when the ACA’s individual mandate becomes effective. Individuals eligible for premium subsidies under the ACA are required to purchase their coverage in the Exchange. The ACA provides funding only to establish the Exchange. Most states are passing similar legislation to create exchanges this year. CT’s Exchange will be a quasi-public agency and includes members with relevant areas of expertise. The bill also includes strong conflict of interest provisions important to advocates. Insurers, brokers, representatives of health care facilities or clinics, and trade groups are excluded. Providers may serve if they are not currently compensated for delivering health care services or invested in a health care practice. The Exchange may create advisory committees including consumer and broker issues and hire independent navigators to help individuals and small businesses understand health insurance and make wise purchases. The Exchange will work with the SustiNet Cabinet to assess the feasibility of exercising the ACA’s Basic Health Option to cover lower income adults not eligible for Medicaid but who may not be able to afford private coverage even with subsidies. The Exchange will also coordinate applicants’ Medicaid eligibility. Next the bill goes to the House.
Ellen Andrews