Disappointing SIM update

Monday a group of 16 independent consumer advocates delivered a letter to the SIM steering committee voicing deep concerns about the implementation development process. Advocates have voiced concerns about the SIM process from the beginning, offering constructive options that support the goals of improving quality and access to care while controlling costs. Concerns voiced in the latest letter include SIM staff soliciting input from consumers and advocates that was not communicated to or considered by the steering committee, a continuing lack of transparency, and a preference to exclude independent consumer advocates with policy expertise from implementation workgroups. Those workgroups will consider complex questions and develop the critically important details of the plan – effective, independent consumer input is essential to success. Advocates are concerned that conveneing the committees has been delayed, including the critical Equity and Access Committee that is tasked with developing a monitoring system to ensure consumers are not inappropriately denied necessary services under SIM’s new payment model incentives. In yesterday’s Health Care Cabinet meeting we learned that SIM will be going forward with their current plans; the consumer letter was not discussed.

In the Cabinet meeting we also confirmed that critical public health priorities were added to the SIM plan at the last minute to improve CT’s chances of getting a federal grant. Consumer advocates have repeatedly objected to re-making CT health reform priorities for the purpose of securing a grant for hiring state agency staff and consultants. CT priorities should be set here in CT by CT stakeholders in thoughtful consensus processes which are ongoing across our state. We should only pursue funding opportunities that already fit with CT’s priorities, not the other way around. We also learned that they intend to develop a common set of standards across all CT payment sources for medical homes to be eligible for shared savings payments. They are moving ahead with plans to develop a survey of CT providers to inform development of those standards. Mirroring advocates’ questions, concerns were also raised about how traditionally public health functions and consumer choice will be protected in the integration into a medical model of care.