Most of today’s Cabinet meeting was spent on
SIM’s
decision to create a CT-specific medical home standard rather than using
well-vetted, evidence based national standards. (May 29
th we are
hosting a
webinar with
NCQA to learn more about the NCQA system that has certified 1,009 PCMH providers
in CT already.
Register
here.) Questions were raised about paying for value/quality and how that
fit with lowering standards to reach “late adopter” practices. SIM intends to
place an emphasis on incentives for practices to engage in a process of
transformation rather than reach a set of standards. Concerns were raised about
eroding consumer protections and not ensuring value for rising health spending.
Concerns were also raised about wasting grant dollars to re-create national
standards that are associated with better health outcomes. Other states add
state-specific requirements on top of national PCMH standards, such as CLAS
standards for culturally appropriate care. Emphasizing outcomes over process
could raise incentives for adverse selection, avoiding exactly the patients who
stand to benefit most from coordinated care.
Other concerns included ensuring that, to avoid past SIM
problems, consultants assigned to workgroups should not steer decision-making
but should be there to support the workgroups of CT stakeholders. Groups should
also solicit a lot of outside input, accessing the wisdom of CT’s health policy
community. A list of possible future policy briefs was shared. SIM agreed to
accept suggestions for others.
The health insurance exchange update included an emphasis on
training and education to retain current members. Plans to improve the SHOP
exchange include a focus on adapting products and lowering prices. There was a
great deal of discussion of high prices but little tangible action toward
lowering them. This year the exchange will not be engaging consultants to
review rates or enhance affordability.
