Tuesday, July 29, 2014

New SIM under service survey -- please help protect consumers

The SIM Equity and Access Committee is working to develop a monitoring system for inappropriate underservice as CT’s health system moves toward shared savings payment models. Underservice can be denial of appropriate care, limiting expensive treatment options, limiting access to certain providers, avoidance of consumers that may not generate savings, or cost shifting to consumers. Limits may be complete denial of treatment, offering only some treatment options, or limiting the scope/duration/frequency of treatment. While inappropriate underservice occurs now, especially in the Medicaid program, it is possible that shared savings incentives will encourage the problem. To protect consumers, the SIM plan includes a principle denying shared savings payments that were generated by systemic, inappropriate underservice.


Development of a robust monitoring system for undertreatment is crucial to protecting consumers as Connecticut reforms our health care payment systems. The Equity and Access Committee is seeking input for our task. To collect input, the CT Health Policy Project has developed a short survey to help us collect measures of likely underservice to share with the rest of the committee. Please take a few minutes to complete the survey. Even if you participated in our last survey, please also fill out this one. If you have any questions, contact Ellen Andrews at andrews@cthealthpolicy.org.