Yesterday
the Health Care Cabinet gave consultants initial feedback on their “straw
man” recommendations to improve health care and control costs in CT. The
Cabinet has spent the last several months exploring leading state reforms
preparing for our December report to the General Assembly. Members
expressed concerns about the proposed consolidation of all state health
agencies into a single agency and creating another new agency for health policy
planning. Members suggested less complicated and less costly ways to achieve
the same goals of coordinating activities and analyzing data. Deep concerns
were voiced about a return to capitated financial risk for Medicaid. Since
leaving capitation four years ago, CT
Medicaid has improved the quality of care, engaged significantly more
providers, and reduced per person costs -- by 5.9% just last year. Concerns
were also raised about an 1115 waiver, which has been a tool for increased
resources but also to reduce care in other states. It’s important to decide on
goals first, before jumping to a risky and controversial strategy. A proposal
to join Medicaid and state employee plan purchasing has failed several times in
the past. While the goal of reducing market concentration is a good one, the
recommendation needs to be much stronger. There was strong support for using data
and evidence in health planning. Dozens of good ideas that will be necessary to
any successful reform were missing from the list and efforts beyond state
government were not recognized in the report. Advocates will be providing the
Cabinet with feedback and alternatives to the recommendations. One thing the
consultants got very right was the main challenge to reform in CT – “Lack of
trust among key stakeholders.” It was suggested that we start with smaller,
more realistic steps (we can afford) that give early successes and build trust.
The next meeting will be August 9th.
