Monday, November 20, 2017

Chartbook: CT drugs costs high and growing fast

14.4% of our state’s economy was devoted to health care services in 2014, slightly below the US average, according to a new Chartbook on CT Health Spending. Based on newly released data from CMS actuaries, the analysis finds that CT health costs per person are not surprisingly high but we out-perform most other states in controlling the rate of increase, particularly for Medicaid members. Since 2009, Medicare and Medicaid have been paying more of CT’s health care bills than private insurance. Over half of CT health spending is consumed by hospitals and physicians/clinics, but drug costs are the largest driver of growing health costs. Per person drug costs for CT residents are the second highest in the nation and rising at the third highest rate among states.

Thursday, November 9, 2017

CT trains lots of doctors but we don’t keep them

A new report on physician workforce finds that CT is a hub for training physicians, both medical school and residency training but we are falling behind in retaining those graduates. The report from the Association of American Medical Colleges finds that physician capacity in CT now is is good ranking 6th highest among states in the number of physicians per population, and 10th in primary care. But the future is less rosy. Our physicians are slightly older than the rest of the nation, and we are not retaining students who study and train here. CT ranks 4th among states in medical residency slots per population, 3rd in primary care, and about average in medical school slots. But we are very poor at keeping those students practicing in our state, ranking 42nd overall. Successful states have proactive policies to retain and attract physicians to serve their residents including assistance with student debt that averages $180,000 for new graduates, opening new schools, which CT has done, funding residency slots, and recruiting physicians with local roots.

Wednesday, November 1, 2017

November CT Health Reform Dashboard – status quo, again and again and again

Like the last two months, November’s CT’s Health Reform Dashboard has changed little. Growing and understandable mistrust remains at the core of problems in CT. Medicaid policy development and implementation is still mired in mistrust, incomprehensible and misleading consumer “notices”, rushing ahead without data, quality problems, and a lack of transparency while state officials refuse to answer questions. CT’s Health IT quagmire gets worse. The state budget is terrible causing thousands more working parents to lose coverage. At the federal level, ACA protections and supports are in jeopardy, Medicaid is not secure, and the budget is also terrible. The Health Care Cabinet workgroups continue digging into our work to control drug costs in CT, but we need to up the game and be sure reforms address the total cost of medications to the entire system. Consumers understand that we pay the entire bill – premiums, taxes, and lost wages – not just out-of-pocket costs. Saving in one area just adds costs in another – and we end up paying more in the end anyway.

Monday, October 30, 2017

Nominations open for New England comparative effectiveness voting panel

The New England Comparative Effectiveness Public Advisory Council is seeking nominations for new members. New England CEPAC is a group of clinicians, economists, and patient/consumer representatives that meets three times each year to take a deep dive into the evidence on the effectiveness and value of new drugs, devices and delivery system innovations. At the public meetings, CEPAC hears from experts, patients affected by the condition being discussed, and other stakeholders. CEPAC then votes publicly on the merits and value for the New England region of the studied treatments. CEPAC, and two similar councils in other regions, are programs of the Institute for Clinical and Economic Research, an independent nonprofit institute that produces reports on the evidence for effectiveness of new drugs and other health services. ICER’s reports are used by a growing list of public and private payers in maximizing value for every health care dollar. To ensure independence, CEPA members must meet ICER’s conflict of interest policies. Nominations can be sent to on or before December 1st at 5pm. Please send a CV and letter to interest. Both organization-sponsored and self-nominations are welcome.

Wednesday, October 25, 2017

CT gets a C for pre-term births

A new report highlights CT’s disappointing performance in reducing pre-term births and ensuring our state’s newest citizens have a healthy start. Almost one in ten (9.4%) CT births happen before 37 weeks, ranking us 31st among states. Hartford County was worst at 10.1%; Litchfield was best at 7.7%. There is wide disparity in pre-term birth rates across race/ethnicity in CT. 12.2% of black births in our state are pre-term compared with 8.6% of whites. CT’s record on preterm births is in contrast to Monday’s report highlighting our state’s enlightened Medicaid policy on access to HepC treatment. CT still has significant room for improvement in health and healthcare.

Tuesday, October 24, 2017

CT Medicaid only state to earn A+ for access to HepC drugs

A new report finds that CT’s Medicaid program leads the US in access to new Hepatitis C medications. Hepatitis C affects 3.5 million Americans and causes more deaths than any other infectious disease. CT Medicaid imposes no liver damage, sobriety or prescriber restrictions to HepC drug access that are common in other states.  The report was authored by the National Viral Hepatitis Roundtable, which discloses funding by HepC drug manufacturers, and the Center for Health Law and Policy Innovation at the Harvard Law School. New HepC treatments are very effective, but costly especially for public programs. However they can be cost effective in the long term. Only CT earned an A+ while five states earned F grades. Nearby states varied with MA earning an A, NY with a B-, NJ with a C-, and RI got a D+. The report credits legal action by New Haven Legal Assistance and patient group advocacy with CT’s enlightened policies.

Monday, October 23, 2017

New CT insurer report card online

CT’s best kept secret, the latest CT health insurer report card is out. Part of the managed care reform law passed twenty years ago, the report allows consumers, policymakers and other stakeholders to compare health plans across dozens of key performance standards, customer satisfaction rates, provider participation by county, and claims denial rates. As in the past, Anthem retains the majority of enrollment, serving 822,625 consumers in 2016. Of concern, the report cites both an increase in the number of specialists and a decline in primary care providers. The report also includes medical-loss ratios, the unfortunate term for how much of your premium goes to medical costs vs. administration and profit, for each plan. Consumers and employers lucky enough to have a choice between plans should consult the report before deciding.

Wednesday, October 18, 2017

President’s plan to end cost sharing payments would cost CT plans $7 million this year

An analysis by Avalere Health estimates that health plans in CT’s insurance exchange, Access Health CT, would lose $7 million in reimbursements this year unless Congress acts to restore payments. Nationally, plans stand to lose over $1 billion this year. Under the Affordable Care Act, low to moderate income Americans purchasing exchange coverage are protected from excessive premium and cost sharing payments to health plans. However, whether the federal government is required to reimburse health plans for those costs has been disputed in court. While plans can roll the lack of reimbursements into premiums for next year, because 2017 health plans contracts are already set, they cannot adjust premiums for this year. Despite the ongoing legal challenge, the federal government has consistently made those reimbursement payments every month for over three years. Last week President Trump announced he intends to end those reimbursements to health plans. Earlier this year, the Congressional Budget Office estimated that ending those reimbursements would result in more uninsured next year and actually increase the federal deficit by $194 billion through 2026 due to sharply higher insurance premiums. A Senate deal to restore the payments is moving through the process.

Monday, October 16, 2017

CT ranks 3rd highest among states in high-deductible health plans

Analysis of new federal data by SHADAC finds that most people (59.3%) in CT covered by employer-sponsored health plans were in high-deductible plans last year, up from 40% in 2013. For purposes of this study, high-deductible plans are defined as meeting the minimum deductible amount required for Health Savings Account eligibility ($1,300 for an individual and $2,600 for a family in 2016). The rate varies significantly between states but CT ranks 3rd highest in the nation, behind only NH and KY. The national average was 42.6%.

The survey found little change in the percent of CT employers offering coverage from 2012 to 2016 (55.8% to 52.6%). Employers with over 50 workers are almost three times more likely to offer health benefits and that gap is growing. As in the past, both premiums and deductibles were higher for employers with less than 50 workers last year. CT workers employed by small firms were more likely to be enrolled in a high-deductible plan (62.4% vs. 58.7%).

Monday, October 9, 2017

Antibiotic prescribing down in CT but more needs to be done

Between 2010 and 2016, antibiotic prescriptions per person have declined 8% in CT, according to a report by the Blue Cross Blue Shield Association. The rate declined even faster (15%) for children. Unfortunately, CT’s rate is still higher than all but 16 other states. Overuse of antibiotics is blamed for contributing to the rise of antibiotic-resistant bacteria or “superbugs”. Every year 2 million Americans become infected with bacteria that do not respond to antibiotics and 23,000 die of that illness. Public health officials have been working to bring down the rate of antibiotic prescribing, especially for conditions that do not respond to antibiotics, e.g. most colds which are caused by viruses.

In more good news, the biggest drop in prescribing was for broad spectrum antibiotics, the most likely to trigger antibiotic resistance, which declined 18% in CT from 2010 to 2016 compared to 13% nationally. Unfortunately, a great deal of work remains. The study found that last year 63% of antibiotics were prescribed for conditions which might be appropriate and another 21% for conditions which were not indicated.

Friday, September 22, 2017

Webinar; CT Health Link -- new CT Health Information Exchange

Next Thursday, September 28th from 10:00 to 11:30am the Complex Care Committee of the Medicaid Council (MAPOC) will host a webinar demonstrating a new statewide Health Information Exchange. The ability for all providers treating each patient to access the information they need to provide the best care is critical. The CT State Medical Society, with KaMMCO Health Solutions, has built a health information exchange, CT Health Link, to serve exactly this purpose for Connecticut. CT Health Link offers a suite of HIT tools to help health professionals across the state connect, analyze, engage and transform health care in our state. Join us to hear about this new tool and how it can especially benefit consumers with complex health needs.

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Meeting number: 596 303 372  

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Call-in toll-free number: 1-(866) 578-5693 (US) 
Conference Code: 785 357 2699