Monday, June 26, 2017

New to the Book Club -- Economic Ideas You Should Forget

The title alone pulls you in – Economic Ideas You Should Forget. Ideas and theories that everyone believes but aren’t true. 71 eminent economists and social scientists from around the world each contributed an economic theory that should be forgotten. Myths debunked include more choice is better, that economic growth increases well-being, and that CEO pay reflects talent and hard work. This book, and the underlying message, should be required reading for all healthcare payment reformers. For more summer reading books, visit the CT Health Policy Project Book Club.

Wednesday, June 21, 2017

Blumenthal holding second emergency field hearing on ACA repeal proposals

Senator Blumenthal has scheduled an emergency field hearing in New Haven Friday to hear the public’s thoughts on federal proposals to repeal and replace the Affordable Care Act. Monday’s hearing in Hartford drew over 200 people with standing room only who wanted to share their concerns. Senate leaders will not allow any official public hearings or committee review of their bill. Senator Blumenthal is scheduling these hearings to give CT residents a voice in this important legislation that will touch every American’s life and one fifth of our economy. A draft of Senate leadership’s bill is expected tomorrow morning.
Sen. Blumenthal’s hearing will be this Friday, June 23rd at 1:30pm in the Aldermanic Chambers, New Haven City Hall, 165 Church St. Street parking is limited. Click here for a map of local parking.

Tuesday, June 20, 2017

Report estimates AHCA would cut $5.9 billion in Medicaid funds to CT

Connecticut would lose $5.9 billion in Medicaid funding from 2019 to 2028 under the American Health Care Act passed by the House last month, according to a new report from the Urban Institute and the Robert Wood Johnson Foundation. Connecticut would likely not be in a position to fill that funding gap with state funds. The authors note that provider rate and benefit cuts are unlikely to generate much in savings. If the AHCA passes, Connecticut would have to decide whether to fill some or all of the gap with state funds and/or cut eligibility to ease state funding. If Connecticut chooses to cut only the 168,300 people estimated to have gained coverage under the Affordable Care Act by 2022, the state funding gap drops to $900 million over those ten years. If Connecticut chooses to cut eligibility enough to keep state Medicaid spending level, 179,600 more people would be uninsured by 2022. The report’s authors point out that their estimates are very sensitive to changes in Medicaid spending growth and per capita cap growth rates.

Sunday, June 18, 2017

New data finds CT leads nation in lowering Medicaid costs

New data from CMS actuaries finds that Medicaid per capita health care spending dropped 5.7% from 2010 to 2014, better than any other state. Of note, in 2012 CT Medicaid shifted away from capitated managed care organizations to run Medicaid. Unfortunately, the rest of the CT’s market is not performing as well as Medicaid – Medicare per person costs rose 1.6% and private insurance by 2.5% over those same years. Despite the progress, at $8,058 per person in 2014, CT was still twelfth among states in per capita Medicaid spending. But for total per capita spending across all populations, CT ranked fifth among states at $9,859 in 2014. Our average annual rate of increase from 1991 to 2014 was 4.9% for total per person spending, equal to the US average. It appears the rest of CT’s market and other US states should be copying CT Medicaid’s success.

Monday, June 12, 2017

Medicaid update – administrative conversion drives up call wait times

Friday’s Medicaid oversight council meeting focused on DSS’s conversion to ImpactCT, a new IT system to handle eligibility and enrollment. The hope is that moving more administrative functions online will streamline the process and reduce errors. Unfortunately, implementing the system is pulling staff away from their desks for 9 days of training, causing a sharp increase in average call wait times up to 54 minutes last month. Also disturbing is the very large volume of calls – 134,903 monthly on average -- which has been pretty steady over the last two years. If those were unique callers (which they probably aren’t) that would mean that one in five members was calling for help every month. The phone tree is only serving half of the callers -- 76,021 average ask to be connected to a real person, and 30% of those callers give up – not surprising as they will lively wait an hour to talk to that real person. In good news, by all reports, when callers do reach a person they are getting what they need and have a very good experience with the call. But in more bad news, shifting members to apply and manage their eligibility online is not working. DSS receives an average of 355,118 separate paper envelopes of applications, renewals and changes each month while only a few thousand are using the online system. An average 33,761 members (4% of the population, if unique) trek to a walk-in service center monthly but that rate is going down. DSS acknowledged the problems, said they’ve learned from past administrative shifts, are working to improve service, and promised to remain transparent, sharing public updates regularly. Committee members noted the large reductions in staff over the years and expressed concern that tight state finances not make the problem worse. DSS asked all of us to help them guide people to the online system, but they never addressed whether the system is user-friendly and working. In good news, DSS noted that timelines for SNAP applications and error rates have improved with the administrative updates so far. The shift to ImpactCT should be completed by this Fall.

Monday, June 5, 2017

CT insurers’ 2018 rate requests as much as 52% increase -- public hearing, comment

As part of the health insurance rate review process, CT’s Insurance Department will hold a public hearing June 14th in Hartford on insurers’ double-digit rate requests for next year. In the morning, the hearing will address Anthem’s requests averaging 33.8% increases and affecting 35,000 policyholders. In the afternoon, the hearing will consider ConnectiCare’s average 17.5% increase request affecting 50,907 policyholders. The hearing will be at 153 Market St. in Hartford in the 7th floor hearing room. Info on the hearings, including parking validation and public comment, and the full rate filings are online. Residents can also submit written comment online by July 1st by clicking “Select” next to the filing you want to address. Commenters can also mail comments to CT Insurance Department, P.O. Box 816, Hartford CT 06142.

Thursday, June 1, 2017

June CT Health Reform Dashboard – concerns remain but some hope for drug costs

CT’s June Health Reform Dashboard remains unsettled. Mistrust remains at the core of problems in CT. The new state HIT environmental scan mentions the need for trust a dozen times.  Medicaid policy development and implementation remains mired in mistrust, rushing ahead without data, and a lack of transparency. The state budget remains dreary and signals around Medicaid from the US Senate are mixed. In good news, CT’s Senate unanimously passed a bill to remove gag clauses so pharmacists can tell us the full truth about our medications, their costs and effectiveness. The Health Care Cabinet is continuing our work to control drug costs in CT with new workgroups to develop options.