New London getting a health needs assessment

Over the next three years, the Ledge Light Health District will be assessing conditions in the New London area that contribute to better health for residents. The study, funded by the CDC, will consider assets that contribute to healthy lifestyles, reducing smoking, and managing chronic problems such as diabetes and heart disease. The goal is to make recommendations to enhance physical activity, good nutrition and smoking cessation. The 2007 New London County Health Needs Assessment found that 19% of New London residents under age 65 were uninsured and 11% of city residents missed a needed medical visit due to cost.
Ellen Andrews

Charter Oak celebrates first anniversary

Friday, Governor Rell announced that her Charter Oak Health Plan has enrolled 10,257 previously uninsured CT residents as of the program’s first anniversary. The program is an affordable option for many people and is providing care to thousands. An important advantage of Charter Oak is that no one is denied coverage due to pre-existing conditions, a common reason for denial of private insurance coverage. The program is available to residents at any income level, with subsidies for lower-income residents. Unfortunately 24,452 people have applied for coverage through Charter Oak and were denied; reportedly most were denied because they had not been uninsured for six months. Advocates have been concerned that the state’s six month exclusion policy would leave too many people uninsured too long, risking both their health and finances. While the numbers are improving, providers have been reluctant to sign up with Charter Oak, making access to care difficult in the program. Only half of CT’s acute care hospitals have signed up and only four are participating in all three HMOs. Legislators reportedly have asked for information about what care is being delivered to Charter Oak members.
Ellen Andrews

Prescription assistance bus in CT

The “Help is Here” bus travelling across the country offering help applying for drug company assistance programs is in CT this week. Drug company assistance applications can be confusing; each company has different eligibility standards and discounts vary widely. The assistance program you apply to depends on which drugs you are taking. Questions you will need to answer at the bus include age, address, income, number of people living in your household, brand name of your prescriptions, and details about any coverage you have. The bus’ services are offered free of charge. This morning, Tuesday, from 10am to noon the bus will be on South Main Street in West Hartford, and this afternoon at Charter Oak Health Center in Hartford from 2-4pm. Wednesday the bus will be on Main Street in Manchester from 10am to noon and at the State Capitol (in a press conference with Sen. Prague) from 2-4pm. On Thursday the bus will be at Hammonasset State Park in Madison from 10am to noon and in Norwich from 2-4pm. For more info on the bus, call (202) 835-3460. If you can’t make it to the bus, you can also apply online or call 1-888-477-2669. The bus is sponsored by the Partnership for Prescription Assistance, a collaboration of drug companies.
Ellen Andrews

CT health insurance premiums grew 7 times faster than our incomes since 2000

From 2000 to this year, family premiums rose 7.4 times faster than median earnings in Connecticut according to a new report by Families USA. Premiums are up 96% while earnings inched up only 13%. Also stunning is that while employers’ average share of that premium rose 91%, workers share jumped 114%. The cost shift to consumers continues.
Ellen Andrews

Extreme out-of-network charges for CT health care services

A new survey of out-of-network physician claims finds some extremely high examples of over charging in CT. The highest example includes a bill for $26,881 for a lower back spinal fusion; the Medicare rate for that service is $1,572.95 or 17 times less. The report includes ten examples of out-of-network charges ranging from 1,709% to 648% of Medicare fees. The survey, sponsored by America’s Health Insurance Plans – an industry lobbying organization, asked for outliers; these are not average out-of-network fees. AHIP argues that, as the nation considers health care reforms, the role of provider fees in rising costs must be considered.
All the examples in the survey were for consumers with insurance. According to Vicki Veltri of the Office of Health Care Advocate, CT consumers accessing care out-of-network may be responsible for the difference between the charges and what insurers will pay. For example, if a provider is charging $200 for a service that the insurer believes should only be $100 (the “usual and customary” charge) and the consumer’s policy includes a 30% coinsurance on out-of-network services, the insurer will pay only $70 and the consumer may be responsible for the remaining $130. Of course, there are no rules for uninsured patients. Any consumers facing these costs are urged to call the Office of Health Care Advocate who has been able to reduce or eliminate those bills in some cases. The Office can be reached toll-free in CT at 1-866-HMO-4446. For a tip sheet on negotiating with your provider from the Consumer Health Action Network, click here.
Ellen Andrews

Value-based purchasing and VT health care reform updates

Our second day of health panels at last week’s CSG/ERC annual meeting in Burlington VT started with a set of talks on value-based purchasing and how states can take advantage of this critical health reform trend. Value-based purchasing reorients financial incentives to align all stakeholders and reward improvements in health. The current fee-for-service system rewards volume over value; costs skyrocket but quality doesn’t follow. If we pay separately for each test and procedure, regardless of value, it should not be surprising that we get more tests and procedures. Panelists included Doug Emery of Bridges to Excellence, Frank Johnson from Maine’s state employee health plan and Susan McDonald from the Minnesota Governor’s Health Cabinet.

The second panel included speakers from Vermont updating policymakers about their ambitious reforms passed in 2006 and concerns about maintaining their progress under federal health reform plans. VT’s reforms include over 60 different programs including covering the uninsured, medical homes, chronic disease management and a nationally acclaimed health information exchange. VT’s uninsured rate has dropped by almost a quarter since the reforms were implemented. Speakers included Jim Hester, Director of the legislative Health Care Reform Commission, Susan Besio, Director of Medicaid, Hunt Blair, Deputy Director of VT Health Care Reform, Cy Jordan, Medical Director of the VT Program for Quality Health Care, and Sen. Jane Kitchel.
Ellen Andrews

Farm to School panel at CSG/ERC meeting

This week I am in beautiful Burlington VT, on the shores of Lake Champlain, at the Council of State Governments/Eastern Regional Conference annual meeting. Our first health track panel was on farm to school programs. F2S programs are about far more than getting local foods into school cafeterias; it’s also about in-class nutrition education, farmers visiting schools and students taking field trips, school gardens, taste testing programs, after school cooking and gardening programs, harvest of the month programs, and composting. Our panel was a joint one with the Agriculture and Education committees and the benefits cross those areas and more. It’s about reducing and preventing obesity, supporting small farmers, encouraging community participation and economic development. There are over 2,000 F2S programs in 41 states. Twenty two states have F2S state legislation and the federal farm bill and child nutrition reauthorizations have opportunities. We heard about innovations across the country, but the Burlington school district is a national leader in F2S. Every day during the school year, local food will be offered in the Burlington schools. Research shows that F2S programs are associated with better eating knowledge and behaviors by kids in the programs. A very popular new initiative is VT Junior Iron Chef which started in Burlington and is catching on across many states as a way to engage young people in local food.
Ellen Andrews