Consumer Advisory Board considers ethics policies

In today’s meeting, the Consumer Advisory Board (CAB) discussed proposed ethics standards to ensure that anyone who makes decisions about funding from SIM not benefit from that funding. According to Connecticut’s Public Officials and State Employees Guide to the Code of Ethics, a substantial conflict of interest exists when “a public official, his or her spouse, a dependent child, or a business with which he or she is associated will derive a direct monetary gain or suffer a direct monetary loss by virtue of his or her official activity.” The guide further states “A public official or state employee must abstain from taking official action on the matter that presents a substantial conflict for them, his or her immediate family, or any associated business.” Under the SIM proposal approved by the SIM Steering Committee, the CAB proposes to fund community organizations and other potential contractors. The proposed language for adoption by the CAB requires transparent and open procurement processes, members, their families or businesses they are associated with are prohibited from bidding on or accepting funds that are directed by or on behalf of the CAB or SIM, and a revolving door provision that extends the provision for one year after the member’s appointment ends. Members expressed support for the concept and avoiding even a perception of conflicted interests. Some suggested following generally weaker non-profit Board standards that often only require that the member with the conflict recuse himself or herself from voting on the application of their business or organization. This allows situations, as happened at the AccessHealthCT Board, where a member argued and voted for weak standards and opposed active purchasing, resigned from the Board, and subsequently went to work for an insurer that intends to participate in the exchange under the weak standards and without facing negotiation with the state to keep rates affordable. The CAB asked for more clarification on whether they are required to follow the Code of Ethics. But at least one member offered that the CAB should adopt the ethics code standards anyway and err on the side of caution.

CT hospitals made $597 million profit last year

A new analysis of CT’s 29 acute care hospital finances by C-HIT found that while operating profits were down last year to $333.6 million from $513.6 m last year, overall profits were still $597 million due to an increase in investment and other income. The annual OHCA report found that just under half (48%) of total CT hospital revenue was from public sources – Medicaid and Medicare. At 3.15% CT hospitals’ average operating profit margin was above margins for many other US industries such as continuing care/assisted living facilities (-1.0%), electronics/appliance stores (1.5%), highway/street/bridge construction (2.2%) and groceries (2.3%). Non-operating margins were still higher than non-operating margin at 2.5%; combined CT hospitals achieved an aggregate 5.64% profit last year. Five of CT’s 29 acute care hospitals lost money last year, while 10 reported higher profits than the year before. Three of the five with negative margins are part of larger networks. Of note is Windham Hospital’s performance, losing money for the last five years despite their affiliation with Hartford Health Care Corp., while the hospital achieved profits for each of the four years preceding that affiliation.

Click here for the full OHCA report.

FDA Advisory Committee recommends streamlining approval for tools to fight super bugs

Yesterday the FDA anti-infective drug advisory committee recommended streamlining approval processes for antibiotics that target super bugs. Decades of overtreatment have escalated bacterial resistance to known drugs – super bugs. CDC estimates that 2 million Americans are infected and 23,000 die of infections by antibiotic-resistant bugs annually. The answers are better hygiene, especially in hospitals and other institutions, better stewardship, using antibiotics carefully and only as necessary, and developing new drugs. The FDA is being extremely cautious and thoughtful, using the best data available, delicately balancing the overwhelming need for new tools to fight resistant bugs with ensuring safety and effectiveness. They offered their thoughts, asked probing questions of the committee, and really listened to the answers. There is a marked difference between how thoughtful, deliberative policy is made at the FDA and my experience of how most health policy is made in CT – by intuition, anecdote and very small groups of people with little information.

Today we’ll be considering a new entry into the antibiotic toolbox.

December CT Health Policy Webquiz: health disparities in CT

Test your knowledge about health disparities in CT. Take the December CT Health Policy Webquiz.

Provider consolidation, facility fee forum testimony

At 2:30 today at the Legislative Office Building, the Office of State Comptroller will hold a forum and public hearing on increasing consolidation in CT’s health care system and the growing impact of facility fee charges. Invited speakers include hospitals and insurers. At 4pm the public will have a chance to comment. The CT Health Policy Project’s testimony focuses on the cost to consumers of both trends, both out-of-pocket costs and indirect but significant costs in higher premiums, higher taxes and lost wages. There is little justification for the rising use of facility fees and no evidence that consolidation fosters care integration or higher value care. The testimony also notes that unfortunately SIM policies have been developed to foster consolidation in the market. The testimony also offers policy recommendations to promote competition, value-based purchasing, and to mitigate rising costs.

CT health reform progress meter down slightly to 29.8%

CT’s progress toward health reform is officially stuck. The meter moved down slightly to 29.8% this month. A very wise advocate summed up the frustration remarking that we have a pattern in CT health care reform of taking one step forward and then two steps back.  Again Medicaid accounted for most of the progress including a great decision affirming MAPOC will guide the program’s reforms, especially crucial underservice monitoring standards. In other good news, the advocates are pulling together to urge Congress to reauthorize CHIP. And again SIM challenges lowered the progress meter with unbecoming budget squabbles, concerns about patient-centered medical home standards and funding supporting agendas other than quality, and Freedom of Information transparency concerns. The CT health reform progress meter is part of the CT Health Reform Dashboard.

CT consumer, provider groups write Congress urging CHIP reauthorization

Thirty-three consumer and provider groups across CT signed a letter to Congress urging reauthorization of the Children’s Health Insurance Program (CHIP). Better known as HUSKY B CT’s CHIP program, now covers over 14,000 children in our state. Passed in 1997, the CHIP program must be reauthorized by Congress by October or over 14,000 CT children will lose comprehensive, affordable coverage that is helping them grow up healthy, and giving working families critical financial relief. The CT advocates and providers have called on Congress to make CHIP funding permanent to ensure consistency and demonstrate their firm commitment to children’s health.