CT Health Reform Dashboard – SIM ethics problems growing, hospital mergers threaten

August’s CT Health Reform Dashboard update is again very active – and not in a good way. Thousands of working HUSKY parents lost coverage this week. SIM ethics problems continue to plague reform efforts. Efforts to bypass DSS’s prudent evaluation of the new, untested, very ambitious Medicaid reform plan are disturbing. Consultants for the Health Care Cabinet have recommended a troubling plan for reform that misses what is working in CT. Yale-New Haven’s health system wants to get even bigger, risking monopoly power and price increases we can’t afford.

August CT Health Policy Webquiz: Top salaries at CT hospitals and health systems

Test your knowledge of top salaries at CT’s hospitals and health systems. Take the August CT Health Policy Web Quiz.

CTHPP website down, apologies

Our CT Health Policy Project website has been down for an unacceptable length of time. (I know some of you feel our pain.) Be assured we are working furiously on a solution – both short and long-term. We apologize for any inconvenience. If there is something you are looking for, please let us know at information@cthealthpolicy.org. (That’s still working).

Twenty-six advocates support DSS decision to evaluate Medicaid reform

Wednesday 26 independent consumer advocates wrote the Lieutenant Governor supporting DSS’s decision to evaluate outcomes after the first wave of 200,000+ members into the new Medicaid shared savings program, MQISSP. The advocates support DSS’s prudent plan to assess the impact, good and bad, and make revisions before moving more people into the untested program. Enlightened policymakers incorporate robust evaluations in all programs, and use them in revising programs to limit harm and build value. More mature shared savings programs in other states and programs have struggled, many have not saved money, and quality improvement is weak. Given the state has recognized the higher danger for inappropriate underservice for Medicaid members in financial risk models, DSS’s plan to evaluate and adjust based on the evidence is especially wise.

OHCA hears more from community about harm from YNHH-L&M deal

Tuesday OHCA got another earful from community members, providers and experts as they continued the public hearing on Yale-New Haven’s application to acquire L&M hospital and medical group. Intervenors, including the CT Health Policy Project, continued our testimony about likely price increases and loss of services in the New London community if the deal is approved. Intervenors and OHCA asked again for price data from previous YNHH acquisitions as well as the ongoing Community Health Needs Assessment, required by the Affordable Care Act, and what identified needs the hospital has acted on.  Intervenors also told powerful stories of lost services in Windham when Hartford Hospital bought their community hospital and that L&M clinical services are already well integrated with YNHH independent of the corporate acquisition. YNHH cited, among other reasons, Medicaid cuts as a reason to merge, but were reminded of CT’s relatively generous provider rates and that CT has maintained provider rate increases even after federal funding ended, despite severe budget deficits that will result in thousands of working parents losing HUSKY this weekend.

ICER seeks input on value asssessment methodology update

There is a growing concern that untested new treatments and drugs are driving up the cost of health care. Consumers and payers don’t have enough trusted sources to evaluate the value of costly, new interventions – whether they are worth what they charge. The Institute for Clinical and Economic Research (ICER), a leading and trusted source for that information, is updating the methods they use to develop value reports. ICER’s Value Assessment Framework is based on almost ten years of experience working with all stakeholders across the health care system. The framework involves a deep dive into the comparative clinical effectiveness and comparative value of interventions. The research is then thoroughly vetted publicly through regional committees of clinicians, researchers, patient and consumer advocates. ICER works with all health care stakeholders to inform their independent assessments, which are increasingly helping payers, policymakers and consumers in maximizing the value of our scarce health care dollars. As part of their ongoing commitment to developing independent and useful assessments to enhance public dialogue about value, ICER is updating their methodology. As part of that update, ICER is soliciting comments and suggested improvements. Comments can be sent to publiccomment@icer-review.org by September 12^th. To help understand the framework and how it is used, ICER is hosting a webinar July 29^th from 1 to 2pm. Register here.

CT second lowest in US in premature deaths, but also among most costly states

Second only to New Hampshire among states, Connecticut residents are avoiding premature deaths preventable with better health care. However, no Connecticut community ranked in the top 10% across health indicators in the Commonwealth Fund’s 2016 Local Health System Scorecard. While we do very well in Healthy Lives measures, we have a great deal of work to do in Avoidable Hospital use. Medicare readmission rates are high in all three noted hospital referral regions – Bridgeport, Hartford and New Haven. Hartford and New Haven area residents also face higher rates of avoidable ED and hospital admissions. Health care costs per person are among the highest in the nation, especially for employer-sponsored coverage. There is wide variation within states across the report’s 36 health care indicators of quality, access, avoidable hospital use, costs and outcomes. Overall the report found almost all localities in the US are making progress improving health but very slowly. New policies are making a difference including Affordable Care Act coverage expansions, Medicare’s hospital readmission and quality reporting initiatives, and FDA regulations and protections. Generally low-income areas perform more poorly but the report includes important lessons. Investments in public health are making a difference including school-based care, social service collaborations, workforce training, data, and connecting people to coverage and medical homes.