June CT Health Policy Webquiz: CT hospital community benefits

Test your knowledge about community benefits at Connecticut hospitals. Take the June CT Health Policy Webquiz.

Advocates propose policy paper topics for SIM

In response to an offer from SIM staff, independent consumer advocates have proposed six topics for SIM policy papers. Topics that need detail and public discussion include protecting consumer choice, competition, and the safety net against contrary financial incentives, ensuring patient-centered care, integration with public health, behavioral health and oral health, conflicts of interest, and details on SIM’s plan to re-create patient-centered medical home standards.

Malloy signs bills allowing for-profit hospital conversions and not allowing e-cigarettes for minors

Among the 23 bills signed by Gov. Malloy yesterday was SB-35 which eases CT hospitals’ conversion to for-profit status, however with more restrictions and protections for patients and workers. The Governor also signed SB-24 making the sale of e-cigarettes to minors illegal.

Anthem & ConnectiCare premiums submitted are up sharply for 2015, HealthyCT rates down -- updated

Proposed premiums for the insurance exchange were due to the insurance dept. Friday and they are up significantly from this year’s premiums, according to CT Mirror. Anthem’s proposed premiums are up 12.5% on average; ConnectiCare’s base rate is up 11.8% for next year. CT’s premiums for this year are the 4^th highest in the nation and the highest among state-based exchanges. CID will now review those rates with the limited tools allowed them under law. Maximizing those tools last year CID was able to bring the rates down slightly. In contrast to Anthem and ConnectiCare the rate filing from Healthy CT, filed Monday, includes rates that are 8.9% lower than last year. United Healthcare, new to CT’s exchange, also filed proposed rates.

Unfortunately, as last year, AccessHealthCT will not be reviewing or negotiating to make premiums affordable. AccessHealthCT has refused to review rates and a bill directing them to negotiate with plans to make coverage affordable has died on the House calendar two years in a row. Consumers in states with exchanges that negotiate rates are enjoying more affordable premiums.

It is important to note that the high rates will only affect unsubsidized indivduals and all small business exchange customers who must pay the full premiums. Most AccessHealthCT individual members have incomes that qualify them for premium subsidies – their premiums are based on their incomes and not plan prices. Along with unsubsidized consumers and small businesses, the federal government (which funds the subsidies) will bear the cost of high premiums. AccessHealthCT’s funding is based on a percentage of premiums across the entire market, so their bottom line will benefit from rising premiums and their decision not to negotiate rates.

Health reform dashboard up again but APCD decision drags down progress

The CT Health Reform Dashboard is up a notch again this month to 29.7% on the progress meter, reversing last month’s slide. Areas of progress include new insurance market entrants and, as usual, Medicaid’s progress in many areas driven by transparent, open policymaking. CT Medicaid has made consistent progress toward turning around a deeply troubled  program by engaging all stakeholders, including consumers and advocates, in building success. Unfortunately the rest of CT health policymaking is not learning from Medicaid. The latest example – AccessHealth Analytic’s decision to overrule consumers’ privacy decisions – is responsible for holding back reform this month.

NCQA patient-centered medical home webinar video posted

A recording of today’s webinar with NCQA about patient-centered medical home recognition is posted online. Experts from NCQA described their process and standards for patient-centered medical homes and the benefits to Connecticut. The slides are posted online as well.

SIM FAQs updated

We’ve updated the Frequently Asked Questions about CT’s SIM plan. SIM is the state’s newest plan to radically reform health care delivery and payment across the entire state. Advocates have raised concerns that the plan doesn’t do enough to protect consumers from stinting on care resulting from payment reform, could reverse recent progress in CT’s Medicaid program, lowers effective medical home national standards now commonly used in our state, and will undermine critical public health functions. The final plan was developed without input from critical stakeholders, including consumers. The updated FAQs include a description of the final plan, the process so far, implementation plans going forward and links to more on advocates’ concerns.