Chartbook: CT drugs costs high and growing fast

14.4% of our state’s economy was devoted to health care services in 2014, slightly below the US average, according to a new Chartbook on CT Health Spending. Based on newly released data from CMS actuaries, the analysis finds that CT health costs per person are not surprisingly high but we out-perform most other states in controlling the rate of increase, particularly for Medicaid members. Since 2009, Medicare and Medicaid have been paying more of CT’s health care bills than private insurance. Over half of CT health spending is consumed by hospitals and physicians/clinics, but drug costs are the largest driver of growing health costs. Per person drug costs for CT residents are the second highest in the nation and rising at the third highest rate among states.

CT trains lots of doctors but we don’t keep them

A new report on physician workforce finds that CT is a hub for training physicians, both medical school and residency training but we are falling behind in retaining those graduates. The report from the Association of American Medical Colleges finds that physician capacity in CT now is is good ranking 6^th highest among states in the number of physicians per population, and 10^th in primary care. But the future is less rosy. Our physicians are slightly older than the rest of the nation, and we are not retaining students who study and train here. CT ranks 4^th among states in medical residency slots per population, 3^rd in primary care, and about average in medical school slots. But we are very poor at keeping those students practicing in our state, ranking 42^nd overall. Successful states have proactive policies to retain and attract physicians to serve their residents including assistance with student debt that averages $180,000 for new graduates, opening new schools, which CT has done, funding residency slots, and recruiting physicians with local roots.

November CT Health Reform Dashboard – status quo, again and again and again

Like the last two months, November’s CT’s Health Reform Dashboard has changed little. Growing and understandable mistrust remains at the core of problems in CT. Medicaid policy development and implementation is still mired in mistrust, incomprehensible and misleading consumer “notices”, rushing ahead without data, quality problems, and a lack of transparency while state officials refuse to answer questions. CT’s Health IT quagmire gets worse. The state budget is terrible causing thousands more working parents to lose coverage. At the federal level, ACA protections and supports are in jeopardy, Medicaid is not secure, and the budget is also terrible. The Health Care Cabinet workgroups continue digging into our work to control drug costs in CT, but we need to up the game and be sure reforms address the total cost of medications to the entire system. Consumers understand that we pay the entire bill – premiums, taxes, and lost wages – not just out-of-pocket costs. Saving in one area just adds costs in another – and we end up paying more in the end anyway.

Nominations open for New England comparative effectiveness voting panel

The New England Comparative Effectiveness Public Advisory Council is seeking nominations for new members. New England CEPAC is a group of clinicians, economists, and patient/consumer representatives that meets three times each year to take a deep dive into the evidence on the effectiveness and value of new drugs, devices and delivery system innovations. At the public meetings, CEPAC hears from experts, patients affected by the condition being discussed, and other stakeholders. CEPAC then votes publicly on the merits and value for the New England region of the studied treatments. CEPAC, and two similar councils in other regions, are programs of the Institute for Clinical and Economic Research, an independent nonprofit institute that produces reports on the evidence for effectiveness of new drugs and other health services. ICER’s reports are used by a growing list of public and private payers in maximizing value for every health care dollar. To ensure independence, CEPA members must meet ICER’s conflict of interest policies. Nominations can be sent to info@icer-review.org on or before December 1^st at 5pm. Please send a CV and letter to interest. Both organization-sponsored and self-nominations are welcome.

CT gets a C for pre-term births

A new report highlights CT’s disappointing performance in reducing pre-term births and ensuring our state’s newest citizens have a healthy start. Almost one in ten (9.4%) CT births happen before 37 weeks, ranking us 31^st among states. Hartford County was worst at 10.1%; Litchfield was best at 7.7%. There is wide disparity in pre-term birth rates across race/ethnicity in CT. 12.2% of black births in our state are pre-term compared with 8.6% of whites. CT’s record on preterm births is in contrast to Monday’s report highlighting our state’s enlightened Medicaid policy on access to HepC treatment. CT still has significant room for improvement in health and healthcare.

CT Medicaid only state to earn A+ for access to HepC drugs

A new report finds that CT’s Medicaid program leads the US in access to new Hepatitis C medications. Hepatitis C affects 3.5 million Americans and causes more deaths than any other infectious disease. CT Medicaid imposes no liver damage, sobriety or prescriber restrictions to HepC drug access that are common in other states.  The report was authored by the National Viral Hepatitis Roundtable, which discloses funding by HepC drug manufacturers, and the Center for Health Law and Policy Innovation at the Harvard Law School. New HepC treatments are very effective, but costly especially for public programs. However they can be cost effective in the long term. Only CT earned an A+ while five states earned F grades. Nearby states varied with MA earning an A, NY with a B-, NJ with a C-, and RI got a D+. The report credits legal action by New Haven Legal Assistance and patient group advocacy with CT’s enlightened policies.

New CT insurer report card online

CT’s best kept secret, the latest CT health insurer report card is out. Part of the managed care reform law passed twenty years ago, the report allows consumers, policymakers and other stakeholders to compare health plans across dozens of key performance standards, customer satisfaction rates, provider participation by county, and claims denial rates. As in the past, Anthem retains the majority of enrollment, serving 822,625 consumers in 2016. Of concern, the report cites both an increase in the number of specialists and a decline in primary care providers. The report also includes medical-loss ratios, the unfortunate term for how much of your premium goes to medical costs vs. administration and profit, for each plan. Consumers and employers lucky enough to have a choice between plans should consult the report before deciding.