State chooses CHN to run Medicaid

The administration announced that they will be negotiating with Community Health Network to administer the entire state Medicaid program as of January 1st. Based on the state’s community health centers, CHN has been a participating managed care provider for HUSKY since its inception sixteen years ago. The managed care program will expand beyond the current 400,000 children and families to include 120,000 seniors, single adults (formerly SAGA members) and people with disabilities. The new program will not be capitated and will focus on coordinating care and building patient-centered medical homes to both improve quality and rein in costs. CHN’s contract is estimated to be between $70 and 73 million for the first year. CHN expects to contract with McKesson for intensive care management and data analytics and with Value Options for intensive case management.
Ellen Andrews

Friday webinar: Cutting costs and improving quality through research

New technologies and treatments are a significant driver of skyrocketing health costs and the resulting overtreatment is harming our health. Join us for a webinar Friday at noon with The New England Comparative Effectiveness Public Advisory Council (CEPAC) to learn more about comparative effectiveness research and how it is being evaluated and applied in New England. CEPAC is an initiative of the Institute for Clinical and Economic Review in Boston, funded by the US Agency for Healthcare Quality and Review. To make informed healthcare decisions policymakers, patients and clinicians need rigorous evidence on the comparative risks and benefits of care options. But that science must be integrated with patient values, individual clinical needs, costs, current patterns of practice, local health system characteristics and public values. CEPAC provides a forum to discuss all these considerations. CEPAC’s mission is to provide objective, independent guidance on how information from AHRQ evidence reviews can be used across New England to improve the quality and value of health care decision making. CEPAC includes clinicians, scientists, policymakers and patient advocates with members from all the New England states.
Ellen Andrews

CTHPP brief: One in ten CT residents still uninsured last year

Results of two new Census surveys found that the rate of uninsurance in CT was stuck at one in ten last year. The number of uninsured in CT is higher than the populations of five counties and exceeds the total populations of Hartford PLUS New Britain PLUS Stamford. Not surprisingly, Black, Hispanic and lower income state residents were more likely to be uninsured, but noncitizens were at highest risk. Among cities, Stamford leads the list with 24% of city residents without coverage; nearby Norwalk had the lowest rate among cities at 10%. Among counties, Fairfield had the highest uninsured rate at 11.7%; Tolland was lowest at only 5.1%. The new numbers reinforce the need for health care reform.
Ellen Andrews

Editorials support consumer representation on CT health insurance exchange

Today’s Hartford Courant and yesterday’s New Haven Register have both run editorials calling on policymakers to add consumer and small business representatives to the CT Health Insurance Exchange Board. Advocates have raised concerns about insurance industry dominance in the Board membership and the lack of consumer and small business representation. One in ten state residents are expected to rely on the exchange to purchase coverage in 2014 when the federal individual mandate becomes effective. An estimated 140,000 state residents will have no choice but to purchase coverage in the exchange to access affordability subsidies. The Board will make important decisions about which plans are included in the exchange, how much they can charge, and what services they will cover. Consumer voices must be at the table, with a vote.
Ellen Andrews

Health care jobs bubble?

An entertaining video from Marketplace explains the folly of policymakers who expect health care to solve their economic troubles.

Oh The Jobs (Debt?) You'll Create! from Marketplace on Vimeo.

eHealth conference

October 20th at Capitol Community College in Hartford there will be a conference explaining health information technology implementation and options. The conference, Connecting Connecticut: EHRs, Meaningful Use and Health Information Exchange, is designed for providers, administrative staff, and payers. The conference is cosponsored by Capital Community College, DPH, DSS, HITECT, and the UConn School of Medicine. CME applications are pending.

CT Health Policy Project comments on DSS proposal for Medicaid person-centered medical homes

To implement the administration’s directive to develop person/patient-centered medical homes for every Medicaid consumer, DSS has proposed a payment model very different from other successful state programs. CTHPP has submitted comments on the proposal including concerns about reliance on retrospective enhanced fee-for-service and P4P payments, the lack of risk adjustment, opaque incentives, and a weak attribution system. For example, under an enhanced fee-for-service arrangement, a provider would have an incentive to bring a healthy child who had recovered from a routine infection back into the office to get paid for care management costs making the child take time from school, a parent time off from work, exposing the child to a waiting room full of sick children, incurring transportation costs, and taking up a slot on the schedule of a busy primary care practice. To read our concerns, click here for comments.
Ellen Andrews

New Census numbers on uninsured – no progress

The number of uninsured CT residents remained essentially unchanged from 2009 to 2010, according to new Census numbers; however that number is up 54% from 1999. CT’s unemployment rate rose from 8.3% in 2009 to 9.1% last year. One in nine (11%) state residents remained without coverage in 2010. Six percent of children had no insurance last year and only 2.2% of seniors over age 65. The percent of CT residents with employer-sponsored coverage is down from 73.4% in 1999 to 65.2% last year, while the percent of us covered by Medicaid rose from 6.6% to 12.4% over those same years.


Ellen Andrews

Study finds new brain stent actually associated with More strokes, approval process faulted – CEPAC webinar

A study of the effectiveness of a brain stent, designed to reduce strokes, instead caused so many more strokes in patients (14.7%) than a control group (5.8%) that the study was quickly halted. The expensive stents had been approved by the FDA under a humanitarian exemption from usual safety reviews. The stent has been implanted in thousands of patients.

The study adds to a growing set of evidence that medical treatments are not always based on the best evidence of safety, effectiveness or cost effectiveness. To learn more about comparative effectiveness research and evaluations of treatments, join us for a webinar with CEPAC September 30th.
Ellen Andrews

Uninsured Cincinnati man dies of untreated tooth decay

Kyle Willis, an unemployed, uninsured 24-year old father, died Tuesday of an infection in his wisdom tooth. He couldn’t afford to have the tooth removed, but went to an ER when his face began to swell and the pain grew. He was prescribed an antibiotic and a pain killer. He could only afford to fill one prescription and he chose the pain killer. The infection spread to his brain. A potent reminder that dental care is integral to health and that uninsurance kills.

An expert commented "He [Willis] might as well have been living in 1927. All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."
Ellen Andrews

September CT health policy quiz – CT health care quality

Test your knowledge of health care quality in CT. Take the September CT Health Policy Webquiz.