Seeking nominations for CT thought leaders

We are refreshing our invitation list for the CT Health Thoughtleader Survey. The survey has been cited by policymakers as a tool in evaluating our state’s progress toward reform. It is part of our CT Health Reform Dashboard. To keep the list robust and ensure a broad reach, we are seeking nominations for the survey. Who do you rely on for information on health reform in CT? Help us improve the tools for our state’s health policymakers and give us your nominations.

CT Health Intern Academy

Last week’s CT Health Intern Academy offered dozens of interns, job changers and volunteers basics and skills to navigate CT’s health care landscape. The day-long conference featured talks by Kevin Lembo (State Comptroller), Pat Baker (CT Health Foundation), Johnny Scafidi (Dwight Hall at Yale), Vicki Veltri (State Healthcare Advocate), Amy Gagliardi (CHC, Inc.), Kevin Galvin (Small Business for a Healthy CT), James Stirling (Stirling Benefits), John Clark (Comptroller’s Office), Jeff Shaw (House staff), Lynne Ide (Universal Health Care Foundation), Rev. Bonita Grubbs (Christian Community Action), Heang Tan (HealthJusticeCT), Patty McQueen (Communication Strategies), Angela Carter (New Haven Register), Hillary Waldman (former Hartford Courant health reporter), and Ellen Andrews (CTHPP). The Academy was co-sponsored by the CT Health Policy Project and Dwight Hall at Yale. For pictures, slides, speaker bio.s, resource list, glossary, and speaker answers to questions posed by student interns, go to www.cthealthintern.org.

Health Insurance Exchange Board recommends standards for benefit package

Last week, the CT Health Insurance Exchange Board voted on their recommendation for the benchmark essential health benefit (EHB) package that must be offered in 2014 by all individual and small group plans, both inside and outside the Exchange, under national health reform. Federal regulators granted states the ability to define the EHB package, within guidelines. The plan is modeled on ConnectiCare’s HMO package, with additions including coverage for prescription drugs and pediatric vision and dental care. The plan includes all state mandated benefits. Abortion coverage is included but must be paid with non-federal funds. The choice of ConnectiCare’s package was a compromise reached in two Exchange Advisory Committees in a contentious process. The plan represents the middle choice in generosity of benefits and price among the federal options. Thankfully, the Exchange Board honored the process of the two committees; advocates had been concerned that the insurance-dominated Board, that includes no independent consumer representatives, would choose a less generous option. The recommendation is now open to public comment for 30 days.

OHA saves CT consumers $2.4 million in last quarter, 99% of state employees HEP-compliant, and HUSKY/Charter Oak member forums scheduled

The Office of Health Care Advocate reported today saving consumers $2.4 million from April through last month. OHA provides assistance and support to CT consumers struggling with insurance. 85% of OHA consumer cases result in overturning insurer denials of coverage.

The Office of State Comptroller announced Tuesday that over 99% of the 53,000 state employees participating in the new Health Enhancement Program are compliant with preventive screening requirements. HEP is designed to reduce ER visits and complications of chronic illness through prevention. Early reports suggest lower ER use and reductions in other costly care. Bucking the national trend, the CT state employee plan saw no increase in cost this year.

The HUSKY and Charter Oak plans will be holding Community Meetings next month around the state to hear from members and answer questions. HUSKY and Charter Oak cover over 400,000 CT residents. The meetings will be in New Haven, Waterbury, New London, Norwich, Danbury and Bridgeport. For details, click here.

Kaiser: 10 things you didn’t know were in the ACA

Postpartum depression, privacy for nursing mothers and assisted suicide are all addressed in the ACA. Go to today’s Kaiser Health News to find seven more issues you probably missed in reading all 906 pages.

Why recessions are good for our health

Honest, more people die during economic expansions than recessions. Economists aren’t sure why but they have theories, according to a paper by the National Bureau of Economic Research. More working hours during good times may mean we don’t exercise as much and eat less healthy food. In recessions traffic and pollution are lower, possibly improving health outcomes. Another theory holds that work is stressful and consequently harms our health (but unemployment is pretty stressful too, so I’m not sure about that one). Alternatively, in good economic times it is harder to fill many health care jobs, which may compromise the quality of health care. Interesting speculation.

Exchange Navigator Committee moves into recommendations

Yesterday the CT Health Insurance Exchange Brokers, Agents, and Navigators Committee started the hard work of developing a structure and defining roles for the Navigator Program. Navigators will educate and help enroll potential individual and small business exchange, and Medicaid enrollees. Under the ACA and federal regulations, navigators must have demonstrated ability to reach those three audiences, meet licensure and conflict of interest standards (yet to be determined), and meet certification standards set by the Exchange (also yet to be determined). Staff draft recommendations include two tiers of navigators. Tier 1 Educators will focus on raising awareness of the Exchange and Medicaid options, distribute impartial information about options and enrollment, and ensure cultural competence. They would be paid on a grant/lump sum basis. Tier 2 Enrollers will focus on collecting the information needed to determine eligibility for appropriate programs, assisting in enrollment, and follow up. The committee is still discussing how to compensate Tier 2 navigators. Organizations, not individuals, will be designated as navigators and can apply for Tier 1, Tier 2 or both functions, but individuals acting as navigators will have to receive the appropriate training and certifications. The committee is still discussing how to certify SHOP navigators. The committee also discussed providing training/information opportunities for stakeholder organizations and individuals who are not interested in certifying, or being paid, as navigators but want to help in outreach and public education.

The committee also reviewed new data from Thompson Reuters commissioned for the exchange on CT’s uninsured, Medicaid and likely exchange-eligible populations to help target outreach and education efforts. Initial analysis found that current uninsured and Medicaid populations live in the same communities, and a small number of urban zip codes, particularly in Hartford and New Haven, account for a significant part of both populations. Researchers estimate that there are currently 66,000 adults and 18,000 children in CT eligible for the current Medicaid program but not enrolled. They also estimate that 205,000 adults and 11,000 children will be eligible for subsidies in the exchange. There is a lot of information on citizenship, race/ethnicity, income levels, and the proportion having difficulty speaking English.

CT gets a Medicare Accountable Care Organization

Today CMS announced 89 new approved Medicare shared savings Accountable Care Organization applicants, including MPS ACO Physicians in CT. Prior to today, CT had no approved Medicare ACOs. Other CT organizations have reportedly recently submitted ACO applications. The Medicare ACO program, created in the Affordable Care Act, is designed to improve access and coordination of care for Medicare fee-for-service members while reducing fragmentation and controlling costs. MPS will share with CMS in any savings earned by coordinating care. To share in savings, ACOs must reach quality benchmarks including patient experience of care standards.

CT Health Intern conference July 24th

Breaking into Health: Tapping into Skills and Experience, is designed for anyone interested in breaking into CT’s health landscape to gain valuable skills from health professionals working in the real world of health care and policy. The free conference will be July 24th from 10am to 4pm at the Divinity School at Yale, is co-sponsored by the CT Health Policy Project and Dwight Hall at Yale. Speakers include Comptroller Kevin Lembo as well as reporters, business people, state agency staff, foundations, health care providers, advocates, and budget analysts. Parking and lunch are free but registration is limited. For more information and to register, go to www.cthealthintern.org.

The ACA and what it means for CT consumers

While we are all celebrating the Supreme Court upholding the Affordable Care Act, consumers want to know what it means in the real world. The CT Health I-Team has a great piece answering just that question.