CT Insurance Exchange update

Friday Trinity College sponsored “The Affordable Care Act: Implications for CT”, a conference on how CT is implementing health care reform and how our state’s system will be different. The conference highlighted Trinity’s new Masters Degree track in Health Policy. The insurance exchange was the subject of great interest, especially specific examples of household options on the exchange. Slides from the talk are online.

CT’s All Payer Claims Database – an important opportunity, if we do it right

A new report for the CT Health Foundation outlines CT’s progress and future options toward developing an All-Payer Claims Database (APCD). Putting all health care claims in the state across providers, payers and regions in one place would allow better health resource planning, identification of hotspots of high utilization, develop targeted solutions, improve patient safety and promote health equity. Through the CT Health Insurance Exchange, our state has received a large federal grant to create the database. The study, conducted by the CT Center for Patient Safety and the CT Health Policy Project, pulls best practices and resources from other states combined with advice from CT policymakers and consumers who could benefit from the data into a set of recommendations.

In Person Assisters application online

Health reform holds great opportunities and some responsibilities for uninsured CT residents and small businesses. But it can be confusing; there is a lot of misinformation. To help people learn about reform, sort out and understand their options, and application assistance, the Office Health Care Advocate is hiring In Person Assisters. Assisters will work with a network of colleagues doing the same work, and will receive support in explaining health reform, finding CT’s uninsured, and helping people apply. If you are connected to your community and interested in helping people get health care, the application is online.

IOM health equity conference in Hartford

Yesterday the Institute of Medicine held a compelling workshop, “Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients”, at the Mark Twain House in Hartford. The conference, sponsored by the CT Health Foundation, featured the Governor, Lt. Governor, and Congressman Larson as well as experts from CT and other states. Speakers focused on tools and opportunities in the ACA and how they can be used to foster equity in access to quality health care. Areas of focus included coverage expansions, patient-centered medical homes, public/private partnerships, the safety net, and consumer engagement. Lots of inspiration and momentum.

Exchange Board approves recommendation to limit insurer administration and profits

At yesterday’s meeting the CT Health Insurance Exchange Board unanimously approved a motion recommending that the state pass legislation limiting the amount of premiums insurers can spend on administration and profits, the Medical Loss Ratio (MLR), beyond the limits included in the federal Affordable Care Act (ACA). OPM Secretary Barnes made the recommendation in response to concerns about expected very large insurance premium increases next year. Reducing the amount of administration and profit insurers can charge to consumers will serve to control costs. Secretary Barnes’s proposal, adopted by the Board, was to limit administrative/profit costs to 15% of premiums for all individual and small group insurance sold in CT, both inside and outside the exchange. The ACA limits administrative costs to 20% for individual and small group plans. Even at that level, last year 137,000 CT residents received rebates averaging $168/family, from insurers who spent too much on administration and profit. Twenty-nine states have separate MLR standards, several stronger than the ACA floor, either through a lower % allowed or with a more limited definition of which expenses are considered administrative. The Secretary said he had not spoken to legislators about the proposal but would make calls yesterday after the meeting and suggested that it could be amended to existing bills for passage.

ConneCT consumer portal looks good

Today’s Medicaid Council focused on ConneCT, DSS’s new consumer portal and document management system. The demonstration by Deloitte was impressive. Unlike the insurance exchange portal, also developed by Deloitte, the DSS system is consumer-friendly, understandable, intuitive, quick, and will integrate medical assistance with other state assistance programs. The DSS portal took less than 5 minutes and only a few questions to get to an answer. In contrast, the exchange portal requires 50 minutes and 34 pages to get to a tentative statement of eligibility for benefits. The DSS portal pages were clear, included useful graphics, easy to read and available in Spanish. Deloitte also demonstrated a ne DSS phone system that allows the same access to information for clients without internet access. DSS workers will also be moving to a paperless system that will reduce processing delays, coordinate with better clients, lower costs and protect privacy. Parts of the DSS system are already online – 3,000 DSS clients have already signed up for a personal account to track their benefits and paperwork. Online applications, redeterminations and change reporting are expected in August. We also heard from the Allied Health Workforce Policy Board about upcoming health care workforce shortages. CT is the seventh oldest state in the nation, affecting both demand for care and the age of our health care workers. The worst shortage is for registered nurses with the need growing 19% by 2020. Changes in the health care system will also require current workers to train in new skills. The Board’s recommendations include creating regional partnerships to support pipelines, creating a virtual CT Healthcare Workforce Center, investing in incumbent workers, expanding learning opportunities that link education and work, and partnerships to prepare the future health care workforce. DSS also described their plans, developed in collaboration with the Council’s Women’s Health Committee, to create an Obstetrics P4P program to reduce pre-term births and newborn intensive care stays. The state plans to spend $1.2 million on the P4P program to better connect pregnant women with care coordination earlier in their pregnancies. Newborn intensive care stays cost the state almost $30 million/year. DSS also announced that they are not taking new applications into the Pre-existing Condition Insurance Plan (PCIP) to ensure that the federal grant lasts until Jan.1st when health plans can no longer discriminate against people based on health status. DSS also described progress on the dual eligible care coordination application to CMS now due April 22nd.

Donaghue conference – How is science serving us?

This year’s Donaghue Foundation conference considers the role of science in our society. Speakers will discuss the history of science, it’s contribution to health and prosperity, and how citizens can be involved in developing science’s role. A Science Opportunities Fair will accompany the conference, highlighting CT institutions that bring science into society. The conference will be Friday, May 3rd from 7:30am to 12:30 pm in Farmington. Donaghue’s thought-provoking annual conferences are free and very well attended, but registration is required.

Help prevent cancer – sign up for a study

The American Cancer Society is beginning a long-term Cancer Prevention Study to study the causes of cancer, how to prevent it, and eliminate cancer as a major health concern for future generations. Previous studies demonstrated the links between cigarette smoking and lung cancer, aspirin use and reduced risk of colon cancer, postmenopausal hormone replacement therapy and various gynecologic cancers (such as breast and ovarian cancer), and physical activity and lower risk of various cancers. The study will follow 300,000 Americans across 35 states for 20 to 30 years. The study is open to anyone ages 30 to 65 who has never been diagnosed with cancer (not including basal or squamous cell skin cancer). Researchers will be signing up CT volunteers this month in Hartford – April 24th from 10am to 1:30 pm in the Old Judiciary Room of the State Capitol. Initial enrollment includes informed consent, a survey, a blood sample and waist circumference. Soon after will be a more detailed survey at home on lifestyle, behavioral and other factors affecting your health. Then you’ll receive surveys periodically to update that information. Click here for more information and to make an appointment.

CT up to 18.5% on health reform progress meter

CT policymakers have completed 18.5% of the tasks necessary for health reform; up from 17.7% from last month. Most tasks must be completed by Jan.1st of next year. Medicaid, patient-centered medical homes and payment reform/quality improvement are leading health reform according to April’s CT Health Reform Dashboard. The health insurance exchange, health information technology, and insurance market reforms are still struggling.

Exchange meeting update

Monday morning the CT Health Exchange Board held a special meeting by phone with only a few days notice and only noticed on their website. The purpose of the meeting was to increase, yet again, costs for consumers in the exchange. They reduced the prescription deductible in the unsubsidized silver standard plan to $400 from $500 but increased the total deductible to the legally allowed out-of-pocket maximum of $6,250. They also increased the prescription deductible and out-of-pocket maximum for the subsidized silver plan as well. The increases were never sent to the advisory committees, which voted out the former plan by a narrow 5 to 3 margin. Staff again blamed the high cost of health care in CT and the federal actuarial value calculator, but not insurance mandates. In conversations with other state exchanges we are not hearing about problems with the actuarial calculator. Despite comments about reluctance and “tied hands”, the Board unanimously approved the latest version of higher costs. Staff also clarified their decision to charge the specialist copay for prenatal visits. Apparently, after reaching out to CT and national physician societies, insurers and researching CT’s market and other states, they found that prenatal care is considered preventive and carries no copayments under the Affordable Care Act. The staff deferred to the federal law and will communicate to plans that they should not charge copays for preventive prenatal care. They also confirmed that this issue has no impact on the actuarial value calculator.

April CT Health Policy Webquiz: CT health care price transparency

Test your knowledge of CT health care price transparency policies. Take the April CT Health Policy Webquiz.