The CT Health Policy Project’s new website is live

The CT Health Policy Project has a brand new, updated website and we couldn’t be happier. The new site integrates our blog, with sections on our work including Medicaid/HUSKY accomplishments and challenges, ways to both improve quality and control costs in Smart Savings, and what’s happening in CT Health Reform. We highlight ways to Get Involved, good books to read in the Book Club, the Advocacy Toolbox, slides for a Health Policy undergrad class, and other Resources. Many thanks to that talented (and patient) people at Krative. Take a look.

CT life expectancy rising, but risks vary

A comprehensive, new analysis of public health outcomes, risks, and causes by state published in JAMA finds that life expectancy for CT residents rose from 77 years in 1990 to 80.8 year in 2016. Healthy life expectancy (maybe more important) also rose from 66.5 years to 69 years. States varied widely in the burden of disease. CT was significantly lower than the US average in all but three of twenty risks for disability, but we didn’t do as well when adjusted for sociodemographics. The highest risk factors in our state are, in order, high body mass index, tobacco use, alcohol and drug use, and dietary risks. The leading causes of disability in Connecticut in both 1990 and 2016 were heart disease and lung cancer. However diabetes rose from number 6 to number 3, while low back pain fell from number 3 to number 6. Interestingly, opioid use disorder dropped from number 5 to number 7. You can spend long hours in this article and even more in the extensive supplements.

Smart CT Medicaid smoking cessation coverage

A new CDC analysis finds that CT’s Medicaid program is among the most progressive in covering smoking cessation treatments. Medicaid members are twice as likely to smoke as other Americans. Smoking-related treatment costs US Medicaid programs about $39 billion annually, so effective tools to quit are a smart investment for states. Despite improvements, most states’ Medicaid smoking cessation coverage is limited. However CT is among the ten enlightened states that covers all ten effective treatments including medications, individual and group counseling. CT also does not levy copayments on tobacco cessation care, but does require prior authorization and has time limits on therapy.

CTNJ op-ed: Connecticut should be careful building a public insurance option through Medicaid

Health insurance is too expensive in Connecticut and it may get worse with troubling new federal policies. But one proposed state solution isn’t as simple as it sounds. Read more

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CT exchange premiums up this year, but similar to other states and still too high

There have been national reports of extreme increases for this year in health insurance exchange premiums, largely due to Trump administration policies. Not surprisingly, a new analysis by the Urban Institute for the Robert Wood Johnson Foundation finds that states with more competition among insurers and more options for consumers have the lowest premiums. Connecticut’s experience was mixed. In good news -- the average lowest silver plan for 40-year-old nonsmoker here rose 24.7% from 2017 to 2018 while the national increase averaged 32%. But we are still an expensive state; our least expensive silver plan premium is 21% higher than the US average. The least expensive gold plan premium in CT rose 34%, much higher than the US average of 19%. In sum, CT’s exchange record remains very mixed.

2018 CTMOM free dental clinic dates announced

This year’s annual free dental clinic will be April 20 – 21 at Torrington High School. Doors open at 8am. The clinic, in its 12^th year, is sponsored by the nonprofit CT Mission of Mercy (CTMOM) moves around the state each year. Last year the clinic provided over $1 million of free dental care to 1,472 mainly uninsured people. Click here for more information, to volunteer or sponsor. And lets work all year to provide decent oral health coverage to every CT resident, regardless of circumstances.

Book Club -- Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions

For the Book Club -- Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions

By Johann Hari, 2018

Depression and anxiety are becoming growing epidemic across the globe. This fascinating book by a sufferer explores the medicalization of the illnesses and over-reliance on drugs as a solution. Instead he explores social causes related to disconnection from meaningful work, other people, nature, meaningful values, childhood trauma, status/respect, and a secure future. He includes an impressive amount of research to support each cause, and ends with reasonable, workable, effective solutions for society, communities and for individuals. As a policy advocate, I appreciated a new perspective and how policies can support or undermine general mental health. Both inspirational and useful.

New Hartford HealthCare-Tufts insurance company raises concerns

Wednesday, Hartford HealthCare and Tufts Health Plan announced the formation of a new, jointly-owned insurer, CarePartners of Connecticut, to sell Medicare Advantage plans to Connecticut residents for next year, pending CMS approval. Hartford HealthCare includes thousands of providers in home health care, rehab services, long term care, behavioral healthcare, and five hospitals, to date. In 2015 Tufts Health Plan moved beyond their Massachusetts-based market, embarking on a similar arrangement in New Hampshire with a network of five hospitals offering coverage to employer groups. Previously, in the 1990’s, Tufts began to sell insurance in New Hampshire, Rhode Island, and Maine reaching 145,000 policyholders before shutting down in 2000 due to financial reasons.

Provider-insurer companies are a new but growing trend across the nation; this will be the first of this type in Connecticut. Similar concerns were raised in 2015 when ProHealth Physicians joined Optum, which also includes UnitedHealth Group. Advocates have been concerned about the growing integration between insurers and large provider health systems. Concerns include weak regulatory oversight, vertical consolidation of the market reducing competition, and confusion about where people call with complaints. While difficult contract negotiations between insurers and large health systems too often spill into the media, scaring consumers about reductions in access to care, the natural tensions also serve to control costs. If both parties are in the same entity, there are concerns that consumers will pay more and get less. There are also competitiveness concerns about provider networks’ willingness to contract with other insurers. 

Committee develops care plan best practices recommendations for Medicaid

The Complex Care Committee of CT’s Medicaid Council has made recommendations to DSS for care plans in the Medicaid program. The importance of effective care plans has arisen often throughout the committee’s work diving deep into barriers to care for Medicaid members with complex health needs. Effective care plans ensure that people are driving decisions about their own care, that everyone is on the same page, and can be an important tool in evaluating care and holding stakeholders (including patients) accountable. The committee spent months searching for best practices within Connecticut and beyond. The recommendations include ensuring the person is the center of care planning, that the plan is clear, complete, actionable and measurable, that the plan is helpful not burdensome, for providers, privacy is protected, and anticipates future needs. The Committee will be following up with DSS to see how the recommendations can be used to improve care for people with complex conditions.

Advocates launch PCMHPlusFacts.org, giving HUSKY members balanced information on the controversial new program

Today, independent consumer advocates launched a website, PCMHPlusFacts.org, to explain the facts about HUSKY’s experimental, new payment plan to run the program. The site was developed in response to the state’s erosion of federally required notices to consumers about their right to opt-out of the program. The state changed the notices at the last minute under political pressure from the large health systems that stand to profit from the program. Reports from community members and DSS’s own survey of members find deep confusion. Advocates have repeatedly expressed concerns about the new program including the refusal to evaluate the impact on access to appropriate care, expanding without information on impact or potential increases in costs, disappointing results from other states with similar programs and great risk to reverse recent progress in improving quality and lowering costs in the HUSKY program. PCMHPlusFacts.org is part of a balanced outreach/media campaign to explain the risks and potential rewards of the program to HUSKY members.

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