For first time, no CT insurers exceeded ACA medical payment standards in 2016

According to CMS, in 2016 Connecticut for the first time since passage of the Affordable Care Act (ACA), no insurers were required to provide rebates because they exceeded the ACA’s Medical Loss Ratio (MLR) standards. The MLR provision of the ACA required that insurers spend at least 80% of premiums for individual and small group plans and 85% for large groups on medical care and quality improvement. Insurers that do not meet the MLR standard must rebate that portion of premiums to employers and consumers. In 2013 Connecticut insurers issued $3 million in MLR rebates on behalf of 69,186 state residents. Connecticut insurers have improved premium setting to match medical and quality spending each year since then reducing rebates to $1.8 million in 2014 and $44,646 in 2015. Insurers in twelve states, including Connecticut, all met the MLR standard in 2016, up from only six states the year before.

CTNJ op-ed: CT health reform reaches new low, but also hints of optimism and lots of advice for the next Governor

Connecticut healthcare thoughtleaders gave our state a C for health reform this year, the lowest grade in our survey’s five years. None of the dozens of leaders across Connecticut’s health care system who responded to the survey gave the state an A. Read more

CORRECTION to Chartbook: Prescription drugs driving CT health costs across payers

According to a new Chartbook, prescription drugs are the largest driver of health costs in our state. We spend more per person on prescriptions than all states but Delaware and that number is rising faster here than most states. Charts regarding Medicaid spending have been corrected to reflect that pharmacy costs in the program have increased over the years, but the proportion of total spending devoted to pharmacy has remained stable.

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CT Health Thoughtleaders Survey drops to a C this year for health reform

In our latest survey, CT health care thought leaders lowered our state to a C grade for health reform this year, matching the lowest grades in five years of the survey. No thoughtleader rated our state an A this year. Connecticut’s grade for effort also dropped in this survey, down to C+. Health policy areas that lost the most ground included Medicaid, data-based policymaking, consumer involvement in policymaking and the insurance exchange. New survey questions found deep concerns about health policy changes at the federal level, but varying expectations about the impact of political changes in Connecticut. Opportunities identified included collaboration and inclusiveness. Concerns centered on costs, prices and government funding for healthcare. Thoughtleaders advice for the next Governor included the opportunity to change direction, promoting inclusive collaboration, resisting special interests and guarding against conflicts of interest, and using data in policymaking. 

CTNJ Op-Ed: Prescription costs are squeezing out other Connecticut priorities, but we have options

Connecticut’s state budget is out of balance, reflecting the weakness in our state economy. Policymakers have been forced into compromising support for critical priorities, in healthcare and beyond. There are a lot of reasons for the problem but soaring health costs, particularly for prescription drugs, are a significant drain. There are cost control options that don’t lower access or quality of care; many could, in fact, improve our health. Read more

Chartbook: Prescription drugs driving CT health costs across payers

According to a new Chartbook, prescription drugs are the largest driver of health costs in our state. We spend more per person on prescriptions than all states but Delaware and that number is rising faster here than most states. Prescriptions consumed 35% of  Connecticut’s Medicaid budget last year, up from 9.4% in 2000. Connecticut’s Healthcare Cabinet is considering dozens of options to control drug costs. Public comment on the options is open through next Monday.

CT, DE share bottom spot on safety of hospital care

Half of CT hospitals will be penalized by Medicare this year for poor infection and patient injury performance last year, according to CMS. Among the states, only Delaware has the same poor performance. Started in October 2014, the program was created by the Affordable Care Act to improve the quality and safety of hospital care. Only 16% of hospitals in Massachusetts will be penalized. The fifteen CT hospitals that will be penalized this year include Day Kimball, Waterbury, Johnson Memorial, Bridgeport, Charlotte Hungerford, Rockville, St. Mary’s, Midstate, Windham, Yale-New Haven, Hartford, Norwalk, John Dempsey, Connecticut Hospice, and Masonicare.

Healthcare Cabinet prescription drug cost control recommendations out for public comment

Connecticut’s Healthcare Cabinet has been working on recommendations to stem the rising costs of prescription drugs in our state. The Chartbook on CT Health Spending, based on newly released data from CMS actuaries, per person drug costs for CT residents are the second highest in the nation and rising at the third highest rate among states. And drug costs show no signs of slowing. Just this week, several drug makers announced increases of almost 10% and payers expect brand name drugs to continue to skyrocket ahead of other health spending. CT ranks third highest among states in high-deductible health plans, meaning that consumers are directly bearing the brunt of much of these rising costs.

The Cabinet’s recommendations are now drafted and available for public comment. They include sensible, feasible, and fair policy options to promote value in healthcare spending, educate consumers and providers about best practices, and control costs that are sacrificing important spending in the state budget, employer and provider resources, and family finances. Comments will be accepted until January 15^th at 4:30pm. Submit comments to Victoria.veltri@ct.gov.

First 2018 CT Health Reform Dashboard reflects lack of progress and growing concerns

The state’s announcement that Medicaid intends to double down on PCMH+ -- the experimental, risky new payment model – starting in March without any idea of how it harmed (or helped) over 100,000 people last year is the top concern moving into 2018. It’s also emblematic of how CT makes health policy – flying blind, following questionable but “trendy” models without any data. Thousands more working parents are facing the loss of HUSKY coverage, that through very hard work is now providing real access to quality care, while controlling costs. Ethics, over-compensation, poor leadership, and lack of accountability concerns continue. The bright note -- the Health Care Cabinet is dangerously close to meaningful policy recommendations to control drug costs. CT Health Reform Dashboard

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