Health Reform Cabinet meeting

The highlight of last week’s Health Reform Cabinet was a report by Frances Padilla of the Universal Health Care Foundation of CT, Co-Chair of the Business Plan Development Committee, outlining efforts to develop option(s) to offer quality, affordable health benefits to individuals and small businesses, possibly including a public option. The Committee is also Co-Chaired by OPM Secretary Ben Barnes and Nancy Yedlin of the Donaghue Foundation and is currently gathering and analyzing data on CT’s insurance market, competitiveness, consumer needs and other states’ models. The next meeting of the Business Plan Committee is Monday Jan. 23rd at 3pm.

Dual eligible care and payment model development committee update

Last week the Medicaid Council sub, sub-committee developing a payment and delivery model for a new Medicaid program serving dual eligible met. The committee is considering shared savings payment options in which savings from coordinating care, reducing duplication and emphasizing quality would be captured and shared with providers. The project grew from a CMS planning grant to DSS received last year. Discussions centered on options available under the Affordable Care Act, integration with other Medicaid and other payer initiatives, and getting reasonable numbers of potentially eligible people. The next meeting is Tuesday Jan. 24th at 1pm in Room 1D of the LOB.

Health Care Workforce forum

It is estimated that CT will need 9,000 more direct health care workers in the next five years. The CT Commission on Aging is sponsoring “The Direct Care Workforce: Meeting the Demand and Responding to the Needs of CT Residents” Friday Jan. 27th from 10 am to noon in Room 1D of the LOB. The forum will include a panel of experts on workforce development and long term services and supports for paid and unpaid direct care workers. The Commission will also release their Direct Care Workforce Strategic Plan at the forum. To RSVP contact coa@cga.ct.gov or call (860) 240-5200.

Legal aid suing over Medicaid delays

Yesterday New Haven Legal Assistance Association filed a federal class action lawsuit against DSS over extreme delays in processing Medicaid applications. The application for one plaintiff, a 27-year old man with a seizure disorder, has been in process for almost six months. He has provided all the information requested and was told by the Department that he is likely eligible. Delays in processing applications have been growing, from 38% overdue in September 2010 to 55% in November 2011. Due to the economic downturn, the number of Medicaid applications has also grown significantly. Delays are affecting not only initial applications, but also eligibility for people with high medical bills in the “spend down” category. Attorneys blame reductions in the number of eligibility workers at DSS. In the last ten years, the number of Medicaid enrollees has grown 52% but the total number of eligibility workers has dropped 30%. Attorneys largely blame neglect by previous Commissioners and are optimistic that the current administration will remedy the problem and avoid jeopardizing federal funds.

Upcoming health policy meetings

CT’s health policy community is making up for the holiday lull in meetings. Next week’s meetings include:

Patrick Hollander, former CFO of the MA Health Connector will speak at the Speaker’s Working Group on Small Business Health Care Monday Jan. 9th at 3pm in Room 1D of the LOB.

Also Monday, the Complex Care Model Design Group of the CT MMAPOC (formerly the Medicaid Managed Care Council) will meet to discuss payment reform models for state residents eligible for both Medicare and Medicaid at 1pm in Room 1E of the LOB.

Tuesday the SustiNet/Governor’s Health Reform Cabinet will meet from 9 to 11am also in Room 1D of the LOB. The agenda is here.

Wednesday the CT MMAPO Council’s Care Management (formerly PCCM) committee will meet from 10am to noon, thankfully in Room 2A of the LOB.

Later that day, at 12:30, the Privacy Committee of the HITE-CT Board will hold its first meeting to discuss protecting consumer privacy in electronic health record exchange and building a sustainable exchange for CT. Room TBD.

We get a day off Thursday, thankfully.

On Friday, the full CT MMAPO Council will meet from 9:30 to noon in Room 1E of the LOB.

Sen. Blumenthal’s survey finds hospital drug shortages harming care

Yesterday, Sen. Blumenthal released a survey documenting serious drug shortages at CT hospitals. The number of drug shortages grew by 76% from 2009 to 2010. Some of the drugs in short supply are used for anesthesia, pain management, treating cancer, and acute asthma attacks. Shortages have led to drug hoarding and price gouging, according to the Senator. In some cases, shortages have led to delays in care and use of less effective medications.
Ellen Andrews

CT consumers can’t get prices for health care; CT hospital costs for the same treatment vary widely

A pair of articles from CT Health I-Team highlights problems with CT’s health care market. Unlike in other states, CT consumers trying to comparison shop have difficulty finding prices for health care services. Consumers in states, like NH and ME, can go online to get prices by payer for most treatments because those states have all-payer claims databases and information is online for consumers. CT is in the earliest stages of planning such a database; fourteen states are well ahead of us.

An accompanying article highlights the wide variation in prices Medicare pays CT hospitals for the same procedure. Dempsey Hospital gets the highest rate for most procedures. For example, the cost of heart valve surgery is 39% higher at Dempsey than at Danbury Hospital (the least expensive). Yale New Haven, Bridgeport and Windom also receive high prices. Variation in cost is based on the type of hospital (teaching vs. not), regional wages, income and acuity of patients, and the number of tests and procedures provided. Cost is not based on quality of care or healthy outcomes.
Ellen Andrews