2013 CT Health Intern Academy June 18th in Hartford

Learn valuable skills from health professionals working in the real world of health care and policy at this year’s CT Health Intern Academy. The event will be June 18th, from 9:30 am to 2 pm at the Legislative Office Building. Free and open to anyone interested in learning more about health policy, the event includes panels on Health Policy Trends, State & Congressional Advocacy, Health & the Media, Networks & Collaboration and a tour of the Capitol. Speakers include State Comptroller Kevin Lembo, along with small business, nonprofit, lobbying, insurer, broker, policy and fiscal analyst, provider, state legislative and Congressional staff, state agency, community organizer, reporter and social media experts. Lunch and parking are free, but registration is required. The Academy is made possible with support from the CT Health Foundation. For more information, visit www.cthealthinern.org.

Cabinet meeting update: SIM project described, exchange plans offering low rates to doctors, Charter Oak redux?

Yesterday’s Cabinet meeting focused on the state’s $2.8 million State Innovation Model (SIM) grant. The plan is to develop a grant proposal by the fall to create a multi-payer approach to design care delivery and payment reforms that touch 80% of CT residents. The project will test innovative models to lower costs and maintain or improve quality. (We have 31 ways to start that.) McKinsey consultants and others have been hired to guide the project which will be headed by a planning committee with three workgroups focused on developing coordinated state models for care delivery, payment, and HIT. The Health Care Cabinet will offer stakeholder input. We are promised all materials and meetings will be completely public and transparent. In a separate discussion concerns about the CT Health Insurance Exchange were raised. It was reported that physicians are being offered Exchange contracts from insurers with payment rates significantly below commercial rates. Exchange staff reported that they do not regulate or monitor provider payment rates but require the plans to comply with network adequacy standards. It was noted that there are many ways that providers can be listed on a panel but not accept appointments. In fact, this is exactly what happened in the capitated HUSKY program and was only uncovered with a secret shopper survey. The exchange has rejected conducting such a survey to monitor real access to care. Concerns were raised that low provider rates combined with high costs, that will leave many young, healthy state residents out of the exchange, will lead to the same dynamic that now plagues the Charter Oak Program -- skyrocketing premiums and plummeting enrollment levels.

Still waiting for insurance exchange rates, UnitedHealthcare is out

Rate proposals by insurers planning to participate in CT’s health insurance exchange were due to the Insurance Dept. last Tuesday, but none have been filed according to the Hartford Courant. However HealthyCT says they filed with the department on Friday. The exchange is blaming federal regulations and delays. UnitedHealthcare notified the exchange last week that they will not be participating in the exchange, leaving Anthem, Aetna, HealthyCT, and ConnectiCare. Insurer rates have been eagerly anticipated by advocates and others hoping for affordable premiums. Concerns about rate shock have been heightened by 25% increases in rates submitted to Maryland’s exchange. Several options are available to the exchange and state policymakers to keep premiums affordable, but some require legislative action. The legislative session ends in four weeks.

Book Club: The Health Care Handbook

Book Club: The Health Care Handbook American health care is complicated, so byzantine that few who work in the system even understand its reach and rules. Two medical students from Washington University in St. Louis have performed a massive public service in writing this book. It is a clear, understandable, practical guide for any audience, and at 226 pages, remarkably brief. Highly recommended. Check out the CT Health Policy Book Club.

Health Insurance Rate Shock: What Connecticut Can Do

All indications are that Connecticut health insurance costs will rise significantly next year. Fortunately there are several tools available to policymakers to mitigate that trend for Connecticut consumers and small businesses who will be mandated to secure coverage as of January 1st. A new brief outlines state affordability options including a stronger state MLR limit, active purchasing, reinsurance, capping rate increases, limiting insurer losses, and state supplemental subsidies. It is also critical to address the underlying causes of rising health costs that drive insurance prices including misaligned payment incentives, overtreatment, poorly coordinated care, waste, excessive administrative costs, and consumer disengagement. Affordable insurance coverage is critical for successful health reform. State policymakers should use every available tool.

May CT Health Policy Webquiz: 2014 CT Insurance claim costs

Test your knowledge of health insurance claims estimates for next year. Take the May CT Health Policy Webquiz.

We are up to 21.5% of the way to health reform in CT

CT policymakers have completed 21.5% of the tasks necessary for health reform; most are due on Jan.1st of next year. Medicaid and some evidence of movement toward affordability on the insurance exchange accounted for the progress in May’s Health Reform Dashboard. CT biggest problem is ensuring new hopeful signs from the insurance exchange are realized.