CT’s APCD chooses data contractor, concerns remain

The Hartford Business Journal is reporting that CT’s developing all-payer claims database (APCD), run by AccessHealthCT, has chosen Onpoint Health Data to run their system. APCDs have enormous potential to improve population health, track problems, evaluate solutions and maximize scarce resources. Most New England states are ahead of CT in APCD development. However, concerns have been raised about consumer privacy and security of extremely sensitive information merged across all CT’s payers into a massive single source, availability of the data to only those who need it, and ensuring uses that do not harm competition, discriminate, or reduce necessary care. Concerns have also been raised about hosting the APCD within the insurance exchange, with potential conflicts of interest in use of data and relationships with insurers. CT’s APCD has been funded by federal funds through our state exchange grant and now new SIM funding is proposed to support the database.

SIM discussion on how to cut the budget

In what was supposed to be a one-hour meeting, the SIM Steering Committee met yesterday to discuss how to cut the original $64m budget in the federal application down to $45m, as requested by CMMI. It was a poorly structured meeting that quickly led to a disorderly grab for money. Staff provided members with a proposal for what to cut and what to keep at least 24 hours before the meeting, but the proposal was not made public. Members argued for their own agencies and providers while carefully explaining why competing items were less worthy. Funding for HIT, community health workers, and state personnel were among the areas questioned. The Consumer Advisory Board agreed to cut travel to conferences for volunteer CAB members from their $1.6m budget. Less experienced members were confused about several areas including staffing and when funding parts of several positions and the use of consultants can be the most effective way to direct complex projects that cross many programs. The voting was not well planned and created deep confusion among members. I hung up after 2 hours but can’t wait to see what was decided. The regularly scheduled public Steering Committee meeting on Thursday has been cancelled.

Webinar – clearing the confusion about payment model options for CT

Join Bob Berenson, MD of the Urban Institute for a CTHPP webinar November 18^th at 1pm as he explains health care payment reform options. Dr. Berenson has long health policy experience, both inside and outside government. He served as Director of Medicare Payment Policy at CMS. His work focuses on quality measurement/improvement and Medicare shared savings. In the webinar Dr. Berenson will focus particularly on shared savings models as CT is considering for both the Medicaid/Medicare health neighborhood pilots and the much more ambitious SIM plan. Click here to register for the Nov. 18^th webinar.

Healthcare tops US nonprofit employment; CT health care employs one in seven private sector workers; state health care workers average 25% higher pay

At 7.7 million workers, healthcare and social assistance employment topped other industries in US nonprofits in 2012 with more than four times as many workers as the next largest category (education), according to the Bureau of Labor Statistics. However, healthcare and social assistance wages at US nonprofits was about average among industries, averaging $47,324 that year. According to CT’s Dept. of Labor, last December in the private sector there were 209,272 health care workers in our state, over one in seven workers, with average annual wages of $57,752. Among state employees, 10,020 were employed in health care with average annual wages of $72,109.

Class slides – Implementing ObamaCare in CT

Slides and the syllabus from a Fall graduate public policy class at Trinity College are online. The course, Implementing ObamaCare in CT, is tracking how the Affordable Care Act is unfolding in our state. Class topics for the class so far include ACA 2.0/CT context, health insurance exchange, Medicaid, insurance reform, workforce/providers, public health, health equity, health care delivery reform, quality, HIT, payment reform, and new state roles. More will be added as the course continues. The class is part of Trinity’s health policy track in the Masters of Arts in Public Policy program. The course slides are part of the CT Health Policy Project’s Resources page – www.cthealthbook.org.

November CT Health Policy Webquiz: Avoidable hospitalizations in CT

Test your knowledge about avoidable hospitalizations in CT. Take the November CT Health Policy Webquiz.

CT health reform progress meter up to 29.9%

CT’s progress toward health reform moved up slightly again this month to 29.9%. Again Medicaid accounted for most of the progress including good news on per person cost stability and successful completion of an underservice monitoring plan for the health neighborhood pilot for dual eligibles. Progress was limited by the continual need to defend proven patient-centered medical home standards in the SIM process and continuing high insurance premiums. The CT health reform progress meter is part of the CT Health Reform Dashboard.