Best practices guide on integrating behavioral health into primary care

Up to 70% of physician visits involve a mental health issue and health care costs for people with mental health issues are often up to three times higher than other patients with similar conditions. CEPAC, New England’s comparative effectiveness council, has published their latest guide featuring best practices for integrating behavioral health services into primary care practice. Based on the strongest evidence base, CEPAC’s membership of providers and consumer representatives from across the region, voted to endorse the Collaborative Care Model of integration. But the group noted that practices pursuing integration “should use available resources and seek guidance from organizations that have experience with the CCM and other models while accounting for differences in population, resources, treatment priorities, and funding.” In addition to the full report, CEPAC has published a guide for policymakers and other decision makers, and a New England-specific action guide that includes resources and implementation support for our region.

June web quiz on CT Medicaid/CHIP enrollment

Test your knowledge of Medicaid and CHIP enrollment in Connecticut. Take the June CT Health Policy Webquiz.

Webinar: Caring for High-Need, High-Cost Patients – Lessons for Connecticut

Join us Monday, June 22^nd at 2pm for a webinar on best practices in complex care management for the most fragile and costly patients. Evidence is growing that we cannot fix our health care system without addressing the needs of the small number of patients with very complex and costly health problems. Luckily CT can learn from other programs across the US as we build reforms for our state and our Medicaid program.  On the webinar we’ll hear from Clemons Hong, MD, MPH, of Massachusetts General Hospital and Harvard Medical School. In addition to coordinating complex care management programs on the ground, Dr. Hong has written extensively about lessons learned across the country. Click here to register for the webinar.

Eight CT health plans request over 10% premium increases for 2016

A search of CT health insurer rate review submissions on ratereview.healthcare.gov  finds eight plans seeking approval of over 10% increases in premiums for next year. The Affordable Care Act requires that insurers planning significant rate increases must submit those proposals for government review. The same search found only two CT plans proposed increases over 10% for 2014 and none did for this year. The eight include both on and off exchange plans, and are offered by Anthem, Celtic, Cigna, Golden Rule, Time Insurance Company, and three from United Healthcare. Average requests range from 10.09% to 32.9% on average, but individuals may experience much higher or lower increases. While most of the plans are expected to impact less than 4,000 people, Anthem’s plan is expected to affect 55,000 CT residents.

20,000 to 25,000 HUSKY parents lose coverage under state budget deal

According to a CT Mirror report, the budget approved by the legislature and Governor today eliminates coverage for up to 25,000 HUSKY parents with household incomes over 150% of the federal poverty level. The deal exempts pregnant women. While tragic for those families, the Governor’s proposal would have cut more parents and pregnant women at even lower incomes. To comply with federal law, the state must extend coverage to some parents for a year, and must first review people for coverage in other categories. Policymakers expect parents cut off the program to purchase coverage on the state’s health insurance exchange – coverage that is less comprehensive, with premiums, deductibles and copays that many working families will not be able to afford.

In 2003, the last time the state cut off HUSKY parents, the results were devastating for families. A study following eight families as parents coped without coverage documented the impact. One working mother, a substitute teacher, was unable to afford to continue taking her medication and had a heart attack. She then qualified as medically needy and over the next six months she recovered (racking up significant personal debt and costs to taxpayers) and returned to work. But she suffered another heart attack just a month after her coverage lapsed, this time far more serious. The costs to her family and taxpayers far exceeded any savings and policymakers wisely restored eligibility levels in 2005.

The current deal also reportedly includes some cuts to Medicaid providers, home care for seniors and mental health provider grants, although less than the Governor asked for.

CT health reform progress moving up again

After five months’ decline, CT’s progress toward health reform rebounded to 27.8% this month. Medicaid’s decision to cover new Hepatitis drugs, six months of breathing room for Medicaid reform development, Senate leadership on health care transparency, and promising comments from the Ethics Board about SIM were responsible for the gains. Uncertainty about the budget and SIM’s secrecy problems continue to hold reform back. The CT health reform progress meter is part of the CT Health Reform Dashboard.

87-page health bill goes to Governor’s desk

The House and Senate have passed SB-811, now on it’s way to the Governor. The bill includes price and consumer cost notices and websites to help consumers shop for services, sets some limits on facility fees charged by hospitals and outpatient providers, adds to the factors and studies required in considering hospital purchases, and limits bills on emergency services. The bill also directs DSS to create a badly needed statewide health insurance exchange.  (This will be CT’s third try to create an HIE). The bill includes two studies promoting future reforms. The Health Care Cabinet will study cost control models in other states and the Insurance Dept. will convene a workgroup to study the causes of rising health care costs.