Archive for January 2012

Medicare changes policies in response to comparative effectiveness research

The Medicare administrator for most of New England has changed policy to approve coverage of Transcranial Magnetic Stimulation (TMS) for people suffering with treatment-resistant depression. The new policy, effective in March, reverses a November 2011 policy of non-coverage and is the first in the nation Medicare TMS coverage policy. It is estimated that 14 million…

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Webinar: engaging patients to lower costs and improve care

As states implement health delivery reform, many are intrigued by the promise of shared decision making. Not only is shared decision making central to patient engagement but it is also a paradigm shift in informed consent. Washington, Vermont and Maine have taken the direct step of promoting shared decision making through legislation and pilots. Several…

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Advocates protest at last week’s Exchange Board meeting

Last Thursday’s Board meeting was attended by dozens of consumer advocates protesting insurance domination of the Board’s membership and the absence of consumer voices. The advocates wore Band Aids over their mouths and stood with signs protesting the lack of even one voting consumer member; federal regulations say the majority of voting members should represent…

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First HIT privacy committee meeting

The HITE-CT privacy committee held its first meeting last week. While mainly organizational, the consensus of the group was that developing a patient consent model – opt-in vs. opt-out – was foundational to our work. Most other policies flow from that decision. Efforts to limit discussion to just tracking federal privacy issues were considered but…

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Medicaid Council meeting

The news from Friday’s Medicaid Council meeting was that there was no news. Unlike previous HUSKY transitions, the shift from three capitated HMOs to only one entity, Community Health Network (CHN), running the program was uneventful. There had been concerns that many providers previously participating in the HMO networks were not enrolled in regular Medicaid,…

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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…

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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…

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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…

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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…

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