research

Advocates offer recommendations for Medicaid shared savings future

The first year of Connecticut Medicaid’s PCMH Plus experiment in shared savings was disappointing. The program cost the state at least $1.3 million extra tax dollars and quality did not improve compared to Medicaid members outside the program. Every Accountable Care Organization (ACO), regardless of savings or quality improvement, was rewarded with a payment. The…

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Comment open on leading healthcare value pricing methodology

The Institute for Clinical and Economic Review (ICER) is seeking public input on their methodology to their development of benchmark prices for tests, treatments, drugs and innovations based on their value. ICER, an independent non-profit research institute, is the key source for value-based assessments. Their reports are used by the VA, Medicare, Medicaid, commercial plans…

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For the Book Club: The Tyranny of Metrics

As the world moves toward data and analytics to evaluate progress (and it should), we need to be careful that the movement is meaningful. This must-read is full of cautionary tales, including a chapter on medicine, of mis-use of metrics to evaluate performance that ended up doing more harm than good and box-checking in place…

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Medicaid update: Quality improving but lots of work to do

Friday’s Medicaid Council meeting focused on quality performance in the program. The good news – ED visits and readmissions continue dropping across the program, although community health centers’ performance remains a problem Well-child visit and lead screening rates are higher than the national average Routine care is increasing and inpatient care is decreasing The bad…

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CT up to third healthiest state this year

According to America’s Health Ranking, Connecticut is the third healthiest state in the union this year, up from fifth last year. We are doing far better than our 13th ranking in 1992 but down from 2nd in 2008 and 2006. The ranking by the United Health Foundation has compared states on 34 health indicators since…

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ICER seeking new members of comparative effectiveness panel

The Institute for Clinical and Economic Review (ICER) has opened nominations for their New England Comparative Effectiveness Public Advisory Council. The council, one of three in the US, is composed of leading clinicians, patient and public representatives, methodologists, and health economists. The group meets three times each year to consider ICER effectiveness reports on the…

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Anthem keeps lion’s share of CT insurance market

The best-kept secret in CT healthcare – the Insurance Department’s Consumer Report Card on Managed Care Plans – is out again this year covering 2017. Once again, Anthem has the lion’s share of the market at 46%. ConnectiCare lost almost 55,000 members between 2016 and 2017. About two out of three insured people in Connecticut…

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Another reason to be glad HUSKY fired managed care

New favorite quote – “If you have a dumb incentive system, you get dumb outcomes.” Charlie Munger, quoted by 46brooklyn A new analysis by 46brooklyn highlights the extra costs to Medicaid managed care programs of drug industry middlemen. Ohio’s Medicaid program pays $224 extra in markups to Pharmacy Benefit Managers (PBMs) hired by managed care…

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Connecticut’s uninsured rate up, reversing four-year trend

New numbers from the US Census Bureau report that 194,000 or 5.5% of Connecticut residents were uninsured last year. That number is up 22,000 from the year before when the uninsured rate was 4.9%. The new data breaks a trend of fewer uninsured that began with implementation of coverage expansions under the Affordable Care Act…

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