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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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Health Affairs: CHC, Inc. eConsult program saved on specialty care and improved access

This month’s Health Affairs includes a study on the effectiveness of eConsults for Medicaid members needing specialty care. Specialty referrals are rising, especially for Medicaid members, who often experience challenges getting that care. In response to this barrier for their patients, in 2011 Connecticut’s CHC, Inc. created a system to link primary and specialty care…

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Advocates get no answers to questions about HUSKY experiment

Last month, a group of independent consumer advocates, the Medicaid Study Group, sent questions to DSS about the impact of PCMH Plus, their new $10.8 million experimental program of shared savings in HUSKY. Advocates have been concerned about PCMH Plus’s potential to deny needed care, raise costs in the program, and erase hard-won progress. Questions…

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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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ICER to report on unjustified drug price increases

Early next year, the nonprofit Institute for Clinical and Economic Review (ICER) will issue its first report on US drug price increases that are not supported by clinical evidence. ICER is a leader in assessing the value of medical treatments, including medications. ICER’s benchmark price ranges for new drugs have been used by Medicaid programs,…

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31 ways to save on healthcare in Connecticut’s budget

Connecticut’s state budget is facing future deficits and health spending is a large share of the budget. The state now spends $3.8 billion between Medicaid and the state employee health plan to cover about a million state residents. Health care spending outside the state budget is also growing. Connecticut has the sixth highest per capita…

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Medicaid update: Quality was rising through 2016, raising concerns about PCMH+

Friday’s MAPOC meeting focused on Medicaid quality and access information from CHNCT, DSS’s administrative contractor for the program. Across the 12 (of over 100) quality measures chosen, there was modest but sustained improvement from 2014 through 2016. However community health center performance consistently lags behind other PMCH practices across the quality measures. Of particular concern…

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Rest of US catching up with CT – Medicaid managed care doesn’t work

Two Health Affairs blog posts highlight the disappointments states are having with their capitated Medicaid managed care programs. Managed care across the US is growing fast, making big profits for private insurance companies, promising improved health outcomes and lowering costs. But CT found exactly the opposite effect when we shifted away from capitated managed care…

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