Advocates’ guide to underservice recommendations

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Connecticut’s State Innovation Model (SIM) is seeking to radically transform our state’s $30 billion health system by aligning incentives to build value. SIM has chosen a shared savings payment model for those reforms. Advocates are concerned about incentives to deny necessary care under the new payment model, as happened in the past. SIM’s Equity and Access Council was charged with developing protections to limit and prevent underservice. The Council has offered its 72-page report with 28 recommendations. One critical recommendation was strongly supported by consumers, advocates, providers and at least one state agency. It was opposed only by insurers and consequently did not reach consensus. A guide to the report includes background on shared savings, its features and how it can impact underservice. The guide also includes brief summaries of the Council’s recommendations, as well as the original report text. We expect the report to be opened for public comment soon.