conflict of interest - CT Health Policy

PCMH + risk scores suggest possible gaming or worse; Advocates call on DSS to delay expansion to protect members and taxpayers

By Ellen Andrews | August 12, 2019 |

A new analysis of PCMH + members’ risk scores finds unexplained increases compared to the control/comparison group that could signal ACO gaming of the system for financial gain and/or, far worse, a decline in the health of members in the program. PCMH Plus, a controversial new payment model, allows ACO (large health systems) to share…

Large study finds selection bias in Medicare shared savings erases savings and quality improvements – advocates saw this coming

By Ellen Andrews | July 3, 2019 |

Researchers from the University of Michigan found that the modest savings and quality improvements reported by Medicare’s extensive shared savings program (MSSP) are likely due to adverse selection. High cost clinicians and beneficiaries were far more likely than others to exit the program. When adjusted for the selective bias in MSSP exit, reported savings and…

SIM primary care capitation proposal gets another tepid reception

By Ellen Andrews | April 12, 2019 |

This week, SIM presented to the Healthcare Cabinet their proposal to capitate primary care, initially for Medicare members, but eventually for all state residents. The proposal is to move primary care to capitated “bundles” – one for basic primary care services and a voluntary, supplemental payment for expanded activities such as infrastructure and HIT and…

YNHH answers latest questions about controversial primary care proposal

By Ellen Andrews | April 11, 2019 |

Monday Yale-New Haven Health System and their community health center partners answered the latest set of questions from the state Office of Health Strategy (formerly OHCA) to their controversial plan to move primary care services for 28,000 low-income New Haven residents out of the current neighborhood sites to Log Wharf. Under the proposal, patients’ care…

CT needs to monitor ACOs

By Ellen Andrews | April 8, 2019 |

Accountable Care Organizations (ACOs) are a growing part of CT’s healthcare landscape. But if you’ve never heard of them, you’re not alone. ACOs are large health systems run by providers, often including hospitals, doctors, home health, nursing homes, and other providers. It is estimated that 15 to 20% of CT residents have already been enrolled…

CTNJ: ACOs may be the new HMOs, And they need a watchdog

By Ellen Andrews | April 3, 2019 |

Care for a growing number of Connecticut residents is being directed by an Accountable Care Organization (ACO) and very few patients know it. Read more

Controversial YNHH/clinic plan delayed over a year, deep concerns remain

By Ellen Andrews | March 25, 2019 |

In response to questions from state regulators, YNHH announced that their controversial plan to shift care for 28,500 mainly low-income New Haven area residents to a new site, far from neighborhoods and to shift Medicaid billing for those patients to the two community health centers will be delayed until late Summer 2020. The delay allows…

Weak answers to state’s second set of questions about YNHH primary care plan for New Haven

By Ellen Andrews | January 4, 2019 |

Yesterday, Yale-New Haven submitted answers to the state’s second set of questions about their controversial plan to shift care for 28,500 mainly low-income people to a new site, far from neighborhoods. They also plan to shift Medicaid billing for those patients to New Haven’s two community health centers “for increased reimbursement through the FQHC enhanced…

More press and a defense on YNHH, clinics plan for New Haven primary care

By Ellen Andrews | December 11, 2018 |

Both concerns and support were raised at the public hearing about the proposal to close Yale-New Haven’s primary care clinics, move patients and YNHH clinicians to a more distant site, but technically transfer 28,500 patients to the Fairhaven and Cornell Scott Hill health centers. CTHPP testified with concerns about potentially substantial new costs to the…