conflict of interest
CTNJ Op-Ed: Let’s Halt the Rush to Risky Medicaid Experiment
Today’s CT News Junkie includes an opinion piece urging caution and more time for thoughtful deliberation in moving 200,000 HUSKY members into a very new, untested payment model that is costing more for Medicare. CT’s Medicaid program is a success story – improving quality, increasing providers, and lowering costs – but that success is fragile.…
Read MoreTen SIM committee members sign alternative stronger ethics policy
Ten brave SIM committee members signed a stronger ethics policy in place of SIM’s weaker policy. Advocates were given until this Wednesday to sign SIM’s policy or they would “not be able to participate as members in future meetings of the advisory groups.” The alternative policy agrees to also abide by the State Code of…
Read MoreACOs not saving for Medicare, model could cost CT Medicaid almost $100m/year
CMS’s vast shared savings experiment for Medicare has disappointed again in its second year. The plan was to encourage providers to assemble into health care systems, called Accountable Care Organizations (ACOs), to coordinate care and keep people well. The incentive was that the systems share half (or more) of the resulting savings. The only problem…
Read MoreNine SIM committee members reject weak ethics policy
In a letter sent yesterday, nine members of various SIM committees rejected the weak ethics policy promoted by SIM leaders. The weak policy does little to limit conflicts of interest, such as those that tainted the awards of SIM’s first grants. Instead they urged SIM to limit conflicts of interest and adopt the State Code…
Read MoreSIM update, equity planning questions
At Thursday’s SIM steering committee meeting in public comments, SB Chaterjee raised concerns about DPH’s planning to address health equity. Important planning meetings occur in closed meetings, without public notice or minutes. (Sound familiar?) Questions were also raised about how federal funds have been spent and the required conflict of interest policy is not available.…
Read MoreCTNJ op-ed: Insurers blocking underservice protections, again
Consumer protections had a good start in Connecticut’s latest health reform plan. But, as always, the devil is in the details. Unfortunately insurers are working to sabotage those protections to benefit their bottom line. Read more
Read MoreTestimony FOI never got to hear
Last week the Freedom of Information Commission held a hearing on my request for SIM documents related to their Consumer Advisory Board’s (CAB’s) votes on appointments to SIM committees. Those committees are making very important decisions about CT’s $30 billion health care system and ethical questions have been raised about committee members receiving substantial SIM…
Read MoreGrowing percent of AccessHealth CT members are not using their coverage
A new survey by AccessHealth CT found that 36% of their customers had not used their health coverage, compared to 26% last year. One in four (28%) don’t have a primary care provider. Enrollment in qualified health plans is now 96, 966, down 13,129 from the open enrollment period earlier this year. The biggest reason…
Read MoreSIM underservice protections get a cool reception, weak ethics policy adopted
Thursday the Equity and Access Council delivered to the SIM Steering Committee a draft report with recommendationsto avoid underservice in SIM’s planned payment reforms. Advocates were successful in getting a provision in the SIM final plan that prohibited payment of shared savings to provider networks that systematically denied needed care to generate those savings. The…
Read MoreSIM ethics concerns intensify with first grants choice
Monday the Lieutenant Governor’s office announced the award of SIM’s first grants from federal funds; two of the four recipients are represented on theSIM Steering Committee. The members represent Northeast Medical Group (Yale-New Haven affiliate) and St. Vincent’s Health Partners. This would have been prohibited under the state’s Code of Ethics but for a loophole…
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