conflict of interest
Only 36% of CT physicians have any shared savings arrangements, correcting questionable SIM estimates from 2013 driving expansive policy
UConn’s new SIM survey of CT physicians found that currently only 36% of CT physicians participate in any shared savings or ACO program. There is no information on whether shared savings are a significant part of revenues in even the minority of physicians who are in this payment model. Not surprisingly, shared savings is slightly…
Read More20 independent advocates share concerns about SIM’s plans for Medicaid
Yesterday twenty independent consumers, advocates and providers sent a letter to the Lieutenant Governor expressing our grave concerns about the “current plans for widespread precipitous changes” in Medicaid’s payment model. The letter outlines concerns about re-imposing financial risk, this time on providers of care, that creates incentives to deny needed care. States with far more…
Read MoreHealth reform update – the power of price transparency, more SIM concerns
At an important Public Health Committee hearing Wednesday, Senate leaders from both parties testified together on a slate of seven bills that would make a great start to reforming health care in our state. Among other things the bills address facility fees, price variation that has no relation to quality, hospital consolidation oversight, EMR assistance…
Read MoreCT 2015 insurance exchange enrollment – the numbers are in
Two thirds of CT residents who secured coverage through AccessHealthCT’s portal this year were eligible for Medicaid, according to the latest federal enrollment report. Another 29% were eligible for financial assistance to buy coverage from a private insurer, and just under 6% bought coverage without subsidies. Of the 109,839 people who selected health plans on…
Read MoreSIM bill hearing in Public Health next Wednesday
HB- 6938, AAC the Delivery of Quality Health Care and Modernization of Health Care Facilities, will have a public hearing next Wednesday March 11th at 10:30 at the LOB in Room 1D. SIM is planning to radically transform health care for every state resident, including moving 200,000 Medicaid members back into a financial risk model…
Read MoreAdvocates call on SIM to adopt state Code of Ethics
A letter was sent yesterday from independent consumer advocates to SIM leadership calling for SIM to follow CT’s Public Officials and State Employees Guide to the Code of Ethics, to protect the integrity of both SIM contracting and larger health reform efforts in our state. The advocates are asking for these protections now, before major…
Read MoreTroubling Medicaid, SIM updates
Friday’s Medicaid Council meeting focused on eligibility, renewal changes and implementation with a very helpful primer on the process. There is no clear answer to why Medicaid membership has dropped by 34,232 since October, but the transition to MAGI income rules and renewal delays to protect consumers from lapses in coverage are probably part of…
Read MoreSIM update – PCMH standards undermined, weak ethics adopted, but underservice group is moving forward
Again, SIM takes one step forward but two steps back. At yesterday’s steering committee meeting, SIM adopted an ineffective, weak conflict of interest policy, without a vote or any discussion. The policy would allow members to bid on significant SIM contracts that they had a substantial role in defining, potentially advantaging their company, provider or…
Read MoreSIM & CAB update
Today’s SIM steering committee meeting has been cancelled. (BTW- the Medicaid Council meeting scheduled for tomorrow has been postponed to next Friday, the 16th.) Tuesday’s SIM Consumer Advisory Board (CAB) meeting was frustrating. They were supposed to vote on an ethics resolution proposed last month, but delayed a vote yet again. (They sent it to…
Read MoreCT News Junkie Op-ED – learning from mistakes in HIT
A new opinion piece in CT News Junkie focuses on the need for CT to develop a functional health information system, that respects consumers’ privacy, is crucial to patient safety, improving quality, controlling costs and thoughtful reform. The merciful demise this year of HITE-CT, a quasi-public entity charged by the state with doing just that,…
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