conflict of interest
SIM FAQs updated
We’ve updated the Frequently Asked Questions about CT’s SIM plan. SIM is the state’s newest plan to radically reform health care delivery and payment across the entire state. Advocates have raised concerns that the plan doesn’t do enough to protect consumers from stinting on care resulting from payment reform, could reverse recent progress in CT’s…
Read MoreCabinet meeting – exchange and SIM updates
Most of today’s Cabinet meeting was spent on SIM’s decision to create a CT-specific medical home standard rather than using well-vetted, evidence based national standards. (May 29th we are hosting a webinar with NCQA to learn more about the NCQA system that has certified 1,009 PCMH providers in CT already. Register here.) Questions were raised…
Read MoreLegislative update: SIM funding may draw lawsuit, nursing home profit sunlight bill passes House
The proposed state budget includes $3.5 million in funds for the new SIM state agency. CT Mirror reports that the funding is planned to come from a tax on insurers. The inclusion of self-insured plans in the new tax may draw a federal lawsuit. The state hopes it won’t and points to a vaccine program…
Read MoreIndependent advocates publish comments on first 4 SIM position papers
CT independent consumer advocates have published comments on SIM’s first 4 policy papers. Regarding Issue Brief #1 (provider surveys), advocates urge that the results of consumer experience of care surveys should be made public to use as tools for choosing care and as a lever to improve care quality, SIM must ensure that results…
Read MoreHealth Care Cabinet meeting — SIM, exchange updates
Yesterday’s Cabinet meeting was lively — not sure it was productive. The insurance exchange reported on a flurry of last minute activity that significantly boosted enrollment. Final numbers will be available in a few weeks when it becomes clear how many people follow through and pay premiums, and the backlog of people in the queue…
Read MoreSIM comments on financial incentives, consumer surveys
SIM has started floating their proposals to implement health care reform in CT and #2in particular is troubling for consumers. One proposal offered as a financing option by SIM staff would replace advanced payments for new, effective services such as care coordination and medication management with shared savings payments. This could create unfortunate incentives to…
Read MoreUnderservice committee starts work
Yesterday’s first meeting of the MAPOC Complex Care Committee underservice workgroup was very productive. (We need a shorter name). The committee is charged with designing a framework for monitoring under service in CT’s plan for health neighborhoods to cover people eligible for both Medicare and Medicaid. Advocates have raised concerns that a shared savings payment…
Read MoreSIM update
Not much happened at Monday’s SIM steering committee meeting. The lists of recommended workgroup members from both the SIM personnel committee and the Consumer Advisory Board were distributed but not voted on. There was dispute over the number of physicians on workgroups centered on a recommendation from physician groups to add significantly to their numbers.…
Read MoreDisappointing SIM update
Monday a group of 16 independent consumer advocates delivered a letter to the SIM steering committee voicing deep concerns about the implementation development process. Advocates have voiced concerns about the SIM process from the beginning, offering constructive options that support the goals of improving quality and access to care while controlling costs. Concerns voiced in…
Read MoreExchange affordability measure gutted in committee
In yesterday’s Insurance Committee meeting, SB-11was amended to delay CT’s insurance exchange negotiating premiums with insurers and changed “shall” to “may”, essentially making the legislation irrelevant. The exchange has refused to negotiate with insurers in the past, arguing among other things that it was too early to worry about high premiums. Since last year, exchanges…
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