Medicare
CTNJ Op-Ed: Labels matter in healthcare, especially the misleading ones
The President was right – healthcare is complicated. There are lots of reasons, but a big one is language. What something is called can add to or lessen understanding. Sometimes it can be deceptive, giving the impression of a more acceptable definition than the truth. It rarely works for long, but a lot of harm…
Read MorePublic comments critical of OHS’s Cost Cap plan
Several comments submitted on the Office of Health Strategy’s plan to cap healthcare costs during the public comment period raised serious concerns. The concerns echo those raised in previous unanswered letters signed by dozens of advocates. Comments were submitted by CT legal services programs, Gaye Hyre on behalf of the advocate letter writers, and one…
Read MoreCommercial plans pay Connecticut hospitals 215% of Medicare prices, but that’s better than most states; No evidence of Medicaid or Medicare cost shifting
A new data set and report from RAND finds that Connecticut hospital prices paid by commercial plan were 215% of Medicare in 2018, varying from 144% for UConn Health to 282% for Stamford Health. If commercial plans had paid the same rates as Medicare that year, consumers would have saved $510 million. While high, Connecticut…
Read MoreOHS committee considers how to sell the Cost Cap to stakeholders
Last week’s meeting of the Office of Healthcare Strategy’s Cost Cap committee, as they are wrapping up the project design, ended with discussion of how to ensure their project is successful in controlling healthcare costs. Despite developing the Cap during a pandemic, there has been considerable resistance and mistrust of the concept and the process.…
Read MoreCost cap committee excludes patients’ provider choices from primary care spending increase
On Thursday, the main committee convened by the Office of Health Strategy (OHS) met to continue their work to set a cap on how much healthcare costs can increase and, at the same time, double spending on primary care. At the meeting they codified a narrow definition of primary care provider for purposes of calculating…
Read MoreCost Cap committee considers who qualifies for increased primary care spending
In response to stakeholder feedback that the prior Cost Cap levels were unrealistic and risk unintended harm to patients, at their last meeting the Office of Health Strategy’s Cost Cap committee slightly softened the cap levels. The committee continued their discussion of which providers qualify as primary care providers. OHS wants to significantly increase the…
Read MoreCost cap project sets limits on healthcare spending without public input, ignoring pandemic impact
In meetings of the committee setting limits on healthcare spending for all Connecticut residents, it appears the advocates’ sign on letter and detailed concerns about the Office of Health Strategy’s (OHS’s) Cost Cap project were not heard. The plan is being developed by a Technical Advisory Team, with members chosen only by OHS, including some…
Read MoreFact Check: Do lower Medicaid provider payment rates cause higher commercial payment rates?
Download this Fact Check There’s a pervasive myth that lower Medicaid provider payment rates force providers to charge private insurers more to cover costs, but there is no evidence of that. On a simple level it makes some sense, but the truth is that providers, like most businesses, charge what they can, regardless of what…
Read MoreHelp for CT’s uninsured
With the recent spike in unemployment, many more Connecticut residents will be joining the thousands that were uninsured pre-COVID looking for healthcare coverage. The state has some new options to help. Check AccessHealthCT. You may be surprised to find that you qualify for HUSKY which is comprehensive, free, and includes most Connecticut providers. You may…
Read MoreCT hospitals would fare better than most if all payers used Medicare payment rates
A new study published in Health Affairs finds that if commercial payment rates were set at fee-for-service Medicare levels in 2017, US hospital revenue (inpatient and outpatient) would drop by 35%. Interestingly, also raising Medicaid rates to Medicare levels does little to mitigate that, changing the revenue loss to 30%. However, the authors note that…
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