quality
Disability advocates register serious concerns with SIM primary care capitation plan
On Friday, thirty consumers and advocates for people with disabilities sent a letter to Vicki Veltri and Mark Schaefer, CT’s SIM officials, expressing their concerns with SIM’s proposal to capitate primary care for everyone in CT. The signers are concerned about the potential to deny needed care, especially for people with complex medical conditions. Capitation…
Read MorePCMH+ quality reports surprisingly underwhelming
At the MAPOC and Care Management committee meetings we finally received the promised quality evaluation of PCMH +’s first year. PCMH+ is DSS’s experimental new payment program that now covers 165,432 HUSKY members. We only received information on the 13 mainly process measures. These measures were chosen as basis for shared savings payments, not for…
Read MoreAdvocates get no answers to questions about HUSKY experiment
Last month, a group of independent consumer advocates, the Medicaid Study Group, sent questions to DSS about the impact of PCMH Plus, their new $10.8 million experimental program of shared savings in HUSKY. Advocates have been concerned about PCMH Plus’s potential to deny needed care, raise costs in the program, and erase hard-won progress. Questions…
Read MoreMedicaid update: LTSS working to keep people out of nursing homes, hospitals
Friday’s Medicaid Council meeting focused on rebalancing long term services and supports allowing more members to stay at home, if they choose, and improve quality of life. Recipients of LTSS services comprise 6% of Medicaid members but 43% of costs. On average community-based care is less costly. The comprehensive strategy that began with a 2013…
Read MoreCT hospital readmission penalties up for next year
Next year, Medicare will penalize CT hospitals by an average of 0.74% in readmission penalties and all CT hospitals will pay a penalty, according to an analysis by Kaiser Health News. Nationally hospital penalties averaged less at 0.57%, and 574 US hospitals will have no penalty. Since 2012 hospitals have been penalized if they have…
Read MoreCTNJ op-ed: Health disparities are real and new payment schemes are probably making them worse
Connecticut is a very healthy place; we rank fifth healthiest among states. But not all state residents share in that good fortune; too many suffer from health inequities. Very good people across the state are doing important work promoting better health for everyone. However some emerging policies, both government and private sector, are working at…
Read MoreNo CT hospitals make US News 2018 Honor Roll
No Connecticut hospital made US News’s Best Hospitals Honor Roll or their Best Children’s Hospitals Honor Roll this year. Four are nationally ranked in at least one specialty or performance area – Yale-New Haven (#1 in CT), Hartford Hospital (#2), St. Francis (#3) and Connecticut Children’s Medical Center. US News ranks hospitals based on patient…
Read MoreCTNJ: Capitation vs. fee for service: Which team are you on?
is a sharp divide within Connecticut’s healthcare community over how to pay for care that’s as fervent as the Yankees vs. Red Sox split. Some believe that capitation is the holy grail, but others believe that fee for service isn’t the problem and isn’t broken. Read more
Read MoreMedicaid update: hints of new data and promises of more, call center wait times still long, but behavioral health progress
There was good and bad news at Friday’s Medicaid council meeting. Call center wait times are down to 85 minutes but more callers are giving up. There are signs of hope in fixing the new transportation problem and DSS has imposed sanctions (maybe a connection there), but concerns remain. But in good news, we heard…
Read MoreCTNJ op-ed — Facts, and data, are stubborn things
Big data is revolutionizing healthcare. The ability to collect reams of detailed information about how care is provided, how much it costs, and then to link that back to effectiveness and outcomes is powerful. New data tools offer the potential to improve individual and collective decision-making that targets just the right resources to the right…
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