research
Medicaid update: New data on high-cost, high-need members
Friday’s Medicaid Council meeting focused on CT’s participation in a national technical assistance program to identify and meet the needs of high-cost, high-need patients. This population has received a great deal of attention from policymakers as the best opportunity to both improve access and quality of care as well as control costs. The concept offers…
Read MoreChartbook: CT drugs costs high and growing fast
14.4% of our state’s economy was devoted to health care services in 2014, slightly below the US average, according to a new Chartbook on CT health spending. Based on newly released data from CMS actuaries, the analysis finds that CT health costs per person are not surprisingly high but we out-perform most other states in…
Read MoreThe Future of Medicine in the Human Genome Genomics — Making a difference in patients’ lives / By Mary Branham
From CSG-ERC’s Annual Meeting in Connecticut Mapping the first human genome in 2000 cost about $4 billion; today, it costs about $1,000. The cost has come down because of investment, and because of the important role genomics is playing in medicine today, according to Dr. Murat Gunel, a professor of neurosurgery, genetics and neuroscience at…
Read MoreNew state health comparison tool shows challenges and opportunities for CT
In good news, CT is 11th best among states in the number of people who had no trouble finding a doctor in 2015 according to State Health Compare. But CT is also 17th worst among states in the percent of residents with high medical cost burdens. Depending on how you look at it, it may…
Read MoreStudy raises concerns about ACO “savings” and gaming the system
A new study published in Health Affairs raises doubts about the effectiveness of Accountable Care Organizations (ACOs) to both improve the quality of American health care while controlling costs. The study found very high physician turnover rates at a large Medicare ACO and that high cost patients were concentrated among a small minority of…
Read MoreAdvocates ask DSS yet again for a robust evaluation of risky experiment before expanding
Twenty-three independent advocates sent a letter today again urging the state to conduct common sense evaluation of the first wave of a risky new program before expanding the program, as promised. Advocates have learned that the planned evaluation will not be available until 2 months after the RFP for the second wave is finalized and released. In addition, current…
Read MorePCMH + evaluation plans – weak review and too late to matter
Wednesday DSS unveiled their initial plans to evaluate PCMH +, the new experimental HUSKY shared savings program that just started January 1st with 160,000 members. HUSKY’s previous experience with financial risk was a universally acknowledged failure. Contrary to promises for a meaningful evaluation of the program before moving another 200,000 members into the program next…
Read MoreICD-10 holiday fun from STAT News
Holiday humor from STAT News includes a piece outlining ICD-10 medical codes for typical holiday health problems. If you’re looking for them, STAT has the codes for holiday injuries (contact with electric knife, struck by turkey), stress of waiting for Santa (behavioral insomnia of childhood, encounter for examination of eyes and vision with abnormal findings),…
Read MoreDSS plans for high-cost, high-need members focuses on behavioral health
At yesterday’s online MAPOC Complex Care Committee meeting, DSS described their innovation plan to address the needs of high-cost, high-need Medicaid members. (meeting video and slides) The project was made possible by a technical assistance grant from the National Governor’s Association. Five agencies and the Medicaid Administrative Service Organizations, CHNCT and Beacon Health, have worked…
Read MoreDownside risk explainer and response to Strawman payment model proposal published
In response to questions, we’ve published two new documents about the most controversial part of the Health Care Cabinet’s Strawman proposal for health reform in Connecticut. To help in understanding how downside risk might work, and whether it works, in the context of other options, we’ve developed a fairly short downside_risk_explainer. To address points offered…
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