SIM

  Yesterday’s SIM meeting showed some positive movement toward a system that respects and protects consumers. Recognizing the potential harm to consumers, SIM leaders now intend to monitor for under-treatment and inappropriate treatment, and the payment model no longer includes capitation, both serious concerns raised by advocates. However advocates remain troubled that there is no…

  This morning, SIM leadership held a forum to explain their plan to advocates. Unfortunately few independent consumer advocates were given an opportunity to ask questions, including this one. Most of the time was taken by SIM committee members expressing their positions, describing their programs and experiences. Many of the questions came from providers and…

  Significant questions have been raised about the methodology and sources for the Sept. 17th SIM presentation (slide 30) asserting that 62% of primary care providers in CT currently have provider risk/shared savings/total cost of care arrangements with providers. Questions relate to whether the populations included are representative of the state, provider types included, whether…

  The September meeting of the SIM steering committee changed little to the plan except the name of the payment model. The planners reported to the committee what will happen in the next phase of the process. They changed the name of their provider risk-based payment model from Total Cost of Care to Shared Savings,…

  An article yesterday in the CT Mirror describes the administration’s plans to apply for millions in federal dollars to radically redesign CT’s health care system – not just Medicaid and the state employee plan, but for all state residents. The article points out that the administration is working with providers and insurers to design…

  The SIM steering committee reviewed final recommendations from their work groups yesterday. The SIM project is developing payment and care delivery models for at least 80% of state residents – 3 million people or more and $30 billion in CT health spending. The recommendations are very detailed and specific, but they maintain that there…

  An update on the SIM project was the main agenda item at yesterday’s Health Care Cabinet meeting. At last month’s meeting, members were asked to collect feedback on SIM proposals for payment and delivery reform to cover 80% of CT residents.  The SIM committee is planning to set payment and delivery models for the…