SIM
CTNJ Op-Ed: Let’s Halt the Rush to Risky Medicaid Experiment
Today’s CT News Junkie includes an opinion piece urging caution and more time for thoughtful deliberation in moving 200,000 HUSKY members into a very new, untested payment model that is costing more for Medicare. CT’s Medicaid program is a success story – improving quality, increasing providers, and lowering costs – but that success is fragile.…
Read MoreTen SIM committee members sign alternative stronger ethics policy
Ten brave SIM committee members signed a stronger ethics policy in place of SIM’s weaker policy. Advocates were given until this Wednesday to sign SIM’s policy or they would “not be able to participate as members in future meetings of the advisory groups.” The alternative policy agrees to also abide by the State Code of…
Read MoreACOs not saving for Medicare, model could cost CT Medicaid almost $100m/year
CMS’s vast shared savings experiment for Medicare has disappointed again in its second year. The plan was to encourage providers to assemble into health care systems, called Accountable Care Organizations (ACOs), to coordinate care and keep people well. The incentive was that the systems share half (or more) of the resulting savings. The only problem…
Read MoreAdvocates support SIM underservice, cherry picking protections
Connecticut’s SIM plan acknowledges that risks of inappropriate under-treatment and cherry-picking are higher in new shared savings payment models. Advocates were successful in getting a provision included in the SIM final plan that prohibits payment of shared savings to provider networks that systematically deny needed care or cherry pick patients to generate those savings. The…
Read MoreNine SIM committee members reject weak ethics policy
In a letter sent yesterday, nine members of various SIM committees rejected the weak ethics policy promoted by SIM leaders. The weak policy does little to limit conflicts of interest, such as those that tainted the awards of SIM’s first grants. Instead they urged SIM to limit conflicts of interest and adopt the State Code…
Read MoreSIM update, equity planning questions
At Thursday’s SIM steering committee meeting in public comments, SB Chaterjee raised concerns about DPH’s planning to address health equity. Important planning meetings occur in closed meetings, without public notice or minutes. (Sound familiar?) Questions were also raised about how federal funds have been spent and the required conflict of interest policy is not available.…
Read MoreCTNJ op-ed: Insurers blocking underservice protections, again
Consumer protections had a good start in Connecticut’s latest health reform plan. But, as always, the devil is in the details. Unfortunately insurers are working to sabotage those protections to benefit their bottom line. Read more
Read MoreTestimony FOI never got to hear
Last week the Freedom of Information Commission held a hearing on my request for SIM documents related to their Consumer Advisory Board’s (CAB’s) votes on appointments to SIM committees. Those committees are making very important decisions about CT’s $30 billion health care system and ethical questions have been raised about committee members receiving substantial SIM…
Read MoreAdvocates’ guide to underservice recommendations
Connecticut’s State Innovation Model (SIM) is seeking to radically transform our state’s $30 billion health system by aligning incentives to build value. SIM has chosen a shared savings payment model for those reforms. Advocates are concerned about incentives to deny necessary care under the new payment model, as happened in the past. SIM’s Equity and…
Read MoreAdvocates’ guide to underservice recommendations
SIM is seeking to radically transform our state’s $30 billion health system and has chosen a shared savings payment model for those reforms. Advocates are concerned about incentives to deny necessary care under the new payment model, as happened in the past. SIM’s Equity and Access Council was charged with developing protections to limit and…
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