SIM
Cabinet meeting – exchange and SIM updates
Most of today’s Cabinet meeting was spent on SIM’s decision to create a CT-specific medical home standard rather than using well-vetted, evidence based national standards. (May 29th we are hosting a webinar with NCQA to learn more about the NCQA system that has certified 1,009 PCMH providers in CT already. Register here.) Questions were raised…
Read MoreLegislative update: SIM funding may draw lawsuit, nursing home profit sunlight bill passes House
The proposed state budget includes $3.5 million in funds for the new SIM state agency. CT Mirror reports that the funding is planned to come from a tax on insurers. The inclusion of self-insured plans in the new tax may draw a federal lawsuit. The state hopes it won’t and points to a vaccine program…
Read MoreIndependent advocates publish comments on first 4 SIM position papers
CT independent consumer advocates have published comments on SIM’s first 4 policy papers. Regarding Issue Brief #1 (provider surveys), advocates urge that the results of consumer experience of care surveys should be made public to use as tools for choosing care and as a lever to improve care quality, SIM must ensure that results…
Read MoreHealth Care Cabinet meeting — SIM, exchange updates
Yesterday’s Cabinet meeting was lively — not sure it was productive. The insurance exchange reported on a flurry of last minute activity that significantly boosted enrollment. Final numbers will be available in a few weeks when it becomes clear how many people follow through and pay premiums, and the backlog of people in the queue…
Read MoreSIM comments on financial incentives, consumer surveys
SIM has started floating their proposals to implement health care reform in CT and #2in particular is troubling for consumers. One proposal offered as a financing option by SIM staff would replace advanced payments for new, effective services such as care coordination and medication management with shared savings payments. This could create unfortunate incentives to…
Read MoreUnderservice committee starts work
Yesterday’s first meeting of the MAPOC Complex Care Committee underservice workgroup was very productive. (We need a shorter name). The committee is charged with designing a framework for monitoring under service in CT’s plan for health neighborhoods to cover people eligible for both Medicare and Medicaid. Advocates have raised concerns that a shared savings payment…
Read MoreSIM update
Not much happened at Monday’s SIM steering committee meeting. The lists of recommended workgroup members from both the SIM personnel committee and the Consumer Advisory Board were distributed but not voted on. There was dispute over the number of physicians on workgroups centered on a recommendation from physician groups to add significantly to their numbers.…
Read MoreDisappointing SIM update
Monday a group of 16 independent consumer advocates delivered a letter to the SIM steering committee voicing deep concerns about the implementation development process. Advocates have voiced concerns about the SIM process from the beginning, offering constructive options that support the goals of improving quality and access to care while controlling costs. Concerns voiced in…
Read MoreSIM update – more consumer concerns
Yesterday’s SIM steering committee was not encouraging for those hoping to see real consumer involvement. The long-awaited workgroups will only have 25% (plus or minus) consumer and advocate representatives. In addition, they expect anyone appointed to be a supporter of the final SIM plan, and to agree to “champion” the recommendations of the workgroup, even…
Read MoreSIM update – answers, sort of, and further delays in starting work
On Monday, advocates received answers to our questions about the SIM final plan – sort of. We did learn that they are not considering pure capitation as a payment model at this time and that any plans for Medicaid payment changes will go through the Medicaid Council – both good. Unfortunately answers to the other…
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