Smart Savings
ACOs 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 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 MoreWebinar online – Caring for high-need patients – Lessons for CT
Evidence is growing that we cannot fix our health care system without addressing the needs of the small number of patients with very complex and costly health problems. Connecticut can learn from other programs across the US as we build reforms for our state and our Medicaid program. On this week’s webinar we heard from…
Read MoreBest practices guide on integrating behavioral health into primary care
Up to 70% of physician visits involve a mental health issue and health care costs for people with mental health issues are often up to three times higher than other patients with similar conditions. CEPAC, New England’s comparative effectiveness council, has published their latest guide featuring best practices for integrating behavioral health services into primary…
Read MoreBackgrounder on Hartford health needs for Malta House of Care
Last week CTHPP gave a presentation for the Malta House of Care on health care needs in Hartford and health care trends. Malta provides free primary care to Hartford’s uninsured with volunteer providers and a mobile van that travels to neighborhoods in need. Given seismic shifts in the health care environment that affect both their…
Read MoreA Better Idea for SIM-Medicaid: Coordinate Care for High-Need, High-Cost Patients
Independent consumer advocates and others have raised grave concerns about Connecticut’s State Innovation Model (SIM) plans to radically change financial incentives in our state’s Medicaid program. The experience of other states offers a proven alternative, targeting resources toward high-need, high-cost patients, that would protect the impressive success we’ve achieved in the last three years. This…
Read MoreIntegrating behavioral health into primary care focus of next CEPAC meeting
The next CEPAC meeting will review the latest research on best practices to effectively integrate behavioral health into primary care practice. Up to 70% of physician visits include a behavioral health component. Patients with chronic conditions are more likely to experience mental illness as well and costs for these patients can be two to three…
Read MoreCutting HUSKY parents increases the total cost of care by $500 per person
The Governor’s budget proposal to cut 34,000 working parents from the HUSKY program into AccessHealthCT will increase the total cost of care for those parents by $500/year according to a new analysis by the CT Health Foundation. While the state will save $2,400 per person annually, two thirds of the cost shift will fall on…
Read MoreCT Mirror looks at Medicaid spending – per person down, but total spending up – and that’s OK
A new analysis of CT’s Medicaid spending by CT Mirror outlines 5 things everyone should know. My top 5, below, overlap the Mirror’s. 1. Per person spending is down, especially among newly eligible childless adults 2. Total spending is up – because we have a lot more people in the program…
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