Stats & Data
PCMH Plus Year 1 Performance and Savings Results: Increased state costs but little evidence of impact on quality
Read the full report This month, Connecticut Medicaid announced the first year performance of PCMH Plus[1], their controversial new shared savings program[2] compared to the prior year. Under shared savings, if health systems (ACOs) are able to lower the cost of their members’ care, they receive a bonus equal to half those savings. PCMH Plus…
Read MoreNew data mapping tool gives changes in uninsured rates by CT town
The CT Data Collaborative has entered new Census data into a mapping tool that gives, among other metrics, the percent of uninsured residents by town or Census tract over time. Two maps compare five-year uninsured rates by town/census tract from 2008-2012 to 2013 to 2017. The uninsured rate in most municipalities dropped between those time…
Read MoreICER seeking new members of comparative effectiveness panel
The Institute for Clinical and Economic Review (ICER) has opened nominations for their New England Comparative Effectiveness Public Advisory Council. The council, one of three in the US, is composed of leading clinicians, patient and public representatives, methodologists, and health economists. The group meets three times each year to consider ICER effectiveness reports on the…
Read MorePCMH+ quality reports surprisingly underwhelming
At the MAPOC and Care Management committee meetings we finally received the promised quality evaluation of PCMH +’s first year. PCMH+ is DSS’s experimental new payment program that now covers 165,432 HUSKY members. We only received information on the 13 mainly process measures. These measures were chosen as basis for shared savings payments, not for…
Read MoreCT hospitals report $1.6 billion in community benefits, but most of that is claims of Medicaid underpayment
Yesterday’s Healthcare Cabinet meeting focused on CT nonprofit hospital community benefit reports to the IRS. Last year, CT hospitals claimed $1.6 billion in community benefits, but over half of that (57%) are claims of Medicaid underpayment. Charity care provided to patients unable to pay for their services constituted 21% of total charity care; health professional…
Read MoreAnthem keeps lion’s share of CT insurance market
The best-kept secret in CT healthcare – the Insurance Department’s Consumer Report Card on Managed Care Plans – is out again this year covering 2017. Once again, Anthem has the lion’s share of the market at 46%. ConnectiCare lost almost 55,000 members between 2016 and 2017. About two out of three insured people in Connecticut…
Read MoreEmployer health benefit costs hit lowest wage workers hardest
The latest Kaiser Employer Health Benefits Survey found that nationally last year premiums for employer-sponsored health benefits rose by 3% for single coverage and 5% for family coverage. In comparison, wages rose 2.6% and inflation was 2.5%. As in previous surveys, premiums were highest in the Northeast. But in a really unfair twist (which also…
Read MoreCTNJ: CT uninsured rate up, especially for higher income households
New Census data on the uninsured is always a big event for policy types. This year most expected the numbers to rise, but the data had a surprise. Read more
Read MoreAnother reason to be glad HUSKY fired managed care
New favorite quote – “If you have a dumb incentive system, you get dumb outcomes.” Charlie Munger, quoted by 46brooklyn A new analysis by 46brooklyn highlights the extra costs to Medicaid managed care programs of drug industry middlemen. Ohio’s Medicaid program pays $224 extra in markups to Pharmacy Benefit Managers (PBMs) hired by managed care…
Read MoreCT hospital readmission penalties up for next year
Next year, Medicare will penalize CT hospitals by an average of 0.74% in readmission penalties and all CT hospitals will pay a penalty, according to an analysis by Kaiser Health News. Nationally hospital penalties averaged less at 0.57%, and 574 US hospitals will have no penalty. Since 2012 hospitals have been penalized if they have…
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