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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 plan; consumers and advocates have not been included in the process. The plan includes important care delivery innovations, many building on inclusive past processes. However the plan also includes giving providers financial incentives to control costs. Advocates are concerned that there are not sufficient controls or data to ensure that savings are generated by reducing duplication, improving quality and eliminating overtreatment rather than withholding appropriate care. To protect consumers, a group of 24 advocates sent a letter asking the SIM proponents to build a robust monitoring system and quality improvement tools for providers, and ensure that that system is working before any provider savings incentives or capitation is implemented. There has been no response to the letter.