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A lot happened in health care in CT this year — a lot of promising projects but some opportunities lost as well, leaving lots of uncertainty for 2015. It’s never boring.

     Thankfully, health care costs held stable   CT seems to be following the US trend of slowing health costs. Spending per person in Medicaid held stable, even for new eligibles. And, thanks to the ACA, CT’s share of Medicaid costs actually dropped this year. Premiums in the exchange are largely unchanged for next year, but we started out fourth highest in US.
    More people have coverage  The final uninsured rate is months away, but all signs indicate it should be down. Medicaid enrollment grew significantly; the large majority of those new members were likely uninsured previously. AccessHealthCT enrolled thousands, but it’s unclear how many were uninsured. Affordability of coverage in CT remains a serious challenge.
     Stunning Medicaid turnaround Since the exit of commercial insurers and financial risk the program, quality of care now rivals commercial plans, 32% more providers participate, and per person costs are stable in CT’s largest health plan.
      CT is trying health reform again, with mixed reviews so far  SIM, the administration’s latest reform attempt, won a modest federal grant but early interest among stakeholders is waning and serious concerns have been raised by consumers. CT’s Medicare ACOs have had a shaky start, with only one of eleven earning shared savings payments. However, Medicaid’s health neighborhood plan to coordinate care and align incentives to support quality is moving ahead with good support. The lesson — thoughtful, open collaboration works.
      New public health strategic plan We are lucky that CT is the fourth healthiest state and DPH has guided development of a thoughtful, realistic strategic plan to address rising public health challenges.             
      CT hospitals staying (mostly) nonprofit Early in 2014, it seemed inevitable that for-profit Tenet would be buying four CT hospitals, but that deal now appears dead.
    Lots of questions remain for CT health care in 2015.
·            Will payment reform sputter out, or more likely, continue it’s fragmented, piecemeal route? Will we know?
·            What does the future hold for CT’s hospitals? Will mergers and consolidation with other providers continue?
·            Can Medicaid continue the quality and access improvements while containing costs? Will plans for shared savings and returns to financial risk unravel the progress?
·          Will CT finally get health IT right? Will patient privacy be protected?
·          Will Congress reauthorize CHIP (HUSKY B in CT) so 14,000 children can keep their coverage?
·          Will the state adopt any measures to make health insurance, especially in the exchange, more affordable?