Yesterday the Health Care Cabinet gave consultants initial feedback on their “straw man” recommendations to improve health care and control costs in CT. The Cabinet has spent the last several months exploring leading state reforms preparing for our December report to the General Assembly. Members expressed concerns about the proposed consolidation of all state health agencies into a single agency and creating another new agency for health policy planning. Members suggested less complicated and less costly ways to achieve the same goals of coordinating activities and analyzing data. Deep concerns were voiced about a return to capitated financial risk for Medicaid. Since leaving capitation four years ago, CT Medicaid has improved the quality of care, engaged significantly more providers, and reduced per person costs — by 5.9% just last year. Concerns were also raised about an 1115 waiver, which has been a tool for increased resources but also to reduce care in other states. It’s important to decide on goals first, before jumping to a risky and controversial strategy. A proposal to join Medicaid and state employee plan purchasing has failed several times in the past. While the goal of reducing market concentration is a good one, the recommendation needs to be much stronger. There was strong support for using data and evidence in health planning. Dozens of good ideas that will be necessary to any successful reform were missing from the list and efforts beyond state government were not recognized in the report. Advocates will be providing the Cabinet with feedback and alternatives to the recommendations. One thing the consultants got very right was the main challenge to reform in CT – “Lack of trust among key stakeholders.” It was suggested that we start with smaller, more realistic steps (we can afford) that give early successes and build trust. The next meeting will be August 9th.