Good and bad Medicaid PCMH, PCMH Plus updates

At today’s MAPOC Care Management Committee, we learned that Medicaid’s successful Patient-Centered Medical Home (PCMH) program is growing and keeping up with higher enrollment due to COVID. In disappointing news, we also learned that the controversial PCMH Plus program has fewer care managers than expected and only 36% of ACO member advisory committees have any…

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OHS committee considering dumbing down successful PCMH standards

Among other troubling plans, the Office of Health Strategy’s Primary Care Subgroup is considering four options to certify high-performing primary care practices for higher levels of reimbursement. The committee is deciding how to double spending on primary care while simultaneously capping healthcare cost growth. At their meeting this week, the committee of mainly primary care…

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ANALYSIS | Who In Health Care Made Money on COVID?

Many COVID heroes who put their lives at risk or died caring for others. We all owe healthcare providers, scientists, public health professionals, and other frontline workers a huge debt of gratitude. But the healthcare industries did just fine. Four of the ten companies that profited most during the pandemic are in healthcare. Read more

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CTNJ: Real Conversation Would Beget Lower Health Care Costs

I recently had an interesting conversation with a lobbyist for the insurance industry. We planned to talk about our narrow legislative issues to find any common ground. Predictably, we disagreed on some key points, but we agreed on a lot more. We agreed that it’s hard to get people across the health care system onto…

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Half of CT hospitals not compliant with new requirement to post negotiated prices for care

Download the report As of January 1st, all US hospitals are required to prominently display on a publicly available website prices privately negotiated with payers for 300 services, under CMS’s Hospital Price Transparency Rule. Hospital “charges” have been available to patients but not the actual prices paid by insurers. CMS requires both a “display of…

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CTNJ: OP-ED | State Should Set Uniform, Public Standards For Rationing Health Care

Disparities in healthcare are not new in our state, but the pandemic has intensified the unfairness. The aged, people with disabilities, and communities of color have been especially hard hit by the virus and the recession. Unfortunately, a striking example of that increased unfairness is reflected in Connecticut hospitals’ policies for rationing scarce resources during…

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More physicians joining large health systems across CT

From 2016 to 2018, the number of Connecticut physicians affiliated with large health systems grew in every area of the state, according to a new analysis in Health Affairs. Nationally the percent of physicians in large health systems rose by 11%, and the rate grew in 92% of US metro areas. Growth was fastest in…

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Top Stories of 2020

A year ago, our predictions for 2020 missed all but the recession. COVID has us giving up on predictions, so we’ll just take a look back at our top stories of this year. Advocacy Toolbox now online — Updates include specific, real world tools for legislative, administrative, and state budget advocacy, how to change public…

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To make health premiums affordable, CT must address input costs

Download the report here Health benefits in Connecticut are costly and rising faster than inflation. Last year, total employer-sponsored health insurance premiums in Connecticut were the sixth highest among states for both single and family coverage. Connecticut workers paid 7.8% more for single coverage and 4.3% more for family plans than other Americans. Although Connecticut…

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OHS Cost Cap committee retreats on quality, providers driving the delay

The Office of Health Strategy (OHS) rejected concerns been raised by stakeholders and some Cost Cap committee members that the Cost Cap on healthcare spending will be implemented at least a year before reporting on quality performance. Concerns center on the possibility of lowering costs by lowering the quality of care to achieve the ambitious…

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