There are a thousand ways that healthcare is different than other economic sectors and those differences keep the market from working to keep care affordable. . . . An important way the healthcare market fails is that industries have powerful tools to drive the prices and use of their products that most consumers aren’t aware…

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Friday, the state Office of Health Strategy gave final approval Yale-New Haven’s application to move primary care for over 25,000 low income consumers out of neighborhoods and shift them to the Cornell Scott and Fairhaven health centers for payment purposes. Under the final agreement patients would still be cared for by the same YNHH primary…

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A new analysis of PCMH + members’ risk scores finds unexplained increases compared to the control/comparison group that could signal ACO gaming of the system for financial gain and/or, far worse, a decline in the health of members in the program. PCMH Plus, a controversial new payment model, allows ACO (large health systems) to share…

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Researchers from the University of Michigan found that the modest savings and quality improvements reported by Medicare’s extensive shared savings program (MSSP) are likely due to adverse selection. High cost clinicians and beneficiaries were far more likely than others to exit the program. When adjusted for the selective bias in MSSP exit, reported savings and…

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Yesterday, the state Office of Health Strategy sent their eighth set of questions about the controversial application of Yale-New Haven Health System and their community health center partners to move primary care for 28,500 mainly low-income New Haven area residents out of the current neighborhood sites to Long Wharf. Among others, critical concerns have been…

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This week, SIM presented to the Healthcare Cabinet their proposal to capitate primary care, initially for Medicare members, but eventually for all state residents. The proposal is to move primary care to capitated “bundles” – one for basic primary care services and a voluntary, supplemental payment for expanded activities such as infrastructure and HIT and…

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Monday Yale-New Haven Health System and their community health center partners answered the latest set of questions from the state Office of Health Strategy (formerly OHCA) to their controversial plan to move primary care services for 28,000 low-income New Haven residents out of the current neighborhood sites to Log Wharf. Under the proposal, patients’ care…

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Accountable Care Organizations (ACOs) are a growing part of CT’s healthcare landscape. But if you’ve never heard of them, you’re not alone. ACOs are large health systems run by providers, often including hospitals, doctors, home health, nursing homes, and other providers. It is estimated that 15 to 20% of CT residents have already been enrolled…

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In response to questions from state regulators, YNHH announced that their controversial plan to shift care for 28,500 mainly low-income New Haven area residents to a new site, far from neighborhoods and to shift Medicaid billing for those patients to the two community health centers will be delayed until late Summer 2020. The delay allows…

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