Medicare

Large study finds selection bias in Medicare shared savings erases savings and quality improvements – advocates saw this coming

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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CTNJ: AG expands generic drug price-fixing lawsuit

Friday, Connecticut’s Attorney General Tong and 43 other Attorneys General filed a federal lawsuit alleging that 20 generic drug manufacturers and 15 individuals conspired to inflate prices for 114 drugs that treat a multitude of conditions. The complaint outlines a broad, coordinated campaign across the industry to fix prices, allocate markets and rig bids. Price-fixing…

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Advocates offer recommendations for Medicaid shared savings future

The first year of Connecticut Medicaid’s PCMH Plus experiment in shared savings was disappointing. The program cost the state at least $1.3 million extra tax dollars and quality did not improve compared to Medicaid members outside the program. Every Accountable Care Organization (ACO), regardless of savings or quality improvement, was rewarded with a payment. The…

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Better, safer ideas to support primary care in Connecticut

Download the report Primary care is the foundation of the health system. It is, or should be, patients’ first interaction with the healthcare system for non-urgent issues. There is strong evidence that care coordination linked to primary care practices, such as patient-centered medical homes (PCMHs), foster improved health while lowering costs.[i] Areas with more primary…

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SIM primary care capitation proposal gets another tepid reception

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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YNHH answers latest questions about controversial primary care proposal

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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