quality
PCMHs in CT – not the “shiny new toy” anymore but moving forward improving care, controlling costs
Ten years ago, patient-centered medical homes (PCMHs) were exotic in Connecticut. PCMHs are one of the best documented innovations to improve health. PCMHs are primary care practices that help keep people well by assessing needs, coordinating care, and giving people the skills and resources to maintain their own health. As a nurse managers told me,…
Read MoreNew PCMH + plans overlook past problems
Wednesday DSS and Mercer unveiled their thinking about plans for Wave 3 of PCMH Plus, Medicaid’s controversial shared savings program. Results from PCMH Plus’s first year, Wave 1, were disappointing with increased state costs and little evidence of improvement in quality. Based on the problems identified in Wave 1, advocates made recommendations to fix those…
Read MoreCT ranks 5th among states in health system performance this year, up from 9th last year
Connecticut’s health system performs better than all but four other states, according to the latest Commonwealth Fund State Scorecard. We are first in Healthy lives, up from sixth last year. Surprisingly, we also do very well on Access & Affordability (sixth) – it must be the access part. But we have a lot of work…
Read More2019 Connecticut legislative session – what happened and what didn’t happen
Download the full report Connecticut’s General Assembly debated an unusually large number of health-related proposals this year. Some were new and some have been debated for years. Some passed, some were rejected, and some are on hold for next year. As of this writing, only the minimum wage increase bill has been signed into law…
Read MoreState budget deal restores coverage for 4,000 HUSKY parents, a move toward quality-based payments, and insurance protections
Policymakers have reached a $43 billion state budget deal to cover the next two fiscal years, on-time before the end of the session. For health policy folks, there is a lot to like in the deal but a few notes of caution. The best part is a partial restoration of HUSKY parents’ eligibility cuts from…
Read MoreYNHH transportation plan for controversial primary care shift troubling, concerns remain
Monday, Yale-New Haven Health System answered the state’s eighth set of questions about their controversial application with the Hill Health and Fairhaven Health Centers to move primary care for 25,000 mainly low-income New Haven area residents out of the current neighborhood sites to Long Wharf. Among many concerns voiced by patients, advocates and community leaders…
Read MoreCT needs to step up public health to keep people out of medical care
Connecticut ranks 29th among states in per person funding from the federal Centers for Disease Control and Prevention, according to the Trust for America’s Health. Connecticut spent only $29 per person on public health in 2017, down from $31 in 2014. That would be fine if the risks to the public’s health were also decreasing,…
Read MoreFor the Book Club: The Tyranny of Metrics
As the world moves toward data and analytics to evaluate progress (and it should), we need to be careful that the movement is meaningful. This must-read is full of cautionary tales, including a chapter on medicine, of mis-use of metrics to evaluate performance that ended up doing more harm than good and box-checking in place…
Read MorePractical Wisdom – The Right Way to Do the Right Thing
New to the Book Club Why do our institutions and systems, including healthcare, seem to be getting more complex and more costly but not better? This fascinating book argues that we have lost practical wisdom – the ability to balance the need for reasonable rules and standards with doing the right thing. The law of…
Read MoreMore questions for YNHH about controversial primary care proposal
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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