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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Read the full report This month, Connecticut Medicaid announced the first year performance of PCMH Plus[1], their controversial new shared savings program[2] compared to the prior year. Under shared savings, if health systems (ACOs) are able to lower the cost of their members’ care, they receive a bonus equal to half those savings. PCMH Plus…

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Albert Einstein believed the definition of insanity is doing the same thing over and over but expecting a different result. Unfortunately, Connecticut policymakers haven’t learned this lesson. Provider financial risk is a bad idea that has failed both in our state and nationally. Read more

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Despite the historic failures of capitation in Connecticut and beyond, our state’s SIM health planning office is continuing the drumbeat to re-impose the risky system across our state, this time for primary care. In Primary Care Payment Reform: Unlocking the Potential of Primary Care, the SIM office is proposing set payments for primary care providers…

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Today, independent consumer advocates launched a website, PCMHPlusFacts.org, to explain the facts about HUSKY’s experimental, new payment plan to run the program. The site was developed in response to the state’s erosion of federally required notices to consumers about their right to opt-out of the program. The state changed the notices at the last minute…

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Across various meetings this month we’ve received a few updates on CT’s SIM planning. CT is competing with 17 other states for 12 test grants. SIM staff has acknowledged receipt of the independent advocates’ letter to CMMI and an FOI regarding Consumer Advisory Board voting and SIM budget development, but we’ve had no response to…

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Today’s Hartford Courant includes a deep dive into instances of steering committee members getting grants and changing policies to benefit their interests. Unfortunately SIM falls into a loophole in CT law that exempts its members from the state Code of Ethics for Public Officials. A bill to close that loophole cruised through legislative committees but…

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As recommended by independent advocates and others at from the Care Management Committee, DSS and SIM have agreed to make SIM’s Community and Clinical Integration Program (CCIP) optional for Medicaid provider networks, at least for the first year. Advocates and others on the committee were concerned that the plan was too prescriptive, very expensive, and…

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Fifteen independent advocates sent a letter to the administration yesterday expressing deep concerns with SIM’s Community and Clinical Integration Plan (CCIP) for Medicaid. Advocates are concerned that CCIP will undermine hard-won progress in our state’s Medicaid program that has improved access to high quality care while controlling costs. In contrast to successful programs in other states, SIM…

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Public comments from the CT Health Policy Project raise deep concerns about SIM’s proposal for Medicaid reform requirements could undermine hard-won successes in the program and may not achieve the goals. The Community and Clinical Integration Plan (CCIP) is SIM’s plan for community-based resources to support Medicaid advanced networks that will be sharing in savings…

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