SIM

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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PCMH Plus Year 1 Performance and Savings Results: Increased state costs but little evidence of impact on quality

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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Thirty-one independent consumer advocates share concerns with SIM’s latest push for capitation

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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Advocates launch PCMHPlusFacts.org, giving HUSKY members balanced information on the controversial new program

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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SIM update

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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Good news on CCIP – SIM’s plan for Medicaid

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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Advocates’ letter urges delay of SIM plans for Medicaid

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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SIM’s CCIP proposal for Medicaid reform – poor process drives weak plan

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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