How CT can save $162 million in healthcare waste

An analysis of Connecticut’s commercial insurance markets finds we spent $9.45 per person per month on wasteful low-value care in 2019, according to a new report by VBID Health. Of the $162 million total, $24.5 million was from patient out-of-pocket costs. Low-value care provides no or minimal benefit to patients and is an important driver…

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Most CT physicians take Medicare patients, but less than US average; implications for payment reform

At 84%, the large majority of physicians in Connecticut take new Medicare patients according to a new analysis by the Kaiser Family Foundation, while 91% take new privately insured patients. The US averages are 89% for Medicare and 91% for privately insured new patients. The analysis was of non-pediatric, office-based physicians in 2015 and 2017.…

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Book Club: Think Again

You have to read Think Again: The Power of Knowing What You Don’t Know by Adam Grant. We all think our minds are open, but we’re wrong. Intelligence is nice, but the critical skills are rethinking, relearning, and the courage to dump baggage. The Dunning-Kruger effect is real – the people with the most confidence…

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CT hospital ownership change rate among highest in US

Over 10% of hospitals in Connecticut changed ownership between 2016 and 2021, according to a federal report using new CMS data. Connecticut and just three other states had hospital ownership change rates over 10%. Most states had rates of 4% or less. Understanding hospital ownership changes and rates of change to identify consolidation in healthcare…

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DSS’s new patient survey has little to say

DSS’s consultants reported on the results from their new patient experience/satisfaction survey for PCMH Plus members at this month’s MAPOC Care Management Committee meeting. The survey is important as the experimental PCMH Plus payment model risks inappropriately denying needed care and cherry-picking more lucrative patients. The main result, revealed in answer to a question, is…

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CTNJ: Fact Check Shows That Raising Primary Care Spending Doesn’t Lower Total Healthcare Costs

The Office of Health Strategy and their consultants have asserted that it is critical to double spending on primary care in Connecticut to lower skyrocketing  total healthcare costs. It’s very appealing to think that increasing investments in prevention and care management will reduce total costs. It avoids the difficult work of getting large health systems…

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Why is healthcare like this?

Healthcare is complicated. It often doesn’t make sense – to consumers, patients, students, policymakers, providers, administrators, and everyone else. The lack of understanding has discouraged people from engaging and slowed progress toward real reform. We’ve heard from people across the continuum that there is no place to find balanced, comprehensive answers that is understandable and…

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COVID’s lessons — and what we can do about them

COVID exposed Connecticut’s underlying health disparities to new audiences, receiving a lot of public attention. But what have we learned? A new report from the CT Health Foundation looks at what went wrong, what went right, and what we can build on to fix this long-standing problem. Going back to the old-normal of inequities isn’t…

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Fact Check: Does OHS’s Primary Care Roadmap include capitation? Yes, 31 times

In the Insurance Committee’s March 1st public hearing on HB-5042, advocates stated that the Office of Health Strategy’s Primary Care Roadmap plan, authorized in the bill, includes capitation as the payment model. Primary care capitation has failed in Medicare despite significant investment and multiple trials. Advocates are concerned that, if implemented, the Roadmap would divert…

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New tool finds all CT health systems’ commercial prices are far higher than needed to cover expenses

According to a new tool, Connecticut hospitals would have needed commercial rates equal to 135% of Medicare levels in 2020 to cover their expenses, much higher than the US average of 114%. However, every health system in Connecticut charged well above that level, far more than needed to cover expenses. The National Academy for State…

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