Search results for: cost cap
Medicaid update
The Medicaid Council workgroup developing quality measures to use in reforming Medicaid’s payment system has held a couple of meetings – one very constructive, the first not so much. The first meeting was hastily called, dominated by SIM representatives, and contentious. However, the comforting bottom line from that meeting was that DSS will make the…
Read MoreMedicaid update – lots of success but a concerning turf battle
Friday’s Medicaid Council meeting focused on new initiatives to rebalance care for long term supports and services. Through a impressive quilt of waivers, DSS has improved incentives for providers, expanded available services, reduced and eliminated waiting lists, and reduced costs allowing fragile people to remain in their homes avoiding costly and unwanted nursing home stays.…
Read MoreSIM 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…
Read MoreIndependent advocates raise SIM concerns with CMMI
Twenty-two independent consumer advocates signed a letter sent Friday to CMMI voicing concerns about CT’s SIM application. While advocates have many concerns, the letter focuses on the sudden planned shift to shared savings payments in Medicaid. Concerns include the prospect that shared savings incentives could drive inappropriate underservice and that state’s quality and financial monitoring resources…
Read More2014 Candidate Health Care Briefing Book online
The CT Health Policy Project has posted our latest Health Care Briefing Book for candidates. The site includes eighteen short briefs on timely topics in Connecticut’s health care landscape. Topics include health care cost drivers, Access Health CT — Connecticut’s health insurance exchange, SIM — CT’s new plan for health care reform, and CT’s…
Read MoreMoving video and panel on the opiod addiction epidemic, with policy options to address the problem
This morning’s standing-room-only panel at CSG/ERC’s annual meeting in Baltimore on the epidemic of opiod addiction combined emotion with constructive options for policymakers. We first watched part of The Hungry Heart, a movie about the rising toll of addiction on rural communities and heard from a former addict and a physician from the movie.…
Read MoreNew SIM under service survey — please help protect consumers
The SIM Equity and Access Committee is working to develop a monitoring system for inappropriate underservice as CT’s health system moves toward shared savings payment models. Underservice can be denial of appropriate care, limiting expensive treatment options, limiting access to certain providers, avoidance of consumers that may not generate savings, or cost shifting to consumers.…
Read More$3 million in ACA insurance rebates coming to CT residents
69,186 CT residents will soon receive $3 million in rebates from insurers that spent less than 80% (individual coverage) or 85% (large groups) of premiums on medical or quality improvement services last year. The rebates result from Medical Loss Ratio provisions in the ACA. CT’s total is down from $5.6 million in total refunds for…
Read MoreQuestions for SIM about radical new Medicaid proposal
Questions sent yesterday for today’s meeting about SIM’s risky, new Medicaid proposal have been posted. One asks why a dangerous 1115 waiver is necessary? Did SIM planners explore other, less dangerous options? 1115 waivers necessarily include a cap on federal reimbursement (to meet the federal budget neutrality requirement) endangering the state budget and potential future…
Read MoreCT News Junkie Op-Ed: SIM shouldn’t just chase a federal grant
A new Op-Ed in CT News Junkie outlines consumer advocate concerns that SIM planners are putting their pursuit of a federal grant ahead of what’s best for CT. Contrary to the original plan, SIM leaders are now planning to move Medicaid back to an incentive scheme similar to the failed HUSKY HMOs. Since we moved…
Read More