Search results for: cost cap
SIM update: PCMH standards affirmed but rushing into a radical Medicaid payment change
The good news: At yesterday’s meeting the SIM steering committee voted to accept their workgroup’s recommendation to use NCQA national standards, with some CT-specific additions, as the patient-centered medical home (PCMH) standard for the SIM glide path program. SIM will work with NCQA to develop the additional standards, possibly to include oral and behavioral health…
Read MoreSIM update – good news but new concerns
Last week’s SIM steering committee included some good news but new concerns. Based on public comment from independent advocatessupporting national standards for patient-centered medical homes and urging SIM to reconsider their decision to create a CT-specific standard, wasting time and resources to fix something that is not broken and working well. In response, the committee…
Read MoreMedicaid Council update
The agenda for last week’s Medicaid Council meeting was very full. We reviewed DSS’s latest ConneCT Dashboard. More clients are using the online system, but more are also walking into a DSS office. The backlog of documents to be scanned is gone and last month the online system was never down. However, the call abandonment…
Read MoreAnthem & ConnectiCare premiums submitted are up sharply for 2015, HealthyCT rates down — updated
Proposed premiums for the insurance exchange were due to the insurance dept. Friday and they are up significantly from this year’s premiums, according to CT Mirror. Anthem’s proposed premiums are up 12.5% on average; ConnectiCare’s base rate is up 11.8% for next year. CT’s premiums for this year are the 4th highest in the nation…
Read MoreNews: Independent CT hospitals discussing tiered networks, Pre-ACA CID routinely approved very high rates for Aetna
The Hartford Business Journal is reporting that some smaller, independent CT hospitals are in discussions with each other and with insurers about options that improve their efficiency and make coverage more affordable. The hospitals are talking with insurers about value-based insurance designs or tiered networks where consumers who choose to access care at lower priced…
Read MoreCTNJ op-ed: Privacy and trust concerns at CT’s APCD
Advocates are raising concerns about the privacy of sensitive medical records at Access Health Analytics, our state’s all-payer claims database (APCD). At the CT Health Policy Projects we have been great supporters of an APCD for CT knowing that, if done well, it could be a powerful tool to give consumers information about the cost…
Read MoreCHC quality conference: Reimagining primary care
Yesterday’s ninth annual Weitzman Institute conference on improving the quality of care did not disappoint. National and CHC, Inc. speakers touched on workforce and technology innovations to build primary care capacity and improve quality of care, engaging youth in coverage expansions, connecting medicine to community services to stop the expensive treadmill of treating preventable health…
Read MoreHealth Care Cabinet meeting — SIM, exchange updates
Yesterday’s Cabinet meeting was lively — not sure it was productive. The insurance exchange reported on a flurry of last minute activity that significantly boosted enrollment. Final numbers will be available in a few weeks when it becomes clear how many people follow through and pay premiums, and the backlog of people in the queue…
Read MoreSIM comments on financial incentives, consumer surveys
SIM has started floating their proposals to implement health care reform in CT and #2in particular is troubling for consumers. One proposal offered as a financing option by SIM staff would replace advanced payments for new, effective services such as care coordination and medication management with shared savings payments. This could create unfortunate incentives to…
Read MoreMedicaid Council update
Today’s Medicaid Council meeting focused on continuing problems with enrollment and recommendations to reduce Medicaid ED use. In response to a letter from Council members, we learned that 63% of calls to the DSS Benefits Center from August through December 2013 were dropped – people waited 17.5 minutes on average before hanging up. Things are…
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