SIM underservice protections get a cool reception, weak ethics policy adopted

Thursday the Equity and Access Council delivered to the SIM Steering Committee a draft report with recommendationsto avoid underservice in SIM’s planned payment reforms. Advocates were successful in getting a provision in the SIM final plan that prohibited payment of shared savings to provider networks that systematically denied needed care to generate those savings. The…

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SIM ethics concerns intensify with first grants choice

Monday the Lieutenant Governor’s office announced the award of SIM’s first grants from federal funds; two of the four recipients are represented on theSIM Steering Committee. The members represent Northeast Medical Group (Yale-New Haven affiliate) and St. Vincent’s Health Partners. This would have been prohibited under the state’s Code of Ethics but for a loophole…

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CT News Junkie reports on SIM ethics debate

Today’s CTNJ is reporting on the SIM ethics debate. The article points out that the weak conflict of interest policy proposed by SIM staff and adopted by the steering committee admits “Members of the advisory bodies may participate in program design and development decisions, even if they or their organizations may potentially reap a benefit.”…

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SIM punts on ethics

In response to the recent state Ethics Board Declaratory Ruling the SIM steering committee took up ethics at their meeting last week. The Ethics Board found that because SIM committee members are appointed by the Lieutenant Governor, SIM was not covered by the state Code of Ethics for Public Officials that applies to similar policymaking…

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CTNJ reports on SIM conflict of interest in grant applications

  Today’s CT News Junkie highlights the ethics loophole that has allowed a SIM steering committee member to apply for SIM funds to his organization. The loophole in the law, identified by the Citizen’s Ethics Board, is that appointees of the Lieutenant Governor are not subject to the Public Official’s Code of Ethics. The Code…

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Ethics Commission recommends SIM adopt conflict of interest policy, pursuing change in the law to close “loophole”

At yesterday’s meeting, the state Ethics Commission issued an opinion that, due to a giant loophole in the law, SIM committee and Consumer Advisory Board (CAB) members are not subject to the Code of Ethics for Public Officials but acknowledged significant potential for conflicted interests and so recommend that SIM adopt such a policy voluntarily.…

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CT conference on SIM payment reforms in other states

Yesterday the CT Health Foundation hosted an interesting conference highlighting SIM plans from leading states – VT, OR, MN, and ME. The conference started and ended with reports from CT’s DSS about our significant Medicaid successes in improving quality and access while controlling costs – and how that progress was only possible when we shifted…

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SIM responds to advocates’ Medicaid concerns

Monday the Lieutenant Governor responded to a letter signed by independent advocates signed by twenty independent consumer advocates and providers raising concerns about SIM’s plans for Medicaid. In her letter, the Lieutenant Governor agreed that CT’s Medicaid program has become a national model of success, improving access to care, raising quality and controlling costs. Those achievements resulted…

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Only 36% of CT physicians have any shared savings arrangements, correcting questionable SIM estimates from 2013 driving expansive policy

UConn’s new SIM survey of CT physicians found that currently only 36% of CT physicians participate in any shared savings or ACO program. There is no information on whether shared savings are a significant part of revenues in even the minority of physicians who are in this payment model. Not surprisingly, shared savings is slightly…

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20 independent advocates share concerns about SIM’s plans for Medicaid

Yesterday twenty independent consumers, advocates and providers sent a letter to the Lieutenant Governor expressing our grave concerns about the “current plans for widespread precipitous changes” in Medicaid’s payment model. The letter outlines concerns about re-imposing financial risk, this time on providers of care, that creates incentives to deny needed care. States with far more…

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