Search results for: SIM
Maryland’s SIM proposal emphasizes quality improvement, community resources and engagement
Maryland’s newly released SIM proposal includes many attractive features CT advocates have been championing for our state. Quality improvement and sophisticated analytical tools to support quality are MD’s priority and constitute most of their proposal’s content. The foundation of their plan is to “integrate patient-centered care with community-based resources while enhancing the capacity of local…
Read MoreSIM proposal draft – no commitment to deny payment to providers who deny care
During yesterday’s meeting, SIM leaders posted their first draft online of the administration’s plan to reform health care in CT. SIM is designed to radically transform how health care is delivered and paid for in our state across all payers – Medicare, Medicaid, private insurance, self-insured employers, individuals and small businesses. Despite earlier encouraging conversations,…
Read MoreSIM update – moving in a better direction
Yesterday’s SIM meeting showed some positive movement toward a system that respects and protects consumers. Recognizing the potential harm to consumers, SIM leaders now intend to monitor for under-treatment and inappropriate treatment, and the payment model no longer includes capitation, both serious concerns raised by advocates. However advocates remain troubled that there is no…
Read MoreSIM forum with advocates
This morning, SIM leadership held a forum to explain their plan to advocates. Unfortunately few independent consumer advocates were given an opportunity to ask questions, including this one. Most of the time was taken by SIM committee members expressing their positions, describing their programs and experiences. Many of the questions came from providers and…
Read MoreSIM update — questions about numbers driving policy
Significant questions have been raised about the methodology and sources for the Sept. 17th SIM presentation (slide 30) asserting that 62% of primary care providers in CT currently have provider risk/shared savings/total cost of care arrangements with providers. Questions relate to whether the populations included are representative of the state, provider types included, whether…
Read MoreSIM update
The September meeting of the SIM steering committee changed little to the plan except the name of the payment model. The planners reported to the committee what will happen in the next phase of the process. They changed the name of their provider risk-based payment model from Total Cost of Care to Shared Savings,…
Read MoreCT Mirror reports on SIM proposal – administration agenda and advocate concerns
An article yesterday in the CT Mirror describes the administration’s plans to apply for millions in federal dollars to radically redesign CT’s health care system – not just Medicaid and the state employee plan, but for all state residents. The article points out that the administration is working with providers and insurers to design…
Read MoreConsumer advocates provide constructive input to SIM
Today a letter was sent to state SIM planners from 24 CT consumer advocates representing 21 organizations proposing an alternative to the state’s proposed SIM plan. The SIM project, funded with a $3m federal grant, is developing payment and care delivery models for at least 80% of state residents – 3 million people or…
Read MoreSIM and Cabinet meeting update
Yesterday’s Health Care Cabinet meeting wasn’t very enlightening. The SIM report on consumer outreach was pretty much as expected. Consultants reported on focus groups with HUSKY and uninsured consumers and described plans for an online survey. Not surprisingly, they found lots of complaints about challenges accessing health care, stigma and poor treatment. They did…
Read MoreSIM update
The SIM steering committee reviewed final recommendations from their work groups yesterday. The SIM project is developing payment and care delivery models for at least 80% of state residents – 3 million people or more and $30 billion in CT health spending. The recommendations are very detailed and specific, but they maintain that there…
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