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Connecticut Health Policy Project
  Improving Connecticut's Health Through Information

CT Health Reform Dashboard

November 2017

2017 Health Thought Leader Survey - CT gets C+ for health reform, Mistrust is serious and pervasive

Current Status

Down Troubling Medicaid payment reform ignores data and serious red flags
 ?  Federal risk and uncertainty about Medicaid and the ACA easing
down Concerning budget proposals to cut health care - more HUSKY parents at risk
Up Health Care Cabinet reviewing policy options to control drug costs
down Mistrust growing in CT health policymaking, threatens all progress
down Broken Medicaid promises on downside risk and consumer notices, weak evaluation of risky new payment model, useless consumer notices, and secret implementation meetings undermine trust and transparency
Up Medicaid savings, quality improvement at risk
Up SIM ethics concerns grow
 

Action Items

  • Delay PCMH+ expansion until there is data on the first wave, avoid past mistakes
  • Begin building trust in CT's health care system
  • Protect consumers and taxpayers from payment models with incentives to deny appropriate care
  • Tell Medicaid consumers the truth about new payment models
  • Ensure reforms make sense for Connecticut - follow best evidence, not failed theories
  • Strong conflict of interest provisions in all programs and policies

 

Medicaid down

  • Nothing works perfectly the first time - Delay expansion of risky payment model to 200,000 more people until we know what worked and what didn't
  • Open all PCMH+ planning and implementation meetings to public view
  • Tell consumers the truth about risks of new payment model experiments
  • Troubling PCMH+ evaluation plan – too little, too late
  • Troubling efforts by unaccountable ACOs to shift costs onto taxpayers, generate false savings payments

Payment & Delivery Reform Down

 

Quality Down

  • Quality information confusing, not easy to access
  • Comparative effectiveness research not well used in policymaking or consumer information
  • Serious, ongoing quality problems across CT hospitals and community centers
  • SIM rush to "align" quality metrics, especially for payment, across diverse populations leaves many out, not protective or meaningful

Health Insurance Down

  • Make affordability a standard for rate setting
  • Build a public option for coverage
  • Must regulate ACOs as they take on financial risk
  • Insurer-dominated insurance exchange board, members with conflicted interests and investments
  • Privacy and security concerns throughout insurance sector

Health Information Technology ?

  • New state HIT plan repeats familiar problems, ignores consumers
  • Physicians building an HIE because government can't/won't
  • Must protect privacy and security of sensitive patient medical information
  • All-payer claims database development slow, rejected consumer privacy protections

Workforce Down

  • Private nursing capacity initiatives filling state policy vacuum
  • Need more clinical training slots
  • Build primary care capacity
  • New and renewed skill training for current professionals

CT Health Reform Dashboard Archive