Healthcare: State Initiatives Update

In addition to dealing with the changes you often hear about under the Affordable Care Act (ACA), the state also is working on other health policy initiatives that are designed, in part, to help address the cost of healthcare in Connecticut—a top concern for many employers.

But because these initiatives, which include an All Payers Claim Database (APCD) and State Innovation Model (SIM), could have impacts beyond cost, businesses need to be aware of their development.

All Payers Claim Database

The All Payers Claim Database (APCD) is a large scale database that collects and aggregates medical data from private insurance companies, including self-insureds, as well as public payers such as Medicare and Medicaid. 

Housed within the state’s health insurance exchange, the APCD is designed to help consumers make better decisions about their care by providing more information about healthcare cost and quality.

Policies on how the data will be handled and utilized by interested parties are still being drafted.

While the database has the potential to become a powerful tool for consumers, it should be closely monitored on how it collects, uses, and protects data because of the sensitive nature of the information and its wide-ranging uses. 

State Innovation Model

Connecticut received about $3 million in federal funding to develop a State Innovation Model (SIM) for payment and delivery reform for medical services.

The SIM is attempting to address a range of goals for Connecticut including better health, better quality and a reduced rate of growth in healthcare costs. 

The state just released its first draft of the model and is currently accepting comments. The draft was developed with input from a 17-member committee chaired by Lt. Governor Wyman but is already facing concerns about whether the draft SIM provides adequate safeguards to ensure patients are not denied care.

CBIA will continue to follow developments with the SIM model, especially considering it already is meeting resistance. 

For more information about healthcare issues, contact CBIA’s Jennifer Herz at 860.244.1921 or jennifer.herz@cbia.com.