Group Proposes Ways to Lower Healthcare Costs
Even between General Assembly sessions, state healthcare policy is getting a lot of attention.
In particular Lt. Gov. Nancy Wyman’s Healthcare Cabinet has engaged consultant Bailit Health to come up with recommendations to address the rising cost of healthcare in Connecticut.
Consisting of providers, consumer advocates, state agency representatives, and other stakeholders, the cabinet’s goal is to present a set of legislative recommendations that would be made into law.
After being hired by the cabinet to conduct a cost containment study, Bailit Health met with several stakeholders, including CBIA’s Health Affairs Council, and recently developed recommendations for the cabinet to consider.
The recommendations breakdown into seven general categories:
1. Consumer Care Organizations
This applies to Medicaid and state employee health plans. It’s a shared savings arrangement with providers that gives providers a financial stake (including downside risk) in healthcare delivery and:
- Builds on the existing State Innovation Model agenda
- Creates community health teams, which will support patients in the community with a diverse range of individuals from pharmacists to social workers; the suggestion is that carriers pay for these teams
CBIA has commented in support of the continuation of the SIM initiative and is generally supportive of further investigation into the concept of community health teams. However, since the proposal did not offer details regarding implementation or payment, we could not provide specific feedback. CBIA did not comment on the CCO model.
2. Cost Target
The original proposal called for a cost-growth cap on payers. The cabinet revised the original proposal to eliminate a hard cap and instead is considering a shared target for cost growth, but without sanctions for not meeting the target.
CBIA provided general comments supporting further investigation into this recommendation.
3. Align State Strategies
The original report called for the consolidation of state agencies and the creation of a Health Policy Council, but the cabinet revised the recommendation to instead consider the creation of an Office of Health Strategy that will oversee healthcare strategy in the state and be advised by the cabinet.
CBIA agrees with the need for better alignment and coordination of state healthcare initiatives, but further investigation is needed to determine how to best achieve those goals.
4. Expand Attorney General’s Powers
Under this proposal, Connecticut’s attorney general would have the power to collect information from any provider or payer to monitor healthcare market trends. Wyman reported that Attorney General George Jepsen is open to this proposal but is concerned that he does not have the budget for it.
CBIA did not comment.
5. DSRIP Funds/1115 Waivers
Connecticut would apply for federal Delivery System Reform Incentive Payment funding through Medicaid Section 1115 waivers to help Medicaid providers update their technology.
CBIA did not comment.
This proposal would require the Health Information Technology Officer (through the existing Health Information Exchange effort) to provide information to the Office of Healthcare Strategy.
CBIA did not comment.
7. Evidence in Policymaking
Under this proposal, a committee within the Department of Public Health would make recommendations to the Department of Social Services and the Office of the Comptroller, using well-established outside medical-evidence review organizations to make coverage decisions.
The committee would also be influenced by a stakeholder group that includes consumers.
CBIA believes this recommendation requires more information before we can provide feedback. While evidence-based decision-making is a sound concept, we have a few concerns with this proposal, including the role a stakeholder group would have in decision-making and the type of resources needed for implementation.
CBIA also supported Connecticut Insurance Commissioner Katharine Wade’s letter to the cabinet expressing the need for more flexibility in network design.
The cabinet recently received public comments on their recommendations and plans to make its final decision at its Dec. 15th meeting.
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