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Health Care Opinion

September 10, 2018

OP-ED | Health Disparities Are Real and New Payment Schemes Are Probably Making Them Worse

by Ellen Andrews | Sep 10, 2018 10:05pm
Posted to: Opinion | Health Care Opinion

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Connecticut is a very healthy place; we rank fifth healthiest among states. But not all state residents share in that good fortune; too many suffer from health inequities. Good people across the state are doing important work promoting better health for everyone. However some emerging policies, both government and private sector, are working at cross purposes to those efforts.

The chief policy risk to health equity is provider risk — the latest shiny new thing in how we pay for healthcare.

Continue reading "OP-ED | Health Disparities Are Real and New Payment Schemes Are Probably Making Them Worse" »

August 7, 2018

ANALYSIS | Capitation vs. Fee For Service: Which Team Are You On?

by Ellen Andrews | Aug 7, 2018 7:19am
Posted to: Opinion | Health Care Opinion

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There is a sharp divide within Connecticut’s healthcare community over how to pay for care that’s as fervent as the Yankees vs. Red Sox split. Some believe that capitation is the holy grail, but others believe that fee for service isn’t the problem and isn’t broken.

But both sides are fighting over something that’s almost irrelevant. It’s a bit like thinking that whether you pay for your ticket to a baseball game with cash or a credit card affects which team wins. Good teams succeed because they are smart; they use data and manage the pitch count, attract great talent and develop a solid farm team, and are lucky to keep great players off the disabled list. The game works because of accountability (umpires) and transparency (instant replay). Healthcare isn’t that different.

Fee for service is just what it sounds like — health professionals and institutions are paid for the services they provide. Fee for service has evolved and improved over the years; most now include features to encourage better care from simple prior authorization to sophisticated bonuses for quality and efficiency. Team Capitation argues that fee for service drives over-treatment since it pays more for more services. This may be true in plans where providers are well compensated, but if providers lose money on each service, as in Medicaid, that argument falls apart. Team Capitation also asserts that fee for service inhibits innovation, but we pay for many things individually, like computers, that have improved immensely over time.

Continue reading "ANALYSIS | Capitation vs. Fee For Service: Which Team Are You On?" »

July 10, 2018

OP-ED | Facts and Data Are Stubborn Things

by Ellen Andrews | Jul 10, 2018 10:46pm
Posted to: Opinion | Health Care Opinion

Big data is revolutionizing healthcare. The ability to collect reams of detailed information about how care is provided, how much it costs, and then to link that back to effectiveness and outcomes is powerful.

Continue reading "OP-ED | Facts and Data Are Stubborn Things" »

May 22, 2018

ANALYSIS | Healthcare Questions for Connecticut’s Next Governor

by Ellen Andrews | May 22, 2018 9:15am
Posted to: Analysis | Business | Child Welfare | Consumer Protection | Corporate Watch | Election 2018 | Health Care | Mental Health Care | Insurance | Opinion | Health Care Opinion | Member Opinion | Public Health | Poverty

How will Connecticut’s next governor fix the state’s healthcare system?

Continue reading "ANALYSIS | Healthcare Questions for Connecticut’s Next Governor" »

April 2, 2018

OP-ED | Connecticut Should Be Careful Building A Public Insurance Option Through Medicaid

by Ellen Andrews | Apr 2, 2018 8:51am
Posted to: Opinion | Health Care Opinion

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Health insurance is too expensive in Connecticut and it may get worse with troubling new federal policies. But one proposed state solution isn’t as simple as it sounds. HB 5463, An Act Concerning a Medicaid Public Option, proposes to study the idea of creating a public health insurance option based on Connecticut’s successful, very efficient Medicaid program.

Continue reading "OP-ED | Connecticut Should Be Careful Building A Public Insurance Option Through Medicaid" »

February 22, 2018

OP-ED | Advocates Must Inform Consumers of Risks When the State Won’t

by Ellen Andrews | Feb 22, 2018 9:56pm
Posted to: Opinion | Health Care Opinion

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This week, independent advocates launched PCMHPlusFacts.org, a campaign to give HUSKY members balanced information about an experimental, new payment model expanding across the program.

Continue reading "OP-ED | Advocates Must Inform Consumers of Risks When the State Won’t" »

January 25, 2018

ANALYSIS | CT Health Reform Reaches New Low, But There Are Hints Of Optimism

by Ellen Andrews | Jan 25, 2018 10:42am
Posted to: Analysis | Health Care | Insurance | Opinion | Health Care Opinion | Public Health


Connecticut healthcare thoughtleaders gave our state a “C” for health reform this year, the lowest grade in our survey’s five years. None of the dozens of leaders across Connecticut’s health care system who responded to the survey gave the state an “A.”

The biggest losses this year were in Medicaid and data-based policymaking, but performance in every issue area has eroded. As in the past Connecticut rated a slightly higher C+ grade for effort. I’m not sure if that is a good thing or not.

In the annual survey we ask Connecticut doctors, nurses, hospitals, other providers, reporters, insurance executives, academics, community and faith-based organizations, labor, employers, trade and industry associations, business leaders, brokers, payers, foundations, and consumer advocates for their assessment of our state’s progress, but this year we also asked about the impact of changes at the state and federal level and for their best advice to the next Governor. There is a lot of wisdom for policymakers in their responses.

Continue reading "ANALYSIS | CT Health Reform Reaches New Low, But There Are Hints Of Optimism" »

January 17, 2018

OP-ED | Replacing The Individual Mandate With Something Better

by Ted Doolittle | Jan 17, 2018 7:17am
Posted to: Opinion | Health Care Opinion

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The Affordable Care Act’s unpopular individual mandate has been repealed as part of a massive tax overhaul, leaving most other elements of the ACA in place. No part of the ACA is less loved than the individual mandate, a tax designed to encourage uninsured folks to get health insurance. It hits working people who do not have insurance through their jobs, but who don’t realize they qualify for the ACA’s no-cost or low-cost insurance options – or who make too much to qualify for assistance, but can’t afford to buy health insurance on their own.

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January 10, 2018

OP-ED | Prescription Costs Are Squeezing Out Other Connecticut Priorities, But We Have Options

by Ellen Andrews | Jan 10, 2018 11:30am
Posted to: Analysis | Health Care | Insurance | Opinion | Health Care Opinion | Public Health | State Budget


Connecticut’s state budget is out of balance, reflecting the weakness in our state economy. Policymakers have been forced into compromising support for critical priorities, in healthcare and beyond.

Continue reading "OP-ED | Prescription Costs Are Squeezing Out Other Connecticut Priorities, But We Have Options" »

December 22, 2017

OP-ED | Policy Failures: Why Healthcare Innovations Don’t Travel Well

by Ellen Andrews | Dec 22, 2017 1:40pm
Posted to: Opinion | Health Care Opinion


Too often policymakers, advocates and others return from conferences or read reports highlighting great ideas that are working in other states. But when we try to implement them here in Connecticut, they too often fail. Not every good idea fails, but too many do.

Each failure erodes our enthusiasm for reform and builds cynicism. This problem isn’t limited to Connecticut, but it happens a lot here. While each failure is unique, there are a few Connecticut-specific themes – politics, failure to monitor and evaluate, conflicts of interest, and missing the essential point of the good idea.

Continue reading "OP-ED | Policy Failures: Why Healthcare Innovations Don’t Travel Well" »

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