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Seeking nominations for CT thought leaders

Tuesday, July 31, 2012

We are refreshing our invitation list for the CT Health Thoughtleader Survey. The survey has been cited by policymakers as a tool in evaluating our state’s progress toward reform. It is part of our CT Health Reform Dashboard. To keep the list robust and ensure a broad reach, we are seeking nominations for the survey. Who do you rely on for information on health reform in CT? Help us improve the tools for our state’s health policymakers and give us your nominations.

Health Insurance Exchange Board recommends standards for benefit package

Monday, July 30, 2012

Last week, the CT Health Insurance Exchange Board voted on their recommendation for the benchmark essential health benefit (EHB) package that must be offered in 2014 by all individual and small group plans, both inside and outside the Exchange, under national health reform. Federal regulators granted states the ability to define the EHB package, within guidelines. The plan is modeled on ConnectiCare’s HMO package, with additions including coverage for prescription drugs and pediatric vision and dental care. The plan includes all state mandated benefits. Abortion coverage is included but must be paid with non-federal funds. The choice of ConnectiCare’s package was a compromise reached in two Exchange Advisory Committees in a contentious process. The plan represents the middle choice in generosity of benefits and price among the federal options. Thankfully, the Exchange Board honored the process of the two committees; advocates had been concerned that the insurance-dominated Board, that includes no independent consumer representatives, would choose a less generous option. The recommendation is now open to public comment for 30 days.

Affordable Medical Insurance - Health Insurance 101

Wednesday, July 11, 2012

If you don't know a deductible from a co-pay, or an HMO from HBO - you are not alone. But if you are among the growing number of Americans who are now using this marvelous tool known as the Internet to shop on their own for affordable medical coverage, these are terms you'll need to get comfortable with, or it can cost you. Lesson one - The Higher the Deductible The Lower the Premium The deductible is the amount that you have to pay out of pocket for covered medical expenses before the health insurance benefit kicks in. Deductible amounts are usually based on a calendar year. The surest and easiest path towards a lower cost heath insurance premium is still to select a plan with the highest deductible. Once you do that it is also a good idea to open up a specific account such as a Medical Savings Account to pay for medical expenses until the deductible is reached. Lesson Two - The Co-Payment The Co-Payment or "co-pay" is a specific dollar amount paid by the policy holder at the time of service of each healthcare visit. It is a fixed amount and does not build to a maximum amount like a deductible. Co-pays are another aspect of lowering health insurance costs that are in your control. You may be able to lower your premium rates by requesting higher co-pay amounts. If you are generally healthy and do not make many trips to the doctor electing a higher co-pay is a great way to ensure more affordable health insurance payments. Lesson Three - What Else you can do While many of the costs that are involved in creating a health insurance premium are fixed and non-negotiable there are other areas that we have seen like choosing a higher deductible or co-pay amount that can help reduce your health insurance rates. There are other things in your control as well. o Generic Drugs - if you do not have prescription drug coverage, always ask if there is a generic available for a given prescription medication. Several large pharmaceutical retailers such as Target and Wal-Mart have programs where many of the most popular generic drugs can be purchased for as little as $ 4.00. o Lifestyle Changes and Wellness Programs - another way to reduce your health insurance costs is to get in better shape. Quitting smoking and losing weight, after choosing the highest deductible and co-pay amounts, is probably the surest way to reduce a heath insurance bill. Many HMO's since it is in their best interest to have you remain healthy, will offer wellness programs, and preventive medicine screenings. Take advantage of these. Believe it or not some employer sponsored health insurance plans will even pay for all or part of a gym membership. It's all part of the concept of paying a little now to keep you healthy, rather than paying more later on.

Exchange Navigator Committee moves into recommendations

Yesterday the CT Health Insurance Exchange Brokers, Agents, and Navigators Committee started the hard work of developing a structure and defining roles for the Navigator Program. Navigators will educate and help enroll potential individual and small business exchange, and Medicaid enrollees. Under the ACA and federal regulations, navigators must have demonstrated ability to reach those three audiences, meet licensure and conflict of interest standards (yet to be determined), and meet certification standards set by the Exchange (also yet to be determined). Staff draft recommendations include two tiers of navigators. Tier 1 Educators will focus on raising awareness of the Exchange and Medicaid options, distribute impartial information about options and enrollment, and ensure cultural competence. They would be paid on a grant/lump sum basis. Tier 2 Enrollers will focus on collecting the information needed to determine eligibility for appropriate programs, assisting in enrollment, and follow up. The committee is still discussing how to compensate Tier 2 navigators. Organizations, not individuals, will be designated as navigators and can apply for Tier 1, Tier 2 or both functions, but individuals acting as navigators will have to receive the appropriate training and certifications. The committee is still discussing how to certify SHOP navigators. The committee also discussed providing training/information opportunities for stakeholder organizations and individuals who are not interested in certifying, or being paid, as navigators but want to help in outreach and public education.

The committee also reviewed new data from Thompson Reuters commissioned for the exchange on CT’s uninsured, Medicaid and likely exchange-eligible populations to help target outreach and education efforts. Initial analysis found that current uninsured and Medicaid populations live in the same communities, and a small number of urban zip codes, particularly in Hartford and New Haven, account for a significant part of both populations. Researchers estimate that there are currently 66,000 adults and 18,000 children in CT eligible for the current Medicaid program but not enrolled. They also estimate that 205,000 adults and 11,000 children will be eligible for subsidies in the exchange. There is a lot of information on citizenship, race/ethnicity, income levels, and the proportion having difficulty speaking English.

CT Health Intern conference July 24th

Tuesday, July 3, 2012

Breaking into Health: Tapping into Skills and Experience, is designed for anyone interested in breaking into CT’s health landscape to gain valuable skills from health professionals working in the real world of health care and policy. The free conference will be July 24th from 10am to 4pm at the Divinity School at Yale, is co-sponsored by the CT Health Policy Project and Dwight Hall at Yale. Speakers include Comptroller Kevin Lembo as well as reporters, business people, state agency staff, foundations, health care providers, advocates, and budget analysts. Parking and lunch are free but registration is limited. For more information and to register, go to www.cthealthintern.org.

The ACA and what it means for CT consumers and small business

Monday, July 2, 2012

While we are all celebrating the Supreme Court upholding the Affordable Care Act, consumers and small businesses want to know what it means in the real world. The CT Health I-Team has a great piece answering just that question.
 
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