Support argues that a series of legislation designed to reduce health care costs and divert more spending to primary care impairs access to treatments that require action, especially for people with disabilities. It spurred the opposition from the person.
House Bill 5042 empowers the Office of Health Strategy to set an annual benchmark for health care costs. If costs exceed these benchmarks, the state will discuss the impetus for growth with providers and insurance companies. These meetings will not be open to the public, said Vicky Bertri, executive director of the office.
“There is no enforcement mechanism,” said Senator Matthew Lesser, co-chair of the Insurance and Real Estate Commission. “That’s just a shame.”
This tactic is also used in several other states, such as Massachusetts, Delaware, and Rhode Island, but conversations usually take place in public forums. Maureen Hensley-Quinn, Senior Program Director at the National Academy for State Health Policy, helps us understand the causes of increased costs, collect data on health care costs and inform policy making.
Senate Bill 15 aims to promote increased use of primary and preventive health services by requiring insurers to provide a “form of health promotion program” available to state employees. .. State programs require regular preventive tests based on age.
These plans must be implemented by January 1, 2024.
Both bills were proposed by Governor Ned Lamont’s office.
“Life is busy and the American health system is often difficult to navigate,” Lamont policy director Johnny Duck said in a statement in support of the bill. “As a result, many of us have postponed life-saving prevention services.”
It also sets requirements for insurance companies to post contact information for primary care services and to set up a hotline on their health insurance cards with detailed information about those services.
If the bill is passed, the presidential directive two years ago will be permanent, allowing the Department of Health Strategy to set an annual benchmark for health care costs and monitor spending growth.
Opponents, in summary, argue that the proposed law limits access to specialty health care, including behavioral health, dentistry, and home care providers.
“The combined legislation could adversely affect access to health care for all patients, especially those with disabilities, the elderly, and blacks and browns who are already suffering from health inequalities,” said the disabled. Sheldon Toubman, a legal counsel for rights in connection cuts, said. Written testimony.
If the housing bill limits overall health care costs and the Senate bill succeeds in increasing primary care spending from 5% of total spending to 10% by 2025, the resources available for other types of care Fewer, supporters held a hearing this week in front of the Insurance and Real Estate Commission.
The state has developed plans to monitor adverse effects, Bertrix said. The plan is “providers improperly reduce access to medical services, especially for those left out of society, and insurers transfer costs to consumers to curb use and spending. We acknowledge that unintended adverse effects may occur.
“There are things you can do here and there,” Veltri said. “As a result of the benchmark, no state has adversely affected access to care and access to services.”
Some of the means to monitor care include well care visits for children and adolescents, prenatal and postnatal care, and breast cancer screening.
Proper preventive and primary care can reduce the need for other services, such as emergency room services, said Dr. Deidre Giftord, Commissioner of the Social Welfare Department, in an interview.
Other ways to reduce overall costs without sacrificing service include using outpatient procedures where possible rather than inpatients, Veltri said.
Lamont spokesman Max Rice said in an email that the Governor’s focus on housing bills is to reduce rising health care costs, with no evidence that it will cost them. Said.
“The governor understands the importance of dental care, home care, behavioral care, and other professional services, especially for people with chronic and complex conditions,” Reiss wrote.
Some states are considering ways to invest in primary care. In many cases, overall spending on other types of health care far outweighs spending on primary care, said Hensley Quinn of the National Academy of Health Policy.
“Focusing on primary care doesn’t necessarily mean focusing on other care,” she said. “I think you have to start somewhere, and other states start from similar places.”
Proponents also said that including the Department of Health Strategy in charge of “development, innovation, command and supervision of health care delivery and payment models” in the House bill means that the state will promote a payment capitalization system in Connecticut. I’m afraid to do it. In the capitalization system, providers are paid per patient, not step by step.
Reese said the bill did not approve the system.
“Under this bill, OHS does not have the authority to require any commercial or Medicaid payer to implement, modify, or otherwise implement any type of payment system.” Reiss said.
But supporters are worried about what will happen in the long run.
Ellen Andrews, Executive Director of the Connecticut Health Policy Project, said the capitalization system can encourage healthcare providers to reduce the frequency of patient visits.
“they [the state] Andrews added that the state needs to monitor more measures to ensure that people are receiving the care they need.
The Steering Committee, established by the Department of Health Strategy, has drafted a plan to enhance primary care, including parameters of the capacity system.
Providers and insurance companies can choose alternative payment methods and the Office of Health Strategies does not require participation. Rather, they will oversee the process of developing alternative payment methods for those in need, Veltri said.
“The work we do is really collaborative work that people want to embark on together to tune the system,” she said.
Critics say that the capacity system motivates doctors to take on more work and provide less service to patients, often introducing patients to specialized services that they may not need. Say to choose.
However, proponents of such a system say it reduces overcharging and reduces the bookkeeping costs of doctors who can provide more services to patients with additional cash.
This gives healthcare providers room to hire professional staff such as nutritionists and community health workers, allowing patients to meet more needs in their GP’s clinic, Bertrix said.
The state has been promoting such a system for years, Toubman said.
“You can save money from capital. You’re paying less than before, but what’s the price?” Toubman said.
Bertrix said her office offers payment options and information, but does not have the authority to mandate those options.
Mr Lesser said his supporters’ concerns were even more focused and he thought the bill should be considered on the basis of their own merits.
“The last thing I want to do is reduce the care needed and needed,” Lesser said. “Now let’s discuss the content of the bill.”
Still, the supporters are cautious.
“”It’s all sorts of “trust us” and that’s not enough. That’s not enough, “Andrews said.
