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Health Payment Transition Plan Could Net CT $70 million

PHOTO: Doctor with x-ray
PHOTO: Doctor with x-ray
October 11, 2012

HARTFORD, Conn. - The Connecticut Department of Public Health is hard at work trying to secure up to $70 million in Affordable Care Act money to help the state revolutionize the way health providers get paid.

The big idea behind the Affordable Care Act funding is to devise a payment system that makes quality the priority, says Jill Zorn, senior program officer at the Universal Health Care Foundation. That represents a major shift from the current payment system for most health-care providers in Connecticut and the nation, she says, in which their fees are based on volume.

"Hospitals get paid per test, per admission, and many experts agree that we need to transition to a system that pays for outcomes - and pays for quality."

It's a big job. That's why the Affordable Care Act will award the state $70 million if it comes up with a winning application. Zorn says the Universal Health Care Foundation and the Connecticut Health Foundation matched a grant from Grantmakers in Health to give the state $45,000 to hire a team of specialists to apply for the federal dollars.

Jeanette DeJesus, who advises Gov. Dannel Malloy on health issues as director of the state Office of Health Reform and Innovation, says a winning application needs to reflect the views of all of the players in the health-care system.

"You're basically looking at completely revolutionizing the way that the health system currently functions. So, you need the insurers in the room at the table, you need the providers - the doctors, the nurses, the assistants."

DeJesus says the tricky part is devising a payment system that incorporates the various roles of doctors, nurses, hospitals, insurers and nonprofits.

"Where you can integrate the type of work they do in order to keep you really healthy, or improve your health; and then for the doctor and the practice to be reimbursed for keeping you well, and for eliminating waste in the system."

Dejesus says the state should learn the fate of ACA funding by early December.

More information is online at healthreform.ct.gov.

Mike Clifford, Public News Service - CT