OP-ED | Be careful when making changes when the glass is half full

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Eileen Andrews

There’s good news about health spending in Connecticut — and we can use it. New data analysis He found, not surprisingly, that Connecticut residents spend a lot on health care. But the good news is that our average annual growth rate, at 1.8%, was the ninth lowest among states from 2013 to 2019.

In 2014, Connecticut spending was seventh nationwide, but by 2019 spending had fallen to eleventh. We are doing something right. Before making big (or even small) changes, we should be careful to sort the kids out of their bath water. We need to follow the evidence, build on what works, fix what doesn’t, and avoid shiny new policy trends that don’t work elsewhere.

in an extraordinary effort, Fourteen researchers from the University of Washington Institute of Health Metrics and Evaluation Compare spending per person on health care across states from 2003 to 2019, before COVID hit. Unlike the controversial Office of Health Expenditure (OHS) Project Cost Cap To reduce the growth of health care spending in Connecticut, Washington researchers showed their calculation. They publicly identified their data sources, reflecting standard federal research, and tested 368,640 models to see which had best predicted past spending. Unlike OHS, University of Washington data allow us to compare Connecticut to other states – apples to apples. They’ve also done it publicly Publish their data online, unlike OHS. This is how you build trust in policy making.

Data analysis to focus on ConnecticutWe found lessons and evidence to guide policymakers to improve our spending on health care. Per capita spending growth in Connecticut slowed dramatically after the 2008/2009 recession and never recovered to the same levels. Between 2005 and 2019, Medicare costs grew faster. Unlike the years after managed care plans, I left Medicaid when we tested it Big savingsSince 2005, Medicaid spending per capita has risen above private coverage. Policymakers need to dig into this and determine whether we are getting better value for this spending.

Hospitals are the largest share of healthcare spending per capita in Connecticut, consuming more than a third. But hospitals are also responsible for the largest share, 61%, of the total increases. Unlike previous years, growth in drug spending lagged behind costs for both hospitals and doctors/clinics between 2005 and 2019. Fewer new brand names and patent-protected drugs have been released in recent years, and many more expensive new drugs are being delivered in hospitals and doctors’ offices, so They are found in various budget items. to tackle hospitals that are raising healthcare costs, Policymakers need to step back On large monopolistic health systems that raise prices and restore competition in the markets.

Connecticut’s costs per capita are similar to neighboring states with similar personal incomes, and it is the largest contributor to spending per person according to University of Washington researchers. However, total costs per capita from 2005 to 2019 grew more slowly than comparable states and equal to the Massachusetts rate. Since 2013, Massachusetts has a project cost maximum Like the one that Occupational Health and Safety intends to implement in Connecticut. The Medicaid per capita rate in Connecticut has grown faster than comparable states, but our private plan costs are growing more slowly. Hospital spending per capita is growing faster than other countries and our drug costs are slower than other countries.

The Affordable Care Act had a tremendous impact in covering more Connecticut residents, expanding services, and reducing out-of-pocket costs, but the impact on health care spending was surprising. The 2008/2009 recession had a massive impact on reducing spending growth. In contrast, the ACA slightly reduced the growth of total healthcare spending per capita in our state by 12%. Spending on Medicaid, Medicare, and personal spending fell after the anti-corruption law was introduced, but private costs per capita rose. There are likely multiple reasons for this like healthy populations getting into Medicaid, Medicare fixes, fewer uninsured paying higher health care rates, and more people eligible for special coverage due to bans on pre-existing conditions.

Connecticut needs to adopt thoughtful, independent, evidence-based policy – without bias. We have to resist convenient myths and health policy patterns that don’t work, like pour money To primary care to save money, transformation Financial risks for Medicaid providersAnd the The myth of lower Medicaid provider payments raise commercial prices. Effective policymaking follows data, even when it conflicts with strong biases and self-serving narratives. We can’t afford to keep disrupting things that work.

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