News From Kevin Lembo

FOR IMMEDIATE RELEASE                                                                                                                          TUESDAY, SEPTEMBER 24, 2019

Contact: Tara Downes
860-702-3308
Tara.Downes@ct.gov 

LEMBO, FOLLOWING COMPETITIVE SEARCH, PREPARES FOR CT’S FIRST HEALTH CARE "CENTERS OF EXCELLENCE" PROGRAM

State Comptroller Kevin Lembo announced today that, following an intensive competitive search, his office is working with health care providers and corporations across Connecticut to establish the state’s first-ever network of “Centers of Excellence” – a system of hospitals and other providers that verifiably provide the best possible health care outcomes for patients. 

This will allow Lembo to ensure that the approximately 210,000 Connecticut working and retired families on the state health plan – and, ultimately every Connecticut resident – are equipped to make the most informed possible health care decisions. 

“Patients have been forced to make important decisions about where to receive treatment or have major surgical procedures with little to no information about which facilities have the best outcomes,” Lembo said. “This is unacceptable. Instead of leaving patients in the dark, the state will work with its partners to identify those facilities that are true Centers of Excellence. Patients will, for the first time, be able to see who performs best for each procedure or service and make informed decisions about where to receive care.”  

Following a competitive search and request for proposal process, Lembo has selected Remedy and Health Advocate to work with his office to establish a regional network of Centers of Excellence (expected to launch next year) for certain complex planned medical procedures, as well as Carrum Health, which will provide access to a national network of Centers of Excellence. Hospitals and provider groups that receive the designation of a Center of Excellence are those that have demonstrated a sustained commitment to excellence and can demonstrate the best patient outcomes.  

"It's a privilege to support the State of Connecticut in its efforts to significantly improve the quality and affordability of healthcare," said Kyle Armbrester, CEO of Remedy. "By aligning physicians, hospitals and other providers into a network of distinction and centers of excellence, and giving them clear incentives to drive better clinical and social outcomes, we believe that this program will be a guiding light for large and small employers across the country." 

This public-private partnership, pursuant to a contract agreement that Lembo’s office is negotiating, will allow Health Advocate to assist state health plan participants in getting their services at a Center of Excellence, and oversee financial reward incentives for patients willing to make smart health care decisions.

“The Northeast is home to some of the best health care providers in the country, which means no patient should settle for anything less than the best,” Lembo said.  

Lembo said this initiative is a double win.  

“When patients are treated by the highest quality providers, it not only results in the best health care outcomes for patients, but it provides the best financial outcome for the state – because low-quality care and poor outcomes, including hospital readmissions or unnecessary prolonged treatment that results from poorly done procedures is bad for patients and compromises the overall operation of the state health plan. “

Innovation will not only drive better health outcomes across the state, but it will save the state money in the process,” Lembo said

The Centers of Excellence model builds off of a provision of the SEBAC 2017 agreement, which allows the state to provide incentives to plan participants in exchange for using high-quality health care facilities.

“This Centers of Excellence Initiative is a true win/win project,” said Carl R. Chisem, President, CEUI-SEIU Local 511. “We are proud to continue our work with the Comptroller and his staff to keep members healthier, save health care dollars, and improve public services. Through collective bargaining, our members have a voice at work, and we will continue to use it to benefit everyone, and most especially the public we serve.”

Rather than simply connect patients with the best providers, Lembo said his office will work with Remedy to identify the best performing hospitals in the region for a multitude of procedures and to contract with the top performing hospitals and other providers in order to get the best available costs for the entirety of services covered under the Centers of Excellence program. This will allow the state to achieve a win-win that results in deeper savings for better patient outcomes.

Health Advocate’s team will assist consumers in getting covered services from hospitals and other providers identified as Centers of Excellence. Services and care included in the Centers of Excellence program would include – but not be limited to:

Joint replacement Comprehensive Spine (a program that seeks alternatives to spine surgery for individuals suffering from back pain) Women’s health and maternity Certain cancer surgeries or treatments Cardiac treatments Bariatric surgery Chronic condition management

The program will also include incentives to encourage plan members to participate in clinical programs that may reduce unnecessary surgeries and interventions, and covered services will expand overtime, Lembo said. 

Lembo said this innovation will not only benefit patients on the state health plan, but will drive better health outcomes across the state.  Direct contracting through Remedy will not be limited to those institutions that have already achieved the quality standards necessary for designation as a Center of Excellence, but will also include those aspiring to improve their performance.  This state engagement, through Remedy, with the broader market of health care providers will influence the greater region of health care providers, because all institutions could improve their quality and efficiency from the technical assistance and reporting on their performance from Remedy. 

“This innovation is designed to inspire changes in practice patterns across the entire state and region – supporting a culture of continuous improvement across all hospitals and provider groups in the state,” Lembo said. 

 

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