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February 8, 2021 OTHER VOICES

Lembo: A public option is good for business

Photo | Flickr/Matthew Hurst Anthem Blue Cross and Blue Shield offices in St. Louis.
By Kevin Lembo

As the pandemic continues to plague our country, access to health care remains a major concern.

Kevin Lembo

Tens of thousands of people have lost their jobs, mostly in the service sector, and small businesses and nonprofits have struggled to keep the lights on. Changes must be made to make life easier for those who are struggling to access care, and to bring more affordable coverage options into the market.

That’s why I’m working with lawmakers, experts and advocates on a package of healthcare reforms aimed to help those struggling the most, including our small business community.

One of those reforms, a public option, will allow small businesses of 50 or fewer employees and nonprofits to purchase coverage derived from the state health plan that I oversee as state comptroller.

A policy this important deserves a robust discussion of the merits. However, basing those conversations in fact, and relying on data, is the only way we can arrive at a reasonable solution that meets this moment of crisis and helps the people of Connecticut.

Here’s one fact: A public option in Connecticut is good for business. Not only for the small businesses who will have affordable, dependable coverage, but for the healthcare sector in our state that is already benefiting from the work of the state health plan.

The plan as envisioned would leverage the existing programs of the state health plan to offer new choices in the market. In my time as state comptroller, I’ve worked hard to run that plan efficiently and to add value by partnering with private-sector companies to drive down costs for members and taxpayers while delivering high-quality health care to members.

Those private-sector relationships have created jobs and led to innovations in the healthcare sector benefiting everyone receiving care in our state. I’m proud that our collective work together has lifted Connecticut’s reputation as a national leader in health care.

Anthem Blue Cross and Blue Shield administers the health plan for active state employees and has added dedicated staff working only on the state plan.

Anthem also administers the Connecticut Partnership Plan, an arrangement much like the one proposed for small businesses and nonprofits, that allows municipal governments to access coverage offered by the state — to ensure that our teachers, police and firefighters have access to more than just health insurance, but health care.

Through its engagement with the state of Connecticut, Anthem recently expanded its book of business in the state by over 80,000 lives and will be working with my office to highlight the benefits of the Partnership Plan with the goal of further expansion.

In recent years, a partnership with UnitedHealthcare to administer the state’s Medicare Advantage coverage for retirees has saved hundreds of millions of taxpayer dollars, raised the overall quality of care for seniors, and bolstered United’s Medicare Advantage reputation as an industry-leading product.

CVS, as the state’s pharmacy administrator, has been a partner in bringing down the costs of expensive life-saving specialty drugs, and has been working with the state to improve the pricing information provided to prescribers at the point of prescription, allowing them to make better-informed prescribing decisions.

Such innovations not only benefit the state employee plan but can be expanded to provide additional benefits to customers across the CVS book of business, improving their value proposition and increasing their competitiveness.

Cigna administers the state dental plan and has also expanded its membership by serving the Partnership Plan while also working with my office on preventive dental care and identifying and recognizing the highest-quality dentists in the state.

Working with the state has allowed each of these large insurers to hire more workers in Connecticut, build on their reputations within the industry and deliver innovations that can be scaled and sold in other markets. The public-private partnerships within the state health plan have been mutually beneficial for all involved, including Connecticut taxpayers and those receiving coverage through the state health plan.

But the state’s connections with Connecticut healthcare companies goes far beyond just large insurers. When the pandemic began, my office was able to contract with several Connecticut laboratories and providers to rapidly expand COVID-19 testing capacity.

The Jackson Laboratory in Farmington, Griffin Hospital in Derby, Yale New Haven Health Systems, Hartford Hospital, PhysicianOne Urgent Care and Sema4 in Stamford all rose to the occasion and, by partnering with the state, were able to hire and train new workers, build testing sites and expand lab capabilities to help Connecticut weather this crisis.

Direct negotiations with hospitals for bundled services will give them predictable revenue streams, save on overhead expenses and result in a replicable cost structure that will help both the hospitals and the state craft more predictable budgets.

Norwalk-based Signify Health has been the state’s partner in identifying these bundles and building a new Network of Distinction program and is seeking to leverage its experience as a model for the country. The Network of Distinction program lifts the profiles of the highest-performing doctors and facilities in the state for certain common procedures by identifying them based on quality metrics and directly contracting with the state for bundled procedural services.

Farmington-based WellSpark has a longstanding relationship with the state health plan as the administrator of a nationally-renowned preventative care program.

The relationships the state health plan has developed with the private sector are already benefiting everyone involved.

As our state continues to endure the pandemic, we have a chance to extend these successful programs to those who really need the help. We can’t miss that opportunity.

Kevin Lembo is the comptroller of the state of Connecticut.

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