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July 17, 2019

Lembo: Affordable procedures eyed in new CT initiative

Amid rising healthcare costs, Connecticut’s top fiscal watchdog is looking to form a regional network of hospitals and providers that offer the cheapest medical procedures for patients on the state’s health plan.

Comptroller Kevin Lembo on Wednesday announced the newly minted network of “Centers of Excellence” will ensure that about 200,000 working and retired families on the state health plan have access to affordable planned procedures. 

Lembo has issued a request for proposals (RFP) to build a network of hospitals and other providers that can “demonstrate the best patient outcomes.”

Under the RFP, Lembo’s office is seeking a contract with a third-party vendor to oversee that patients are receiving adequate services through the Centers of Excellence, and to ensure financial incentives are awarded to them.

lembo public option
Photo | Contributed
Comptroller Kevin Lembo

“When costs for the same procedure vary by thousands of dollars, in some cases, small financial incentives to direct patients to the best provider will save significant immediate and long-term costs,” Lembo’s office said in a statement detailing the initiative.

In addition to connecting patients with Connecticut hospitals and providers, Lembo’s office plans to work with the selected vendor to identify the “best-performing” entities in the area in an effort to find the lowest available rates for services.

The vendor will also provide staff and services to help patients receive coverage from hospitals and providers with the “highest quality lower cost procedures, elective surgeries or screenings” through the program.

Services and care under the program include joint replacement, women’s health and maternity care, certain cancer surgeries or treatments, cardiac treatments and bariatric surgery, among others. 

Patients will also be encouraged to participate in clinical programs that may prevent unnecessary surgeries and interventions, Lembo said.

“The program will reduce the costs paid by the state health plan for certain high-cost procedures, while improving patient outcomes,” he said. “Ultimately, patients have the power to pick and choose where they go -- but we’re going to make sure that they have as much information as possible to make their choice.”

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