CON Task Force Breaks Open Its Box

By Lynne Ide

opportunitysign

I’ve watched various commissions, task forces and government appointed bodies do their work over three decades now.  Rarely have I witnessed such bodies openly embrace mid-course corrections.

On November 21, the Certificate of Need (CON) Task Force decided to reconsider its course of action to-date and step out of its box.

And my response is: Bravo!

You may ask what this really means – and why should I care?

A bit of background is in order.  Earlier this year, Governor Malloy issued an executive order (Order 51, amended by Order 51A) that put a time-limited moratorium on the state’s approval of large hospital network acquisitions of additional hospitals.

It also created the CON Task Force, which was directed to assess the state’s regulatory approval process of hospital and health care provider systems (such as doctor practices, networks and related facilities) and make recommendations for changes in January 2017. In a nutshell, the CON process is run by the Office of Health Care Access (OHCA) and has oversight over things such as large equipment purchases (e.g. MRI machines), acquisitions, mergers, discontinuation of services and closures.

It’s no secret that there has been major consolidation in our state’s health care delivery system in the past decade.  In fact, Yale New Haven Health Systems and Hartford HealthCare now own multiple hospitals and medical practices controlling the lion share of state’s market.

View our 2015 explainer:

 

Fast forward to this week.

For several months, Universal Health Care Foundation of CT and other advocates have led the call for OHCA’s authority and oversight, as well as the rules of the road for hospital systems in the state, to be recalibrated with an emphasis on accountability and service to the state’s health care needs.

Thus far, health system consolidation in Connecticut has delivered higher costs and limited choices for care with no demonstrated increase in quality.

On November 21, during public comment, I implored the CON Task Force to hit the pause button and recalibrate its approach.  Since the state’s health care delivery landscape is barely recognizable from the landscape in which the CON process was created, it seems inadequate to approach the work of the Task Force from the box of “What should we keep and what should we get rid of?”  You may read my full comments here.

I challenged the Task Force to address the following questions:

  • What does the overall Connecticut health care delivery landscape look like right now – and what do we project it to look like in three, five or ten years?
  • What is the current and anticipated unmet need in this landscape?
  • What are the state’s residents experiencing in this landscape vis-a-vis cost, access and quality measures?
  • What are the state’s front line health care providers experiencing in this landscape?
  • How can we re-design the state’s oversight role to address the needs of our residents first and foremost – and support successful, responsive health care delivery systems into the foreseeable future?

And then it happened – one after another, Task Force members gave voice to the desire to get more out of their work together, rather than focusing on what we want to keep or get rid of in the CON process.

Lieutenant Governor Nancy Wyman stepped into the discussion and swung the door open for a more expansive exploration of what we really need from this process, stating that, “We need to get something done that we are proud of.”

Dr. Tekisha Everette, of Health Equity Solutions, summed up the discussion saying, “Let’s spend the rest of our time, even if it is in the express lane, getting to what we need.”

So, here we go!  This Task Force may be on its way to laying new groundwork for robust, impactful oversight of a health care delivery system that will address the needs our state’s residents and support successful, responsive health care systems into the foreseeable future.

That is one New Year’s wish that I’d like to see realized.

 

Resource Links

CON Task Force page

Universal Health Care Foundation’s October/November testimony to the CON Task Force

Video of Nov 21, 2016 CON Task Force Meeting (Recorded by CT-N)

 

 

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