Healthcare Q&A speaks with Victoria Veltri, executive director of the state Office of Health Strategy.
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Victoria “Vicki” Veltri's new role as executive director of the newly created state Office of Health Strategy (OHS) this year builds on her two decades of work in Connecticut's healthcare policy arena.
The Colchester resident previously worked as a healthcare legal aid lawyer and general counsel for the Office of the Healthcare Advocate before being named Healthcare Advocate in 2011. She held that position until 2016, taking a job as Lt. Gov. Nancy Wyman's chief health policy advisor. The legislature created OHS last year, merging many of the state's major healthcare initiatives under one 45-employee umbrella.
Gov. Dannel P. Malloy named Veltri as OHS's leader in January.
Q: In creating the Office of Health Strategy, lawmakers consolidated a number of ongoing (and complex) projects relating to healthcare policy, technology and innovation. What was the purpose?
A: The priority in Connecticut is to build on our progress in making healthcare more affordable and accessible, and that requires that policymakers and consumers collaborate with insurers, providers, pharma, employers and others. A key asset of the OHS structure, which brings together all the state's healthcare initiatives, is its responsiveness to the evolving healthcare landscape both on the federal and state levels.
Q: You now oversee development of a statewide health information exchange, a system that would give doctors a secure, fast way to share patient records with the goal of reducing readmissions and errors.
Connecticut has tried for years to develop a health information exchange but has continually hit roadblocks, including a state contractor bungling a prior attempt. Since then, the Connecticut State Medical Society has launched its own exchange (CTHealthLink).
In February, the state Bond Commission approved $15 million to build and maintain a state information exchange.
How close are we to a working statewide exchange, and are you concerned about overlap with CTHealthLink?
A: We are very close to having a statewide health information exchange, and in getting there, we engaged over 300 stakeholders and 130 organizations that helped us recognize the importance of meeting providers wherever they were in developing their own internal systems.
Their systems will connect to the state exchange and allow information sharing regardless of what technology platform a provider is using. The Medical Society is a good example; they are a great partner and are one of the exchanges that will connect to the state exchange.
The health information exchange is like an interstate highway, and the providers have their own roads that connect to the interstate. They don't compete with one another, they work together to get information moving, and that improves coordination, reduces medical testing, and means patients are getting better care.
Online only Q: The State Innovation Model program (SIM) is another duty of your new office. Now in its third year, the federally backed plan aims to lower various disease rates, slow annual growth in health costs and push more providers toward shared savings models. Can you point to any significant areas where SIM is bearing fruit?
A: SIM is among our most productive endeavors and is helping us lower the cost of care and improve how a patient’s care is coordinated. So far, SIM has helped 123 medical practices become “advanced medical homes.” That means that patients have one place that can help coordinate their care, which not only lowers costs but also increases medication and treatment compliance. It’s an important support that also improves the value of healthcare dollars -- ensuring that the money consumers are spending on healthcare is actually making them better.
SIM has also helped design and implement the Person Centered Medical Home Plus program, or “PCMH+.” The plus means that advanced medical homes are part of Medicaid’s first shared savings program, representing over 130,000 Medicaid members, seven federally qualified health centers, two large healthcare provider systems, and 649 primary care providers. SIM is now supporting the second phase of this initiative that will allow providers to better coordinate care, support community health workers, and receive assistance in learning how to better address health inequities and meet quality standards while reducing costs.
SIM has also worked with the state’s Health Information Technology Officer to design the HIE in a way the meets providers where they are and achieves patient and provider goals of improving care and outcomes.
SIM supports Consumer Advisory Board events (which have reached 320 patients) to listen to the needs of underserved communities and patients. It’s how we close gaps in care and access to services and improve outcomes. The board has held listening forums for young adults with disabilities, the Southeast Asian community, rural communities, Black Congregational Churches, and patients with behavioral health conditions. It has also held a social media town hall for Kids As Self-Advocates (“KASA”) for youth to discuss their healthcare concerns.
SIM supported the hiring of community health workers to improve patient care and help manage patients who have very complex medical needs.
SIM has also developed a core quality measure set that could be used by insurance payers in Connecticut to ensure providers are providing quality care, and developed tools for employers to help engage their employees in managing chronic illness and engaging in preventive care.
Q: Come July, your office will also house the Health Care Cabinet, which has advised state officials on Obamacare and state-level health reform efforts since 2012. In February, the cabinet weighed in on prescription drug prices — the No. 1 driver of healthcare costs growth.
A key recommendation is that the state create a regulatory board to investigate drug pricing abuse. Some drug makers don't like the idea.
How crucial is a “drug review board” to reining in drug costs?
A: The Cabinet recognizes that pharmaceutical costs continue to grow rapidly and that prescription drugs are already unaffordable for many consumers. Drug costs also contribute to rising health insurance premiums.
Among other recommendations, the Cabinet recommended establishing a drug review board that could serve several important functions designed to keep consumer costs down and prevent pricing abuse.
The drug review board would determine if the manufacturer prices at the pharmacy counter are justified by market norms and the clinical value of the medicine. The recommendations are currently in front of the legislature.
