Business Case for a New Economic Opportunity

By July 2015, the health system Connecticut was serving over 3,590,886 people, most of whom reside in the urban regions and has for quite a while been facing barriers that hinder it from achieving the Triple Aim despite the large quantity of resources that the state allocates to healthcare. The state is also facing a big challenge regarding high healthcare costs in both the private and public sectors (Aseltine & Katz, 2009). This is why the state is implementing Innovation Plan that promotes the Triple Aim for all the people Connecticut: (1) improved healthcare quality and experience, (2) better health while reducing health disparities, and (3) decrease of growth in healthcare costs. This article presents a comprehensive report about the cost–benefit considerations and feasibility of executing the proposed economic initiative in the next five years.

The analysis covers an assessment of different risks and opportunities relating to the new initiative. Risks Associated with the Economic Initiative and Ways to Address Them The research identified the potential risks associated with the implementation of the Innovation Plan. The main risk facing the initiative, especially its implementation of the transparency and aligning the payers to assume same reward structures which are bound by a common scorecard, is the fact that the providers who have been benefiting from the unwarranted denials of care may be reluctant to support it. Since 2012, the state of Connecticut has never spent less than $29 billion, ranking among the top three in the country in terms of healthcare spending per capita (Volpintesta, 2014). This type of spending can be a threat to our initiative because despite the much spending that has been done previously, there has been very little amount of achievement noted, thus creating a problem on the affordability of healthcare access and coverage as the budget deals a great blow to the competitiveness of the system as the healthcare spending has constantly been outpacing the economy in terms of growth.

The state may thus be reluctant to support our initiative on the basis of the poor historical performance by previous ventures in medical development. We have many opportunities available in Connecticut to generate value. Savings in healthcare expenditure will be generated from improvements in prevention efforts, poor healthcare outcomes, and reducing excessive costs like unnecessary and/or duplicative tests and procedures. It is estimated that in Connecticut, about 40% of the Medicaid enrollees having chronic conditions use approximately 70% of the Medicaid expenditure, which includes the amount spent on acute events which can effectively be prevented by using an effective primary care. Also, the state accounts for not less than 26% higher hospital emergency departments’ per capita use compared to other states and more than 50% of these visits involve non-urgent care.