Gov. Ned Lamont has selected Deidre Gifford, the state’s social services commissioner, to take over as head of the Office of Health Strategy, where officials are managing Connecticut’s certificate of need process on health system closures, expansions and consolidations, and monitoring the rising cost of health care across the state.
Gifford has been head of the social services department since 2019. She was also appointed interim commissioner of public health in 2020 after Gov. Ned Lamont fired then-leader Renee Coleman-Mitchell, leaving Gifford to work in dual roles during the height of the coronavirus pandemic. She remained acting public health commissioner until September 2021, when Dr. Manisha Juthani took over.
Andrea Barton Reeves, chief executive officer of the Connecticut Paid Family and Medical Leave Insurance Authority, will replace Gifford as commissioner of social services. At the Office of Health Strategy, Gifford will take up the position vacated by Victoria Veltri, who had been in the role since the office was created in 2018 and left at the end of June.
“A well-coordinated, comprehensive approach to public health and health care access is vital to supporting the basic needs of the people of our state, and I am thrilled that we are assembling a team of the most dedicated, educated and respected professionals in this field who will be able to hit the ground running as we begin our second term,” Lamont said Wednesday.
“After two and a half years of COVID, how we know how important universal quality, affordable health care is for every one of our citizens. I know how important it is for small business. … And getting that right is priority number one.”
Gifford said a primary focus in her new job will be health equity.
“One of the less prominent roles that OHS has taken on is to lead some of the work around equity. We’re doing a study on how to make sure we’re collecting appropriate data on race, ethnicity and language across our state health programs,” she said. “I really want to continue to focus on that work.”
This year, the Office of Health Strategy developed a tool called the Health Care Affordability Index, which uses several factors, such as insurance type, family size, health status and age, to determine health care costs and affordability. Gifford said she was struck by some of the findings.
“I was reviewing some of the affordability index work, where they show that almost one in five working families in Connecticut would have to limit their spending on things like housing, food and clothing in order to afford their health care costs.
“A health system that only works for part of the residents of the state isn’t a high-functioning health system. We’ve got to have a system that provides equal access for everybody.”
Following double-digit rate hikes approved this year for fully insured health plans, including those on Connecticut’s insurance exchange, Access Health CT, state officials and lawmakers have begun to think about how they might propose policy changes to help curb the rising cost of health care. Hospital and pharmaceutical costs are two areas they are looking into ahead of the legislative session that begins in January.
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The Office of Health Strategy has started a cost growth benchmarking program, setting annual benchmarks for the ballooning price of health care by requiring providers, insurers and others in the industry to report their yearly increases.
The program is designed to expose the hospitals, medical practices and insurance companies whose costs soar beyond the state-imposed targets. There is no penalty for those who exceed the benchmarks, but officials say the annual reporting mandate will create public pressure to keep costs down.
The findings are also likely to help inform legislation during the upcoming session. Some lawmakers have already cited the office’s work when discussing bills they hope to raise.
“If you look at the pre-benchmarking work that OHS has released, there are really two primary areas where cost growth is concentrated: in pharmacy and in hospital spending — not just inpatient, but also outpatient,” Gifford said. “You have to follow the money. If the cost growth is in pharmacy and hospital, then those are the areas where we need to focus and we need to partner.
“There should be a big emphasis on partnering with payers, providers — including hospitals — and employers who pay for a lot of the health care in the state and have a huge stake in making sure health care remains affordable for them and their employees. We can’t have health care costs becoming a drag on the economy.”
With health care consolidation and its effect on patients in the spotlight, a task force has convened to review the state’s Certificate of Need process and suggest modifications. Hospitals that wish to shut down services such as labor and delivery, or open a new unit, must go through the certificate of need process, overseen by OHS.
Gifford said she will look at any recommendations the task force submits as she steps into her new position.
“It’s important to look at health care consolidation and its impacts on cost growth,” Gifford said. “It has the promise of being more efficient, providing better access and better integration for patients. But we have seen evidence that consolidation does drive cost, and the impact on quality is sort of mixed.
“It’s important for us to be looking at, talking about and thinking about the impacts of consolidation and if there any ways to mitigate some of the adverse impacts.”
Gifford and Barton Reeves’ appointments must still be confirmed by the General Assembly. Lamont said he will forward their nominations to the legislature soon after his second term begins on Jan. 4.