There's no question that Connecticut is in lean budget times. Looking for efficiencies in state government is undoubtedly a priority. Look no further than the Office of the Healthcare Advocate to find a lean operation that produces five to six fold of its budget in taxpayer savings each year. In fact, for calendar year 2010, OHA produced $5.7 million in savings for consumers on its $1 million budget. While being efficient, OHA managed to assist consumers with the most difficult situations in securing medically necessary treatment or services, earning high praise and the respect of its consumers.
There is probably no entity in state government that provides the level of services that OHA provides to consumers. There's a reason for that. OHA was established specifically to assist health insurance consumers who have problems accessing or receiving the medically necessary care they need. The legislature recognized that a unique agency with expertise in handling consumer issues with plan selection and complaints would hold insurers accountable and get consumers the care they needed. OHA's independent status allows it not only to advocate for individual consumers, but to bring systemic issues to the attention of the legislature and Governor for further action.
OHA is unique. Its consumer assistance staff consists of clinical expert-advocates who can not only understand the clinical issues at hand, but also advocate for the care the consumers' providers request. OHA is so unique in state government, that it was one of the models used to establish consumer assistance programs under the the Patient Protection and Affordable Care Act (ACA). That uniqueness resulted in a $396,400 grant to OHA from the federal government--only one grant was awarded per state--to continue its effective advocacy model.
Housing OHA in state government is the ideal model. Giving the force of government to OHA's advocacy is important, while allowing it the independent status of a watchdog, brings accountability. OHA has brought legislation to the table to support consumer access to medically necessary care. OHA's personal, real-time consumer assistance is unmatched, which is why referrals from legislators and people who have used our services continues to rise. Our consumers report that they would come to us again 96% of the time.
The reasons that OHA was established in the 1999 managed care accountability act still exist today.
What other entity in state government can show such efficiency with its budget, a nearly six to one rate of return, and such high satisfaction rates from state taxpayers? Anytime, but especially in lean times, OHA is a model state agency.