Hartford Business Journal

20 Hartford Business Journal • June 22, 2015 www.HartfordBusiness.com OPINION & COMMENTARY EDITORIAL Fertile business climate must be top priority T he special legislative session tentatively scheduled for the end of June couldn't come at a more critical juncture for Connecticut's economy. With rumors swirling about some of the state's largest employers — Sikorsky Aircraft, Cigna and Aetna — being acquisition targets of out-of-state companies, the need to maintain and improve Connecticut's business climate is paramount. If any of those corporate giants are gobbled up by competitors in lower-cost states, thousands of Connecticut jobs could be at risk. Hartford's perch as the Insurance Capital of the world could also be threatened. Unfortunately, Connecticut has been put in a very vulnerable position following the House and Senate's passage of a $40.3 billion budget that raised taxes by $2 billion. That budget drew national attention and significant consternation from Connecticut employers that would feel the brunt of the tax hikes. Gov. Dannel P. Malloy has proposed rolling back business tax increases by $223 million to sate the outcry from CT Inc. That's a good starting point. We urge lawmakers to heed Malloy's policy shift; to ignore it or play hardball would risk striking a major blow to the state's economy. The timing of the merger talks is actually fortuitous because it shines a spotlight on the importance of having a competitive business climate. United Technologies Corp. last week confirmed that it will sell or spin off its Sikorsky helicopter division; Cigna was rumored to be in acquisition talks with Indianapolis health insurance giant Anthem; and Aetna was identified as an acquisition target of Minnesota-based UnitedHealth Group. To be clear, these deals aren't being driven by Connecticut's tax policies. UTC is look- ing to unload its least profitable business, while the health insurance industry is heading toward a major consolidation wave. But if any of those deals are struck, Connecticut's business climate will play a critical role in determining where the surviving jobs stay or go. Any health insurance industry consolidation will surely mean lost jobs either in Connecticut or other states as insurers scale up and drive cost savings from their opera- tions. The surviving management teams will crunch numbers and weigh other factors to determine where to maintain their operations. If state lawmakers don't back off their $2 billion tax increase, there's a greater chance Connecticut jobs will go elsewhere. We urge lawmakers to work with Malloy and rewrite what was a very bad budget for Connecticut's economy. n Health insurance consolidation a small business concern Speaking of consolidation, we hope state and federal regulators keep a close eye on the pending merger wave in the health insurance industry. Beyond the potential job losses Connecticut faces, businesses of all sizes risk higher costs if the insurance market becomes too consolidated. A merger, for example, between Cigna and Anthem would allow the combined company to control nearly two-thirds of the Con- necticut market, according to an analysis by the Stamford Advocate. Such clout would give the company significant leverage in negotiations with hospitals and doctors and consumers. Medical providers, too, have been caught up in a prolonged merger-acquisition period, the consequences of which are yet to be known. Health insurance costs are a major burden on Connecticut employers. Any mergers that threaten to increase those costs further must be looked at carefully. Connecticut's Insurance Department is considered one of the strongest state-based regulatory bodies in the country. We hope it leverages that expertise to make sure the state maintains a competitive health insurance marketplace. n OTHER VOICES Insurers holding back access to advances in women's health By Dr. Jean Weigert O ne of the most rewarding moments of a doctor's career is witnessing first- hand advances in medicine that saves lives. As a breast cancer imaging specialist in practice for three decades, one of the most remarkable advances I've seen is the advent of 3D mammography. 3D mammograms provide enhanced clarity, which leads to fewer false alarms and increased cancer detection. Given the notable benefits, I wish some- one could explain why some private insurance companies aren't covering this important technology. Since the Food and Drug Adminis- tration first approved the technology in 2011, multiple peer- reviewed studies have shown that 3D mammo- grams provide greater accuracy than 2D mam- mograms alone. Doctors can now look at the breast tissue layer-by-layer, which is especially helpful for women with dense breasts. With this technology, we're calling back fewer patients due to inconclusive images, saving women the inconvenience, cost and anxiety of needless follow-up visits and the healthcare system the cost of unnecessary additional testing. The benefits do not stop there — not only does 3D mammography help reduce false positives, it helps find cancers that might be obscured by, or look like, normal tissue. The technology has shown a 41 percent higher inva- sive cancer detection rate when compared to conventional mammograms. This is a game- changer for women, and it's not surprising that Medicare has recognized its value and is now covering and paying for 3D mammography screening. However, some private insurers' policies, such as Cigna and Aetna, based here in Connecticut, are considering this "experi- mental" technology, which it certainly is not. Until private insurers cover 3D mam- mography, not all women will benefit from these more accurate mammograms. I've made it my personal mission to educate Aetna, Cigna, Anthem (of which Blue Cross Blue Shield of Connecticut is a subsidiary) and others, explaining the clinical and eco- nomic data supporting the superiority of this technology. Furthermore, I believe coverage of this technology is particularly important for the state of Connecticut, which current- ly ranks second in breast cancer incidence rates nationwide. With health insurers so focused on their bottom line, you'd think they'd be eager to reimburse for 3D mammography — but that has not been the case. A study published last year in the Journal of ClinicoEconomics and Outcomes Research found that 3D mam- mography leads to significant cost savings because of the significant reduction in unnec- essary follow-up visits due to false alarms. It showed that insurance companies could save $28.53 per every woman screened with 3D mammography. It's hard to understand why insurers are hesitant to cover a technology that not only saves lives but dollars too. But beyond the bottom line, lack of reim- bursement is a shame given we are talking about the lives of real women. Women whose 3D mammogram meant this year they may not need to go in for an unnecessary follow-up exam or biopsy. Women deserve better than this. The sad fact is, when insurers' policies don't keep pace with the new standard of care, it slows innovation and the adoption rate of vital advances. Many doctors will only be able to invest in 3D mammogram equipment when they know insurance will cover it. 3D mammog- raphy is an important advancement in breast cancer screening; it is a victory for women, their families and our healthcare system. I call on all of Connecticut's insurance providers to join our state's doctors in ensuring all women have access to 3D mammograms. n Dr. Jean Weigert is a breast cancer research- er, physician and patient advocate who serves as director of breast imaging at The Hospital of Central Connecticut in New Brit- ain and Southington, and is president of the Radiological Society of Connecticut. HARTFORDBUSINESS.COM POLL Should the state increase hospital Medicaid reimbursement rates? ● Yes ● No To vote, go online to HartfordBusiness.com. Last week's poll results: Do you think GE, Travelers or Aetna will actually leave the state? 56.3% Yes 43.8% No LETTER TO THE EDITOR GE isn't bluffing Growing up, my dad, a World War II veteran who grew up in West Haven and worked in the private sector his entire career, taught me to beware of politicians when it comes to tax policies. "They're always looking for more cookie jars," he'd say. "Their thirst for more revenue is relentless. They have little incentive to stop because the consequences of their decisions are often revealed after they're gone from political office." I'm a Connecticut native and have operated a small business here for 27 years. I've also had experience working with General Electric, and in my observation, they don't bluff. It takes a corporation such as GE a long time to choose to move. They don't make im- pulsive, impetuous decisions. However, when they do choose to move, that's it. They're not coming back. Connecticut politicians seem to think that they can heap more and more tax burdens on businesses, year after year, without any negative consequences. They seem to think that Connecticut is such a unique and marvelous place, that businesses will swallow hard, cough up the money, and never leave. Wrong! When will our power brokers in government realize that they must change their big-spending ways? Drew Crandall Founder Keep In Touch dcrandall@keeptouch.com Dr. Jean Weigert

• Cover