Overview

Sub Committee #1: Use Case Model Working Group

Purpose

Identify and recommend approximately 10 use cases for measuring healthcare affordability in Connecticut.
The affordability of healthcare in Connecticut differs from region to region, municipality to municipality, and among family types. The Self-Sufficiency Standard will provide a base of economic information in different regions, towns and family types. Healthcare affordability includes many different factors such as: 
• Insurance including premium cost, deductibles, co-pays, prior authorization and denials (out of pocket costs) and other variables.
• Health status
• Employment status 

Affordability also differs by race, gender, age, marital status, immigration status, and many other factors. 
Participants will discuss and develop use case models that can be used to guide data gathering and design of the analytic tool. 

Challenges

There are many variables in the current healthcare system that affect cost and affordability. Insurance plans, locations, environment are all different.  Health and well-being situations are different in each individual. Each individual’s race, ethnicity, gender, age, socio-economic status (differences in health outcomes related to SES) are some variables in developing an affordability standard. 

Goals and Objectives

• Identify approximately 10 priority use cases by selecting criteria and by describing the illustrative value of each use case
• Identify a set of clearly defined affordability requirements associated with the priority use cases