CMS State Innovation Model (SIM) Testing Award - Connecticut

Program Location: 
Hartford, CT
Payer Type: 

In December 2014, CMMI awarded Connecticut up to $45 million implement and test its State Health Care Innovation Plan. Connecticut will collaborate with public and private stakeholders to design a transformed health care delivery system that incorporates promotion of integrated care models; use of the Health Insurance Exchange to inform and connect consumers to coverage; expanded supply of primary care physicians and other professionals; and increased engagement among regulators, providers and consumers. The resulting payment and delivery system model will advance greater alignment across multiple payers on contracting and payment strategies that promote value over volume, greater consistency in quality and other performance metrics, and expanded primary care.

For more information, see the Connecticut project narrative.

Payment Model: 

In March 2013, Connecticut was awarded a $2.8M grant to fund a six-month planning process to develop an implementation plan for comprehensive healthcare transformation.

This project proposes to move from volume-based to value-based payments using the following mechanisms:

  • Providers new to value-based payment will begin in "Pay for Performance," which introduces rewards for performing well on quality and care experience targets. 
  • All providers, eventually, will be moved to a "Shared Savings" program in which practices are eligible for shared savings when they provide more effective and efficient care (losses occur when care becomes less effective and efficient).
  • Payers will be encouraged to tie shared savings and pay for performance to a "Common Scorecard" for quality, care experience, health equity and cost. 
Last updated June 2015
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