Connecticut

In 2009, Connecticut Public Act No. 09-148 authorizing the creation of the SustiNet health plan option also established a medical home advisory committee to recommend internal procedures and proposed regulations governing the administration of patient-centered medical homes that provide health care services to SustiNet Plan members. In addition, the state of Connecticut encourages issuers offering Qualified Health Plans (QHPs) on the state marketplace to submit non-standardized plans including those that utilize different care management models (e.g., PCMHs, community health teams). 

Under the Connecticut Department of Social Services’ PCMH program, practices that demonstrate a higher standard of person-centered primary care service delivery qualify for a higher level of reimbursement for primary care services. Qualified PCMH practices are also eligible for additional financial incentives and HUSKY Health recipients are included in the PCMH program. The State Innovation plan builds upon this program by furthering the development of payment and delivery system models that 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.

 

Primary Care Innovations and PCMH Activity

Dual Eligible 2703 SPA CPC CPC+ PCMH QHP PCMH Legislation Private Payer

State Legislation

Legislation Status Year
Public Act No. 11-58

This act allows cities and towns to join the state employee health plan. In addition, a provision was included to "develop and implement patient-centered medical homes for the state employee plan and partnership plans... in a manner that will reduce the costs of such plans".

Enacted 2011
HB 5506

Establishes an Office of Health Care Strategy Office to develop an annual health care cost growth benchmark and primary care spending target. Develops and adopts health care quality benchmarks. Develops strategies, in consultation with stakeholders, to meet such benchmarks and targets developed. Enhances the transparency of provider entities. Monitors the development of accountable care organizations and  patient-centered medical homes in the state. Monitors the adoption of alternative payment methodologies in the state. Legislation enacted as a provision of 2022 state budget legislation.

Enacted 2022
Executive order 5

Monitoring healthcare spending growth, setting initial annual benchmarks for primary care investments. Progressively increase primary care spending goals to reach a target of 10% by 2025

Enacted 2020

State Facts:

Population:
3,545,500
Uninsured Population:
9%
Total Medicaid Spending FY 2013: 
$6.7 Billion 
Overweight/Obese Adults:
62.5%
Poor Mental Health among Adults: 
34.8%
Medicaid Expansion: 
Yes 

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