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.

 

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
Yes
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
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 

Western Connecticut Health Network Medical Neighborhood Demonstration - Connecticut

This award is part of the Health Care Innovation Awards program, a Department of Health and Human Services initiative investing up to $1 billion to test promising new approaches that aim to improve health care and lower program costs for recipients of Medicare, Medicaid and the Children's Health Insurance Program (CHIP).

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

A review of the year’s academic and industry-generated PCMH evaluations finds significant impact across a number of clinical and financial outcomes.

Embargoed Until Monday, January 13th, 4PM

PCPCC: Michelle Shaljian, 347-754-1692, michelle@pcpcc.net

Milbank: Tara Strome, 212-355-8400, tstrome@milbank.org

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

Reform Update: Specialty physicians make inroads into medical homes

The proposals to scrap Medicare's sustainable growth-rate formula for updating physician pay include less-noticed provisions rewarding practices that operate as a patient-centered medical home. There is a twist, however.

News Author: 
Andis Robeznieks

Cigna Collaborative Care Program

Cigna Collaborative Care (previously called Collaborative Accountable Care) is Cigna's approach to accountable care organizations, or ACOs. An ACO is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs. Care coordinators work closely with Cigna's case managers and help their patients access Cigna's clinical support programs, such as chronic condition management (diabetes, heart disease) and lifestyle management programs (weight, stress, tobacco).  

Aetna Integrated Primary Care Behavioral Health Program

Aetna's Integrated Primary Care Behavioral Health Program supports a collaborative health care model that provides coordinated and effective services for individuals with mental health needs.

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