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 

Husky Health Person-Centered Medical Home

In January 2012, Connecticut's Department of Social Services introduced a person-centered medical home (PCMH) initiative within their redesigned HUSKY Health program.

CMS State Innovation Model (SIM) Testing Award - Connecticut

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

Cigna and ProHealth Physicians Enhanced Care Coordination Program

In October 2009, Cigna and ProHealth Physicians, Inc., implemented an enhanced care coordination program that includes pay-for-performance provisions and many of the features of a patient-centered medical home program. In accordance with one of the goals of a medical home, to increase patient access to care, ProHealth will help patients obtain services that are appropriate to that individual's age and situation, particularly patients with chronic conditions, such as heart disease or diabetes.

Connecticut Health Enhancement Program (HEP)

Connecticut State Employees implemented the Health Enhancement Program (HEP) in October 2011. HEP includes robust Value-Based Insurance Design (VBID) principles, including that HEP enrollees benefit from cost sharing reductions if they commit to: yearly physicals, age- and gender-appropriate screenings and preventive care, two free dental cleanings, and (as appropriate) participation in disease management programs.

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