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
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