Guidance for Payers and Providers

Overview

 

On January 22, 2020, Governor Lamont signed Executive Order No. 5 directing the Office of Health Strategy (OHS) to establish annual statewide healthcare cost growth benchmark for calendar years (CY) 2021-2025, in consultation with a Technical Team of experts and a Stakeholder Advisory Board representing a cross-section of the health care landscape.  The goal of the executive order is to slow the growth of healthcare spending and make healthcare more affordable for the citizens of Connecticut. Connecticut is the fifth state to have a statewide healthcare cost growth benchmark, joining Massachusetts, Rhode Island, Delaware and Oregon.

Executive Order No. 5 also requires OHS to implement several additional, related initiatives, including:

  • setting targets for increased primary care spending as a percentage of total healthcare spending to reach 10 percent by 2025;
  • developing quality benchmarks across all public and private payers beginning in 2022, potentially including clinical quality measures, over- and under-utilization measures, and patient safety measures;
  • monitoring and reporting annually on healthcare spending growth across public and private payers, and
  • monitoring accountable care organizations and the adoption of alternative payment models.

The Implementation Manual explains the technical and operational steps that OHS will take to implement the healthcare cost growth benchmark.  The Implementation Manual contains the methodologies that OHS used to set the healthcare cost growth benchmark and the primary care target, and for calculating performance against the benchmark and primary care spending target.  The manual also contains the technical specifications for data reporting and collection, timelines, data due dates and where to upload the data.

OHS held a Cost Growth Benchmark Technical Webinar on March 31, 2021 to review the data submission requirements for the health plans. The slides for the webinar are posted here.

Benchmark Technical Implementation Webinar