Healthcare Benchmark Initiative Proposes Cost Growth and Quality Benchmarks Primary Care Spending Targets for Next Five Years

(Hartford) – Today the Office of Health Strategy (OHS) released a report containing their proposed target values for the next five years of the Healthcare Benchmark Initiative. The report included recommended healthcare cost growth and quality benchmarks as well as primary care spending targets for 2026 – 2030. The proposed cost growth benchmark, 2.8% for each of the next five years is tied to projected Connecticut median household income values over the same period.

“Restraining healthcare spending growth to the rate of median household income growth would be a substantive step towards affordability,” said Deidre Gifford, MD, MPH, commissioner. “Connecticut residents already face a crisis in healthcare affordability, and we must continue to have meaningful healthcare cost and utilization discussions to achieve real savings for consumers and employers. This benchmark sets a target for payers, providers, stakeholders and policy makers to meet in working towards that goal.”

Healthcare cost growth for 2023, the most recent year reported was 7.9%, significantly exceeding the benchmark of 2.9%. Hospital outpatient and retail pharmacy costs have been identified as contributors in both 2022 and 2023. Policy proposals to restrain cost growth appeared in multiple bills this session including efforts to reduce prescription drug costs and cap out of network costs. Senate Bill 10, an Act Concerning Health Insurance and Patient Protection, passed by both the House and Senate allows the insurance commissioner to limit rate increases for insurers that repeatedly exceed the cost growth benchmark.

A highly functioning and affordable healthcare system requires a strong foundation of primary care. Both OHS and the Healthcare Benchmark Initiative Technical Team recommended that the state target 10% of healthcare spending on primary care for each of the next five years. This is consistent with the 2025 target. Primary care spending in 2023 did not meet the 6.9% target for the year and decreased to 4.5% from 4.8% in 2021 and 2022.

“The Technical Team recommended that Connecticut pursue additional strategies to boost primary care investment,” said Gifford. “We have already begun that work in partnership with the Department of Social Services, through the Connecticut AHEAD model which includes a focus on enhancing primary care practices and resources.”

Read the full report

Connecticut established the Healthcare Benchmark Initiative, in 2020 to lower healthcare spending growth, enhance investment in primary care and ensure healthcare quality. The initiative established cost growth and quality benchmarks as well as primary care spending targets for 2021-2025 and has reported annually on payer and provider performance against these benchmarks.

Quality benchmarks, proposed with endorsement from the Healthcare Benchmark Initiative Quality Council, are designed to ensure that efforts to constrain cost growth do not impact healthcare quality. Specific clinical measures related to chronic health conditions including diabetes, asthma, obesity and mental health have been incorporated into the program in multiple phases. The Quality Council recommends adoption of the following quality benchmarks:

Proposed 2026-2030 Quality Benchmarks

OHS will accept public comment on these proposed benchmarks, and conduct both a public hearing on June 23, 2025 and virtual listening session on June 16, 2025. Final recommendations will be issued by July 1, 2025. Comments may also be directed to OHS@ct.gov.