Healthcare Benchmark Initiative Guidance for Payers and Providers

Payers are required to submit data to the Office of Health Strategy (OHS) annually by August 15. Carriers are highly encouraged to submit data as soon as possible before the deadline to allow OHS sufficient time to validate the data.

Alternative Payment Model (APM) data must be submitted by November 1, 2025. This change applies to APM data submission for this year only.

We have provided technical and operational procedures that OHS employs to implement these initiatives and the specifications for data reporting and collection.

OHS holds a technical webinar on the Cost Growth Benchmark, Quality Benchmark, and Alternative Payment Model Data submissions each year. The latest presentation can be accessed here: CT Benchmark Technical Implementation Webinar.

Cost Growth Benchmark and Primary Care Target Data Submission Guidance

Review the latest Data Submission Guide, and download templates specific to your organization.

Cost Growth and Primary Care Data Submission Guide

The Cost Growth Data Submission Guide explains how OHS carries out the healthcare cost growth benchmark and primary care spending target. It covers how these benchmarks are set, how performance is measured, and provides instructions for data reporting.

Cost Growth Benchmark Performance Submission Template

Download the Cost Growth Benchmark Performance Submission worksheet (.xsls). This file should be uploaded through the payer data portal.

Dept. of Social Services Cost Growth Benchmark Performance Submission Template

Download the DSS Cost Growth Benchmark Performance Submission worksheet (.xsls). This file should be uploaded through the payer data portal.

Office of State Comptroller Cost Growth Benchmark Performance Submission Template

Download the OSC Cost Growth Benchmark Performance Submission worksheet (.xsls). This file should be uploaded through the payer data portal.

Primary Care Taxonomy, Procedure, and Place of Service Codes

Access the Primary Care Taxonomy Code list from the data submission guide or by downloading the file.

Standard Deviation Example

Insurers will need to provide variance information for 1) each line of business and 2) each provider entity by line of business. The file shows an example variance calculation using hypothetical information.

Quality Benchmark Data Submission Guidance

Quality Benchmark Initiative Data Submission Guidance

The Connecticut Quality Benchmark Initiative Data Submission Guide contains the technical and operational steps for collecting and reporting on the Quality Benchmarks.

Insurance Carrier Quality Data Submission Template

Download the Quality Benchmark Data Submission Template worksheet (.xsls). This file should be uploaded through the payer data portal.

Alternative Payment Model (APM) Guidance

Alternative Payment Model Implementation Manual

This manual explains how OHS will assess the use of APMs. It also includes the technical details for how to report and submit the required data.

Alternative Payment Model Data Submission Template

Download the template to submit Alternative Payment Model data.

Payer Data Portal and Credentialing

All data templates (excel worksheets) for the Cost Growth Benchmark and Primary Care data submissions as well as the Quality Benchmark data submissions are to be uploaded through the State of CT secure file web client portal.

Please refer to the Cost Growth Benchmark and Quality Benchmark Initiative Data Submission Guidance sections for the technical and operational steps for collecting and reporting on the Benchmarks and to access the worksheets.

Only a State of Connecticut credentialed contact will be able to upload or access data for the carrier they represent. Additionally, only authorized OHS staff will be able to download the submitted data.

Each carrier should complete the contact form and email it to OHS@ct.gov to be credentialed. The information is required:

To facilitate user access to the State‘s SFT Web Client;
To confirm the user is the authorized and designated contact for the carrier;
To facilitate securing and protecting confidential data;
To enable OHS communicate with the contact about data error correction and validation, system or process changes and updates.

OHS will credential the contact within two business days of receipt of the completed form.

Once the credentialed contact uploads the required data files, they will alert OHS through email at OHS@ct.gov with the subject line “Healthcare Benchmark Initiative Data-{Carrier Name}.”

Contact Form

Download and complete the Contact Form and email to OHS@ct.gov to be credentialed.

Secure File Transfer

Submit your data by uploading it via State’s secure file transfer web client.

Questions?

Please email OHS at: ohs@ct.gov with any questions regarding data submission guides, data upload process, or credentialing.

Legislation

Read the public act and executive order on the data collection requirements for payers and providers.