Guidance for Payers and Providers

Notices

On December 17, 2021, OHS distributed a letter and attachment to payers, advanced networks, and federally qualified health centers to notify them of the 2022 benchmarks:

  • Connecticut’s 2022 healthcare cost growth benchmark is 3.2%
  • Connecticut’s 2022 primary care spending target is 5.3%
  • Connecticut’s 2022 quality benchmarks are provided in the table below:

Quality Benchmark Measure

2022 Commercial Benchmark

2022 Medicaid Benchmark

2022 Medicare Advantage Benchmark

Asthma Medication Ratio (Ages 5-18)

79%

66%

N/A

Asthma Medication Ratio (Ages 19-64)

78%

63%

N/A

Controlling High Blood Pressure

61%

61%

73%

Hemoglobin A1c (HbA1c) Control for Patients with Diabetes: HbA1c Poor Control

27%

37%

20%

 

For any questions regarding the 2022 benchmarks or the health care benchmark initiative, please contact Kelly Sinko Steuber, Director of Healthcare Innovation, at Kelly.Sinko@ct.gov.  

 

 

 

 

Implementation Manual

Per Public Act 22-118, the deadline for submitting data to OHS is August 15th of each year. Carriers are highly encouraged to submit data as soon as possible before the August 15th  deadline to allow OHS sufficient time to validate the data.

To further assist carriers with this data request, Bailit Health will hold calls with individual carriers during the following dates and times to answer questions and provide guidance on the data specifications:  

    • Wednesday, June 15, 2022:  10:00am -12:00pm
    • Tuesday, June 28, 2022:  1:00 - 3:00pm
    • Monday, July 18, 2022:  2:00 - 4:00pm
    • Thursday, July 28,2022:  10:00am - 12:00pm
    • Friday, August 5, 2022:  12:00 - 2:00pm

 

This page provides payers and providers information on the data filing schedule, data due dates, and any additional alerts.

Table A-1.  Insurers’ TME Filing Schedule

Date

Files Due

June 18, 2021

CY 2018 and CY 2019 TME

August 15, 2022

CY 2019, CY 2020 and CY 2021 TME

August 15, 2023

CY 2021 and CY 2022 TME

August 15, 2024

CY 2022 and CY 2023 TME

August 15, 2025

CY 2023 and CY 2024 TME

August 15, 2026

CY 2024 and CY 2025 TME

OHS has provided a contact form  for the carrier’s contact(s) to fill out and email to OHS@ct.gov.  This 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 at registration;
  • 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 filled form. The authorized user will then upload the required data files and alert OHS through email after uploading the file(s).

After data is uploaded, OHS will actively engage with the contact to validate the data and ensure the data conforms with the specifications outlined in the Implementation Manual. OHS will engage each carrier, one-on-one, to discuss the initial analysis of data, and then to review the final data before it is published.