CONNECTICUT SELECTED FOR FEDERAL DEMONSTRATION PROJECT TO CURB HEALTHCARE COST GROWTH, IMPROVE POPULATION HEALTH AND ADVANCE HEALTH EQUITY

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07/02/2024

CONNECTICUT SELECTED FOR FEDERAL DEMONSTRATION PROJECT TO CURB HEALTHCARE COST GROWTH, IMPROVE POPULATION HEALTH AND ADVANCE HEALTH EQUITY

IMMEDIATE RELEASE

July 2, 2024

(HARTFORD, CT) - The Connecticut Office of Health Strategy and Department of Social Services announced today that the U.S. Centers for Medicare & Medicaid Services (CMMI) has selected Connecticut to participate in a new, voluntary, state total cost of care model: the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model). The AHEAD Model focuses on improving population health, advancing health equity by reducing disparities in health outcomes and curbing healthcare cost growth. Connecticut will receive $12 million over five years to develop and implement the model. CMS selected Connecticut to participate in the AHEAD Model based on a joint application submitted by the Office of Health Strategy (OHS) and Department of Social Services (DSS).

"This award reflects the outstanding work happening in Connecticut to ensure that high-quality health care is accessible and affordable for all of our residents," said Governor Lamont. "We will now have additional capacity to advance efforts designed to improve outcomes and control costs: investing more of our health care spend in primary care, strengthening linkages with community programs to address health-related social needs and exploring opportunities to transform payment models."

"Participation in the AHEAD Model will further strengthen our statewide approach and will give us new tools to meet the target benchmarks set for investments in primary care, chronic disease management, health equity and cost growth," said Deidre Gifford, MD, MPH Commissioner of the Office of Health Strategy and Senior Health and Human Services Advisor to Governor Lamont. "Our state Medicaid agency, DSS, Medicare and commercial payers, as well as our hospital and primary care colleagues will be critical partners in the initiatives we launch through the model."

"As the agency providing health insurance coverage to over one million residents, the AHEAD Model allows DSS to continue to invest and innovate to provide the highest level of service to our members" said Department of Social Services Commissioner Andrea Barton Reeves. "Importantly, this model will be part of our overall effort to reduce persistent health disparities in the state by investing more in primary care, paying providers in a way that promotes holistic care, and further coordinating the social and medical care needs of our members."

The AHEAD Model is a total cost of care modeldesigned to support health care transformation through multi-payer alignment with the goal of improving quality and population health outcomes, while controlling health care costs. A key focus of AHEAD is advancing health equity by supporting underserved patients through greater care coordination and by addressing social determinants of health. Activities will be guided by the Connecticut's Health Care Cabinet.

Initial funding will support participant recruitment, Medicaid payment model development, a state health equity plan, data alignment and analysis and additional quality and cost-growth benchmark initiatives. The AHEAD Model also offers hospitals and primary care practices new opportunities to participate in innovative components of the total cost of care model:

• Hospital Global Budgets: Connecticut hospitals will be offered the opportunity to participate in a global budget payment model that sets a prospective fixed revenue amount for the upcoming year for all payers including Medicare fee-for-service, Medicaid and commercial insurance. This payment structure allows hospitals to have more stable, predictable funding and invest in strategies to enhance care coordination and reduce or eliminate avoidable hospitalizations.
• Primary Care AHEAD: Connecticut primary care practices participating in the model will receive a Medicare management fee designed to help advance person-centered care. DSS will align these practices with ongoing Medicaid primary care transformation efforts. Federally qualified health centers will also be eligible to participate.

"The AHEAD Model provides a flexible framework, the opportunity to use benefit enhancements, and the resources and technical support needed for care transformation," said Pat Charmel, President and Chief Executive Officer of Griffin Health. "We are very interested in the potential long-term impact of the model's methodology on the strength and sustainability of our health system, the quality of our services, and our efforts to drive better health and health equity in the socially vulnerable communities we serve."

"Prioritizing health care investments that ensure access to high-quality primary care with attention to health-related social needs will improve health quality and outcomes for all Connecticut residents," said Anthony Yoder, DO, Assistant Professor of Medicine at UConn Health Center. "We also know that this approach helps to control cost growth, which aids our ability to keep quality health care affordable in our communities." Dr. Yoder is a member of the Healthcare Cabinet and Co-Chair of Health and Public Policy for the American College of Physicians Connecticut chapter.

"We look forward to partnering with state agencies and others to move forward with the AHEAD model as a way to improve health equity and outcomes in our state," said Tiffany Donelson, President and CEO of the Connecticut Health Foundation. "We are especially excited about the health equity plan that will be developed as part of the AHEAD model. We see this as an opportunity to continue to engage all stakeholders in making the changes necessary to ensure everyone can live their healthiest lives."

Connecticut's own State Employee Health Plan will also participate in the AHEAD Model, as a commercial payer. "The Connecticut State Employee Health Plan has been at the forefront of driving statewide health care reform and population health improvements efforts," said Sean Scanlon, Connecticut State Comptroller. "We look forward to working with OHS, DSS and our partners across the health sector to achieve sustainable health care cost growth trends and improve health outcomes through the AHEAD Model."

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