In the latest survey, CT health care thought leaders give our state a C+ grade on health reform, down from last year’s survey. CT’s grade for effort also dropped to a B-/C+ in this survey. Higher marks go to the health insurance exchange, Medicaid, and patient-centered medical homes, as for last year. Payment reform/quality improvement scored lowest followed by HIT, workforce and health insurance market reform. Suggestions to improve progress are to engage consumers (a perennial leader), learn from what works (also a familiar theme), opening the process to all voices/transparency in planning (also not new), and support Health Information Technology and data tools. Recommendations were more diverse and specific than in previous surveys; all responses are included in the brief.