State Innovation Models (SIM) Initiative
Clare Wrobel, MHSA SIM Team Lead State Innovations Group
CMS Innovation Center September 4, 2014
State Innovation Models (SIM) Initiative Clare Wrobel, MHSA SIM - - PowerPoint PPT Presentation
State Innovation Models (SIM) Initiative Clare Wrobel, MHSA SIM Team Lead State Innovations Group CMS Innovation Center September 4, 2014 CMS Innovations Portfolio Accountable Care Organizations (ACOs) Capacity to Spread Innovation
Clare Wrobel, MHSA SIM Team Lead State Innovations Group
CMS Innovation Center September 4, 2014
Accountable Care Organizations (ACOs)
Medicare)
Care Initiative Primary Care Transformation
(MAPCP) Demonstration
Primary Care Practice Demonstration
Bundled Payment for Care Improvement
Post Acute
Capacity to Spread Innovation
Health Care Innovation Awards (Rounds 1 & 2) State Innovation Models (Rounds 1 & 2)
Initiatives Focused on the Medicaid Population
Diseases
Medicare-Medicaid Enrollees
Nursing Facility Residents
2
EXPAND VALUE BASED PAYMENT MODELS TRANSFORM HEALTHCARE DELIVERY IMPROVE POPULATION HEALTH
initiative
Health Care Innovation Plan
based payment
transformation
preponderance of care
experts and technical assistance contractors
in improvements in quality, health and cost
CA http://www.chhs.ca.gov/PRI/CalSIM%20State%20Healt h%20Care%20Innovation%20Plan_Final.pdf MI http://www.michigan.gov/documents/mdch/Michigan_Bl ueprint_APPENDICES_REMOVED_454499_7.pdf CO http://coloradosim.org/ship-final/ NH http://www.dhhs.state.nh.us/ocom/documents/nh-sim- plan.pdf CT http://www.healthreform.ct.gov/ohri/lib/ohri/sim/plan_doc uments/ct_ship_2013_12262013_v82.pdf NY https://www.health.ny.gov/technology/innovation_plan_i nitiative/docs/ny_state_health_innovation_plan.pdf DE http://dhss.delaware.gov/dhss/dhcc/cmmi/files/chooseh ealthplan.pdf OH http://www.healthtransformation.ohio.gov/LinkClick.asp x?fileticket=WsSlPFly5GI%3D&tabid=138 HI http://hawaiihealthcareproject.org/images/pdf/policy- papers/Hawaii%20Healthcare%20Innovation%20Plan_ February%202014.pdf PA http://www.portal.state.pa.us/portal/server.pt/communit y/department_of_health_information/10674/center_for_ medicare_and_medicaid_innovation_(cmmi)/1535774 ID http://healthandwelfare.idaho.gov/Portals/0/Medical/SHI P/IdahoSHIP.pdf RI http://www.healthcare.ri.gov/healthyri/resources/SHIPw ithAppendix.pdf IL http://www2.illinois.gov/gov/healthcarereform/Documents /Alliance/Alliance%20011614.pdf TN http://www.tn.gov/HCFA/forms/SHIP.pdf IA http://www.dhs.state.ia.us/uploads/IA%20SHIP%20Final. pdf TX http://www.hhsc.state.tx.us/hhsc_projects/Innovation/pr
MD http://hsia.dhmh.maryland.gov/Documents/SIM%20Plan %20Final%20(compressed).pdf UT http://health.utahsummit.com WA http://www.hca.wa.gov/shcip/Documents/SHCIP_Innov ationPlan.pdf
What is the State testing? What is CMMI funding?
patient-centered medical homes
conditions
technical assistance and learning system
models
and Patient-Centered Medical Home (PCMH))
governance, and technical support
State HIT Plans and Existing Infrastructures:
processing and payment system for Medicaid.
– Storing data in a centralized location bring Department of Human Services (DHS) closer to the goal of full data integration.
Arkansas Payment Improvement Initative (APII) Investments in existing and new HIT & Analytics infrastructures:
– Connecting large practices and hospitals serves as a key accelerant to HIT adoption and transformation in Arkansas.
What is the State testing? What is CMMI funding?
Health Homes
to accelerate delivery system reform
health and long term delivery
Structure (including personnel)
behavioral health providers
advanced data sharing, and enhanced analytics
Existing Infrastructure:
data on all patients in an inpatient, outpatient, and ER setting
development of data analytics capability for population health management.
Ongoing SIM Investments:
Future Investments:
providers.
What is the State testing? What is CMMI funding?
Reform Initiative (MassHealth)
experiences of care measurement strategy
management
Ongoing investments in existing and new HIT & Analytics infrastructure:
– Goal is to receive Quality Reporting Document Architecture (QRDA) data from provider EHRs via HIE, use quality data for payment reform, research and reporting, and make MMIS more “quality aware.”
Services and Support providers
– Goal is to enable providers to provide electronic referrals to community resources.
– Mass will utilize their APCD to enable providers to access claims-based reports for their entire patient panels with standard formats and timeframes.
What is the State testing? What is CMMI funding?
behavioral health, long-term support services, and social services
for Health
primary care practices
exchange
transformation
for Health
ACO metrics, payment methodologies
Ongoing HIT Investments
Ongoing Data Analytics Investments
Data analytics reporting and support for partners participating.
customized reports
What is the State testing? What is CMMI funding?
model to cover state employees
Transformation Center that will disseminate best practices among Coordinated Care Organizations (CCOs) and other health plans
management
Center
What is the State testing? What is CMMI funding?
patient-centered medical homes
conditions
technical assistance and learning system
advanced analytics
design
support
– Up to $30 million to fund up to 15 Model Design cooperative agreements – Up to $700 million to fund up to 12 Model Test cooperative agreements – Applications were due July 21, 2014 – Expect to announce selected states for Model Design and Model Test cooperative agreement awards Fall 2014
Questions? Contact Clare.Wrobel@cms.hhs.gov or StateInnovations@cms.hhs.gov