Evaluating the State Innovation Models (SIM) Initiative

Population Focus: Medicaid beneficiaries
Demographic Group: Adult
Type of Literature: Grey


Insights Results

Overview of article/program

  • This article assesses independent evaluations of rounds 1 and 2 of State Innovation Model (SIM) Initiative
  • In 2013, CMS Innovation Center awarded over $250 million to 6 round 1 SIM states: Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont
  • In 2015, CMS Innovation Center awarded $622 million to 11 round 2 SIM states: Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington

    Methods of article

    • Authors used 1) qualitative data collection and analysis to document what states are implementing ; and 2) quantitative analysis to detect significant changes in care and outcomes in the 3 years following implementation of the SIM Initiative
    • Authors used a framework to guide evaluation, that consisted of 5 components: 1) Models and strategies (e.g., workforce development, health IT and data analytics); 2) Levers (e.g., state legislation, Medicaid waivers and state plans); 3) Implementation (e.g., wide stakeholder involvement in transformation activities); 4) Model impact (e.g., numbers of physicians and practices participating in models, lower healthcare costs); and 5) Statewide impact (e.g., Improved care coordination and quality of care, improved population health)


    • Each state’s SIM includes: 1) 1+ healthcare delivery and payment reform; 2) Strategies to enable the operation of these models (e.g., IT, data analytics investment) and plans for integrating population health activities; and 3) Policy levers to allow or facilitate the spread of these models and strategies throughout the state

    Key takeaways/implications

    • Policy makers can look to lessons learned from how SIM states leverage policies and strategies intended to grow delivery system and payment models to reach more providers and consumers
    • Results could also guide decisions to help build the infrastructure and capacity to operate delivery system and payment models, and help refine strategies based on stakeholder feedback and recognition of a changing environment