Michigan Receives Approval for Continuation of State Innovation Model; Continues Effort to Reinvent State’s Healthcare System

Publication Year: 2018
Patient Need Addressed: Care Coordination/Management, Chronic Conditions, Homelessness/housing
Population Focus: Complex care, Medicaid beneficiaries
Intervention Type: Partnership
Type of Literature: Grey


Insights Results

Overview of article/program

  • This brief describes a recently approved model for Year 3 in Michigan to test and implement a new model for delivering and paying for healthcare through CMS’s State Innovation Model
  • The award is based on the Michigan state governor’s Blueprint for Health Innovation, a document that explores ways to achieve an efficient, effective, and accountable government that collaborates on a large scale to provide quality service
  • The Michigan SIM initiative is organized into 3 categories: 1) Population health; 2) Care delivery; and 3) Technology. Each category also focuses on improving outcomes for 3 priority populations: 1) Individual at risk of high emergency department utilization; 2) Pregnant women and babies; and 3) Individuals with multiple chronic conditions
  • Community Health Innovation Regions (CHIRs) implement the population health component. These regions are broad partnerships of community organizations, local government agencies, business entities, healthcare providers, payers, and community members that work together to identify and implement strategies that address social determinants of health Given the strong correlation between housing issues and high emergency department utilization and poor health, which was observed in all CHIRs, year 3 of the model will focus on developing programs to help communities identify individuals in need of housing assistance
  • The care delivery component revolves around a Patient-Centered Medical Home initiative and the promotion of alternative payment models. PCMH Year 3 activities will continue development, refinement and sustainability of clinical community linkages, which will support patient linkage and coordination between clinical care and community-based social services
  • For technology, Michigan is leveraging new and existing statewide infrastructure and related health information exchange initiatives including the Relationship and Attribution Management Platform (RAMP). RAMP supports several aspects of care management and coordination, including a health provider directory, a system for tracking active care relationships between patients and provider and the exchange of quality-related data and performance results, and the transmission of admission, discharge and transfer notifications. Year 3 will expand RAMP to support broader statewide health initiatives, establish a roadmap for increasing quality and detail of patient-level attribution data within Medicaid and develop a use case for the collection and reporting of social determinants of health