State Innovation Models (SIM) Round 2: Model Design Final Report

Nichols D, Farrell K, Morrison M, Berkman, Gavin N
Publication Year: 2017
Patient Need Addressed: Care Coordination/Management
Population Focus: Medicaid beneficiaries
Intervention Type: Service redesign
Study Design: Other Study Design
Type of Literature: Grey

The RTI team reviewed and abstracted data from the State Health System Innovation Plan (SHSIPs) and other Model Design documents for 21 states. The team used data from the SHSIPs, state data, and supporting document submissions, and state web sites to complete a data abstraction template that RTI had developed with CMMI’s input for each of the awardees. These data abstractions, along with the SHSIPs and supporting data, were used to identify cross-state themes and answer three research questions:1) What healthcare payment and delivery models and enabling strategies are proposed in the SHSIPs by the Model Design Awardees? 2) What is the geographic and population reach of the SHSIPs? 3) How did the SHSIPs address the core elements identified in the SIM Round 2 funding opportunity announcement?

Insights Results

Approach to Care

  • To implement new models, states propose approaches to greater patient engagement, health information technology (IT) initiatives, workforce development, and stakeholder involvement
  • As an initial effort, states propose to begin in the portion of the market where they
    can make changes, namely, Medicaid and state employee benefit plans. Across states, new PCMH and health home initiatives are most often proposed, as is greater coordination of physical and behavioral health, and improving service availability in rural areas Health IT
  • Health IT initiatives, such as promoting furthering EHR adoption, advancing health information exchange (HIE) capacity, and developing and expanding telehealth usage were often part of a strategy to improve connectivity and improve access to care in rural, underserved areas