SIM provider newsletter

Tracking SIM practice transformation efforts

January 31, 2019

D efining and communicating SIM success

The Colorado State Innovation Model (SIM) is embarking on its last six months and celebrating successes across its four pillars of practice transformation, population health, payment reform and health information technology. This federally funded, Governor's office has accomplished a great deal in its four years and will continue to ensure that federal investments across the state continue to have a positive influence on patient health while reducing or avoiding unnecessary health care costs.

SIM team members continue to meet with Gov. Polis's administration to illustrate how the initiative's investments in health care reform contribute to the new Office of Saving People Money on Health Care. Stay tuned for more information about this and reach out with stories of how SIM funding has influenced your care delivery processes, personal health care experiences and dealings with the health care industry.

Please look for emails from TriWest, the state evaluator for SIM, and from RTI, the federal evaluator. The SIM team encourages all practice teams to take advantage of these opportunities to share input about how SIM supports helped you deliver integrated physical and behavioral health, and improve efficiencies. Your input can help influence future initiatives.

BHTCs help ensure families get care they need

Expanding access to integrated care is a primary goal for SIM, which is why it is exciting to share news that SIM-funded behavioral health transformation collaboratives (BHTCs) in the Health District of Northern Larimer County Child, Adolescent and Young Adult Connections Team, and Aurora Mental Health Center, have connected more than 3,000 community members with behavioral health resources. Both BHTCs work with local school districts to address the need for behavioral health services in students and their families in these regions as illustrated in this new graphic . Learn more about how these BHTCs are improving the lives of Colorado families .

Deadline to submit CQMs

All SIM practices must submit their quarter-4 of 2018 clinical quality measure (CQM) data to SIM by Jan. 31. SIM practices must report quarter-4 results in the traditional ways.

Apply now for the eCQM solution

The SIM team recognizes the practice work entailed in submitting CQMs, and is funding a SIM-funded electronic clinical quality measure (eCQM) solution that will help practices report eCQMs while reducing the administrative burden of doing so. SIM practices must report quarter-4 results in the traditional ways and are encouraged to apply for the solution, which will help them in the future. The SIM-funded eCQM solution has been called the first to leverage blockchain technology for HIPAA-compliant data aggregation and reporting in Colorado. Read more and apply.

Insights into community mental health centers

Hear two representatives from the Jefferson Center for Mental Health (JCMH), one of four SIM-funded community mental health centers, talk about how they are improving whole-person health in the latest episode of Innovation Insights, the SIM podcast series. JCMH professionals talk about testing innovative approaches to care, analyzing data from screenings and assessments to improve care, establishing/maintaining workflows that are patient-centered and more.

New Office of Saving People Money on Health Care

On Jan. 23, Gov. Jared Polis created the Office of Saving People Money on Health Care, which will be led by Lt. Governor Dianne Primavera to study, identify and implement policies to lower health care costs while ensuring all Coloradans have access to affordable, quality care. Read the executive order, which mentions SIM .

Communicating the value of integrated care

The SIM team created a "good standing" process for primary care practices in cohort 2 to illustrate the work required to integrate care and provide patient-centered, team-based care. It is exciting to report that 85% of SIM practices in cohort-2 achieved good standing by the end of their first year. Practices achieve good standing by successfully completing identified building blocks and key milestones in the SIM framework. SIM sent annual good standing reports to practices and payers that support them in the initiative at the end of December. Read more.

Invoice for small grants or forfeit funds

All SIM small grant funds for cohorts 2 and 3 must be invoiced by March 30, 2019. Funds that have not been invoiced by this date will be forfeit. If your practice has remaining funds you should have received personal communication from Megan Comer (megan.comer@state.co.us), SIM small grants administrator. Get a refresher on invoicing details in the cohort-3 welcome webinar or email Megan as soon as possible with questions or concerns.

Using your cost and utilization reports

The most recent Milliman Cost and Utilization Reports for SIM cohorts 1 and 2 practices are available in the Shared Practice Learning & Improvement Tool (SPLIT) . Reports for all three cohorts are expected to be available by the end of February. These reports use data from the Colorado All Payers Claims Database for patients attributed to your practice. Information about the Milliman Cost and Utilization Reports and how one clinical health information technology advisor encourages practices to use them can be found in this archived webinar . Representatives from Milliman are available to address questions about these reports. Please direct questions to Katie Matthews at Katie.Matthews@milliman.com.

Communicating SIM practice work with patients

New materials developed by the SIM team help practices communicate the work entailed in delivering integrated physical and behavioral health care. The goal is to help practices share their stories with patients and to prompt discussion between patients and care team members. The patient-facing material, which was shared in December, was reviewed by the SIM consumer engagement workgroup and also by the Member Experience Advisory Council, a patient group that is convened by the Colorado Department of Health Care Policy and Financing. SIM practice representatives can download material, which can be customized for each practice.

Addressing medication complexity

A new infographic and fact sheet from the Center for Health Care Strategies highlights the risks of medication complexity and how community-based efforts can provide help. Some might be surprised to learn that 29% of U.S. adults take five or more medications daily and individuals with complex needs can take as many as 15-20 medications daily. These complicated drug regimens can have serious effects, including hospitalizations and even death. In the U.S., 119,000 deaths annually are attributed to prescription medication-related issues. Click here to learn more.

Final CLS for SIM practices

The final Collaborative Learning Sessions will be held March 7 in the metro Denver area, and March 8 in Grand Junction. Practice representatives are strongly encouraged to take advantage of this last, SIM-funded opportunity to hear from local and national speakers, subject matter experts and to connect with your peers and share lessons learned while celebrating collective successes. Registration for the Grand Junction event is open and registration for the metro Denver event will be available at the end of January.

Thursday, March 7: Denver Metro SIM Collaborative Learning Session
Friday, March 8: Grand Junction SIM Collaborative Learning Session

All SIM cohort practices and partners are invited to attend.

TCPi practices recognized by CMS

Two, Colorado Transforming Clinical Practice Initiative (TCPi) practices were recognized for the exceptional work they do for patients at the 2019 Centers for Medicare & Medicaid Services (CMS) Quality Conference. Both SurgOne and The PIC Place were selected as the "top story" out of respective categories of medication management and patient and family engagement.

SurgOne obtained significant physician buy-in throughout the practice and cut its opioid prescribing by 50% in 2018. In addition to a lower surgical infection rate, SurgOne's use of ambulatory surgery centers saved $10 million dollars annually.

The PIC Place developed an internal, complex needs team, and was recognized for excelling in patient and family engagement work. The complex needs team engages each patient by asking what each individual's best version of health looks like. Regular reviews of these journeys engages the patient, provides opportunities to celebrate success and systematically addresses health concerns before patients and providers start to feel overwhelmed.

Have you read the SIM blog?

SIM launched a blog in 2018 to highlight lessons learned, successes and challenges associated with this federally funded health care reform initiative. Please read, share and let us know what you think of the blog and what topics you'd like to see covered in future posts.

Tell the feds how SIM is doing

In March SIM practices will receive invitations to participate in a federal evaluation of the initiative's ability to accelerate health care transformation that result in better quality care, healthier people and access to integrated physical and behavioral health. SIM practices will receive emails from the SIM federal evaluation team, which includes RTI International, The National Academy for State Health Policy and The Henne Group (federal evaluation team) to gauge interest and willingness to participate in focus groups or interviews. Emails will end in @thehennegroup.com, @rti.org, or @nashp.org.

This evaluation team wants to hear from all types of practices including small and large, private practices, safety-net practices and those in and outside of the Denver area. The federal evaluation team will conduct focus group discussions and key informant interviews with SIM physicians, nurse practitioners and behavioral health providers. Interviews will last 60 minutes, and no stipend will be provided. Focus groups will last 60 minutes, and participants will receive a $300 stipend for their time.

The federal evaluation team will be in Denver April 24-26 to conduct in-person key informant interviews (at your office or a location you choose) and to conduct one, in-person focus group. From April 22-May 1, the federal evaluation team will also hold key informant interviews on the phone and conduct one, 60-minute virtual focus group using videoconferencing technology for providers outside the Denver area. If you are interested in participating in a focus group or being interviewed, contact Melissa Romaire: mromaire@rti.org.

Content review for the Colorado Health Care Data Summary

Please join the Colorado Business Group on Health on February 12 for a webinar to review the Colorado Health Care Data Summary™. This Report is an overview of the demographic, utilization, pharmacotherapy and financial measures for Type 2 diabetes, cardiovascular, and other chronic disease patients in key local markets across the state of Colorado. The Report also provides data on hospital utilization, readmissions, and other chronic disease spending measures that can help employers and providers better identify opportunities to serve the needs of their employees and patients. Learn more and register.

Get tips, tools about the QPP

Get details on the final rule for year 3 released by the Centers for Medicare & Medicaid Services in the latest installment of the Colorado Quality Payment Program (QPP) Coalition's "Fast Facts in 5 Minutes." The Coalition, which was formed in 2017 to help practice teams transition to value-based payment models, releases new resources monthly. Visit the web page for updates.