Health Innovations                                                                                February 2019
Telling the SIM story
Health care reform efforts in Colorado are paying off with improved patient health and the reduction in or avoidance of unnecessary health care costs. Those efforts, which have been led by the Colorado State Innovation Model (SIM) for the last three and a half years, proves that better health and lower costs are not mutually exclusive. SIM team members continue to share that message with stakeholders and SIM practice data support those claims. Two examples: SIM practices are improving patient control of diabetes and show a reduction in avoidable emergency department visits. Hundreds of practices and thousands of providers are accomplishing this by integrating behavioral and physical health and delivering patient-centered, team-based care. Gov. Jared Polis heard directly from Salud Family Health Center team members in Fort Collins about how the federally qualified health center has used SIM funds to expand patient access to integrated care. This is work that SIM practices plan to continue after the initiative ends in July 2019, which is good news for patients, who say integrated care boosts their confidence levels in health care providers, helps them make more informed health care decisions and affects their care experiences. How has your involvement with SIM affected your organization’s work, your approach to patient care or your care experience? Please share your story .
Articulating the value of SIM
Remembering all four pillars of SIM and how they influence the health reform initiative’s goal to increase patient access to integrated care and help providers succeed with alternative payment models can be difficult. Please remember to check out SIM resources including podcasts, articles, videos and blogs that help illustrate how SIM investments across the state will have a sustainable, meaningful effect on patients, health care providers and health plans.
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.
Insights into community mental health centers
Jefferson Center for Mental Health (JCMH), one of four SIM-funded community mental health centers, is testing innovative approaches to whole-person care, analyzing data from screenings and assessments to improve care, establishing/maintaining workflows that are patient-centered and more. Get specifics in the latest episode of Innovation Insights , the SIM podcast series.
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.
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.
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.
Are you ready?
The Farley Health Policy Center will be working with the SIM office to assess stakeholder readiness to develop and participate in multi-sector partnerships that sustain and expand SIM’s work to increase patient access to integrated care in Colorado. Cross-sector partnerships created with SIM funding have created a strong foundation for ongoing communication between community organizations, health systems, health plans and philanthropic organizations that support behavioral health integration across the state. This work will examine those relationships and ask stakeholders if and how they would like to continue working together to expand SIM’s influence on health care delivery after the initiative ends in July. A diverse group of stakeholders will be asked to participate in an online readiness assessment in March, and findings as well as recommendations will be disseminated to influence and support policy changes and systems-level infrastructure that will sustain and advance access to integrated care in Colorado. Stay tuned for more information.
Last SIM Collaborative Learning Sessions
The final Collaborative Learning Sessions (CLS) for SIM will be held on Thursday, March 7 ( Registration Deadline is February 28) in the Denver Metro area and Friday, March 8 on the Western Slope. All SIM cohort practices and partners are strongly encouraged to take advantage of this last opportunity through SIM to hear from local and national speakers, subject matter experts, and most importantly to connect with your peers and share lessons learned while celebrating our collective successes.
Please visit the Practice Innovation Program Colorado Website CLS page to register and for additional details.
  • Thursday, March 7: Denver Metro SIM Collaborative Learning Session
  •  Friday, March 8: Western Slope SIM Collaborative Learning Session
Quick-hit connections to CO communities
Regional health connectors (RHCs), a new health care workforce that was partially funded by SIM, have become key partners in building, designing and sharing websites with information about community services and supports. RHCs know that nothing replaces an in-person meeting and connection, and appreciate how helpful the internet can be when people are looking for quick answers. Learn about four examples in this blog.
Sustaining behavioral health integration
Listen to this on-demand webinar with Lori Raney, MD, principal, Health Management Associates, who walks SIM practices through ways to financially sustain integrated care efforts with specifics on therapy codes, billing tips and more using password “hWg3dW7v.”
Screening for adverse childhood experiences and trauma
There is a growing realization among health care providers that exposure to trauma, including neglect, abuse and violence, can have a lasting impact on health. Screening patients for trauma and adverse childhood experiences is often a key component of a trauma-informed approach to care. This new technical assistance tool from the Center for Health Care Strategies (CHCS) offers a variety of approaches for screening adults and children for adverse childhood experiences and trauma, including examples of screening protocols used at several provider practices that have embraced trauma-informed care. Click here to read more and download the resource.
New video explores trauma-informed care
How do our experiences as children shape our health as adults? What does it mean to be trauma-informed, and what does trauma-informed care look like in a health care setting? In this new animated video , meet “Dr. Cruz,” who addresses these questions and shares what she has learned about caring for patients with exposure to trauma, including abuse, neglect, and violence.
HHS launches innovative payment model
The U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (Innovation Center), which tests innovative payment and service delivery models to lower costs and improve the quality of care, announced a new payment model for emergency ambulance services that aims to allow Medicare Fee-For-Service (FFS) beneficiaries to receive the most appropriate level of care at the right time and place with the potential for lower out-of-pocket costs. The Emergency Triage, Treat and Transport (ET3) model will make it possible for participating ambulance suppliers and providers to partner with qualified health care practitioners to deliver treatment in place (either on-the-scene or through telehealth) and with alternative destination sites (such as primary care doctors’ offices or urgent-care clinics) to provide care for Medicare beneficiaries following a medical emergency for which they have accessed 911 services. Click here to learn more.
Third annual behavioral health skills training
The Practice Transformation Team at Rocky Mountain Health Plans is proud to announce they will be hosting the third annual Behavioral Health Skills Training. This training is open and free of charge to all medical and behavioral health providers, nurses, administrators, and office staff members in primary or specialty care. Learn more and register .
QI coach opportunity
Follow your passion and work with clinical and community-based partners and stakeholders of the Accountable Health Communities (AHC) to promote the screening, navigation and community service delivery of Medicare and Medicaid beneficiaries to address their identified health-related social needs. Learn more and apply .
Share your experience with integrated care
Are you interested in sharing your practice’s work on integrating behavioral health into primary care? If so, consider submitting a proposal to present a poster or a workshop at the October 2019 Collaborative Family Healthcare Association (CFHA) annual conference in Denver, CO. The deadline to submit a proposal is March 15, 2019. For more details, visit  CFHA’s conference website.
Suggested reading
As a cardiology nurse practitioner in Chicago, Barbara Martin often asked her patients if they had chest pain walking up a flight of stairs. At Valley View Hospital on the western slope of Colorado, she might ask her patients about their stamina during hunting season. The patients she worked with had heart problems. But for Martin, RN, MSN-ACNP, MPH, her approach to talking to her patients differed to fit their environment, and that made all the difference in how she worked to coordinate their care.
Health and Human Services Secretary Alex Azar spoke to the National Congress of American Indians on the importance of engagement between the federal government and tribal governments, 
and efforts to advance tribal health.
To provide better patient care, the health world is turning to screening tools to uncover issues like loneliness and food insecurity.
The Joliet Treatment Center, southwest of Chicago, is one of four facilities now providing mental health care to some of Illinois' sickest inmates. It's a start, say mental health advocates, but many more inmates in Illinois and across the U.S. still await treatment.
The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). The Colorado State Innovation Model (SIM), a four-year initiative, is funded by up to $65 million from CMS. The content provided is solely the responsibility of the authors and does not necessarily represent the official views of HHS or any of its agencies.