Health Innovations                                                                                January 2019
SIM continues to prove success, ensure sustainability
The first two weeks of January have been busy for the Colorado State Inn ovation Model (SIM) team, which will work with Governor Jared Polis (pictured to the right during his inauguration) and his administration to ensure that work funded by SIM and the Transforming Clinical Practice Initiative (TCPi) continue to influence the health care system in Colorado well beyond July and September 2019, when both initiatives (respectively) end.

SIM team members have met with the Polis administration several times and continue to highlight success we see across the state — from an increase in referrals to behavioral health services (outlined below) to more depression screenings, improved blood sugar levels (Hemoglobin A1C) for patients with Diabetes, who go to SIM practices, and more.

This data proves the success of SIM and TCPi efforts across the state, which continue to be communicated to policy makers, health plans and a growing number of stakeholders. The SIM office recently received a question from a practice representative seeking guidance for integration efforts. The practice is not affiliated with SIM or TCPi, which makes the request exciting since a main goal is to ensure that all investments lead to sustainable, meaningful change.

The team is pleased to welcome Sanjai Natesan as health information program advisor. Natesan brings a wealth of knowledge and expertise with state and private information technology solutions to the table, and will help ensure success of the SIM eCQM solution.
BHTCs refer families to behavioral health services
SIM-funded behavioral health transformation collaboratives (BHTCs) in the Health District of Northern Larimer County (CAYAC) and Aurora Mental Health Center have connected more than 3,000 community members to 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
Communicating the value of integrated care
The SIM team created a "good standing" process for SIM 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 will send annual good standing reports to practices and payers that support them in the initiative. The first report was sent Dec. 31. Read more
SIM practices submit CQMs
All SIM practices must submit their quarter-4 2018 clinical quality measure (CQM) data to the SIM initiative by Jan. 31. 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 apply.
SIM practices recognized nationally
It is exciting to report that three SIM practices (out of 18 practices chosen nationally) will be recognized by the Centers for Disease Control and Prevention as “hypertension champions” for the national Million Hearts Campaign. Learn more about how these practices (listed below) helped their patients control their blood pressure.
  • High Plains Community Health Center Holly Clinic - SIM cohort 2
  • Hinman Family Medicine – SIM cohort 2
  • Southern Colorado Medicine – SIM cohort 3
Helping SIM practice teams raise awareness of their work
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 email the SIM team to receive a link to the material, which can be customized for each practice.
TCPi practices take national stage
Two practices that participate in the Transforming Clinical Practice Initiative (TCPi) were chosen to represent “exemplar practice” criteria for practices in Colorado during the 2019 CMS Quality Conference. The focus for the conference is “innovating for value and results.” TCPi is a federally funded, Governor’s office initiative that is managed by the SIM office.

The two exemplar practices that will share their stories are SurgOne in Denver and the PIC Place in Montrose, which is also a cohort-3 SIM practice. Each practice will share successful strategies for cost containment, high-value referrals and patient and family engagement that qualify them for the “exemplar practice” status.

Exemplar practices are in phase 4 or 5 of the initiative, have completed the fifth phase 5 or completed 85% of their possible Practice Assessment score. These stories will be published on the TCPi page of the SIM website this month.
SIM provider shares value of integrated care
The latest episode of Innovation Insights illustrates the value of offering integrated physical and behavioral health in primary care settings from a provider and practice administrator’s points of view. “We’re seeing such a huge impact with people getting better,” says Katrina DeRomana, NP, practice owner, Heartlight Family Clinic in Colorado Springs. “I will never go back,” she adds. “It’s such a huge improvement (in patient outcomes) that we’re seeing.” Hear more from DeRomana about how the practice’s involvement in the Transforming Clinical Practice Initiative (TCPi) and SIM has helped her practice team expand patient access, retool processes and use data in actionable ways.
Last SIM Collaborative Learning Sessions
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 take part in these memorable events. 
Educational series helps providers lead integration effort
Integrating behavioral health into primary care settings creates new roles and responsibilities that lead to new challenges. This free, five-week series , which was designed for behavioral health providers, will help you develop strategies to resolve common ethical dilemmas, implement and operationalize tools linked to financial sustainability and discuss ways providers can lead integration efforts. Sessions run Feb. 6 through March 6 on Wednesdays from 12 – 1 PM MST. Register and learn more.
Share your perspectives
The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), issued a Request for Information (RFI) seeking input from the public on how the Health Insurance Portability and Accountability Act (HIPAA) Rules, especially the HIPAA Privacy Rule, could be modified to further the HHS Secretary’s goal of promoting coordinated, value-based healthcare. This RFI is a part of the Regulatory Sprint to Coordinated Care, an initiative led by Deputy Secretary Eric Hargan.
The strategy is intended to address three overarching goals designed to reduce clinician burden: Reduce the effort and time required to record health information in EHRs for clinicians; Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and healthcare organizations; and improve the functionality and intuitiveness (ease of use) of EHRs. HHS will only accept comments electronically. The deadline for comment submission is 11:59 pm ET on January 28.
Events
Jan. 18: “Thrive in the Value-Based World: Financial Keys to Succeed,” an interactive workshop for SIM and TCPi clinicians, office managers and business office staff Jan. 18, 8:30 a.m. to 12:30 p.m. at the Catalyst HTI Building (3513 Brighton Blvd, Denver CO). Learn about successful payer-contracting methods, managing patient attribution through improved workflows and budget basics. Contact, Pam Ballou-Nelson, RN, MSPH, CMPE, PhD, presenter, for more information.

Jan. 14: Health Care Advocacy Training: Colorado's legislative session will bring a lot of opportunities to advance health care policy. Learn advocacy basics and different ways you can advocate for a better health care system. Join this free training to learn how you can make your voice heard on the health care issues that are important to you. We'll walk you through the who, what, where, when, why and how of health care advocacy, provide a quick overview of the health care landscape, answer your questions, and give you practical next steps to start your advocacy efforts.

April 3-4: The state's Office of Suicide Prevention is pleased to offer its next Zero Suicide Academy for Colorado healthcare organizations on April 3-4, 2019. Apply here for the opportunity to send a team of four from your organization to the Academy to learn the ins and outs of implementation of this critical initiative. Contact Emily Fine with questions.
Suggested reading
Nurse leaders should recognize and respond to factors that contribute to nurse suicide. Here are three actions you can take to prevent it.
As the 2019 legislative session kicks off, Mental Health Colorado applauded lawmakers for making mental health a priority by introducing key bills to improve prevention and treatment services throughout the state.
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.