Health Innovations                                                                                 November 2018
Gaining traction: SIM investments show results
There are many successes to celebrate as 2018 draws to a close. This has been a productive year for the Colorado State Innovation Model (SIM) team with thousands of providers integrating behavioral and physical health and gaining the skills they need to succeed with alternative payment models. SIM investments, which include public health agencies that cover 31 counties and development of an electronic clinical quality measure solution, will influence health care in Colorado well beyond July 2019, when the initiative formally ends. The SIM team looks forward to working with Governor-elect Jared Polis’s administration next year, and appreciates ongoing support from Governor John Hickenlooper, who appointed Kate Harris, MPA, as ombudsman for behavioral health access to care and director of that office. The SIM team looks forward to meeting Harris, who is currently the policy and external affairs director for Connect for Health Colorado, and sharing SIM practice successes. One example is the increase in depression screenings (shown above and published on the SIM data hub ), which help providers identify and address depression to ensure the best outcomes. Read on for exciting news about a new e-Consult opportunity, support for Colorado veterans and more work underway, check out SIM social media channels for late-breaking news and bookmark the SIM blog, which focuses on payer-provider partnerships. 
Protect CO youth: Vape-free November
Data shows that Colorado youth are vaping nicotine at the highest rate of 37 states surveyed, which led Governor John Hickenlooper to proclaim Vape-Free November. “While cigarette smoking among high school students has dropped, vaping nicotine continues to increase,” according to the Colorado Department of Public Health and Environment (CDPHE). The 2017 Healthy Kids Colorado Survey shows that while only 7% of high school students smoke cigarettes, 27% said they vape nicotine. The school survey shows 87% of Colorado high school students think cigarette smoking is risky, but only 50% think those risks apply to vaping nicotine. Get the facts about vaping in this handout and read more on the CDPHE website
SIM invests in veteran health
The Colorado State Innovation Model (SIM), a federally funded, Governor’s office initiative, is pleased to announce the creation of a veteran health connector (VHC) role in eastern Colorado to connect veterans with the community resources they need for better health and wellness, who will engage veterans, community partners and develop a community-based plan to prevent suicide. The VHC role is patterned after regional health connectors, who are partially funded by SIM to facilitate stronger community partnerships. Connecting with veterans was part of the original SIM proposal and the team is pleased to extend this resource to the veteran community in Colorado. More information will be published in the coming weeks. Please watch SIM social media channels and the website for more details and information about the new VHC, who has already started her work.
SIM expands access to care: RFP open Oct. - Nov. 19
A new SIM request for proposal (RFP) will help health care entities plan for or expand electronic consultations (e-Consults) to increase patient access to care across Colorado. E-Consults are a cost-effective way for primary and specialty care teams to deliver the right care in the right setting, which positions them for success with value-based payment models. Funding will be awarded to three health systems to evaluate workflow, engage providers, support technology and create an implementation plan to advance e-Consults in Colorado. Read the request for proposals, listen to a quick webinar and submit a proposal by Nov. 19 .
eCQM solution helps SIM practices bolster success with APMs
The application for the SIM-funded electronic clinical quality measure (eCQM) solution, which helps practices report eCQMs while reducing the administrative burden of doing so, is open and SIM practices have priority access to it. The solution has been called the first to leverage blockchain technology for HIPAA-compliant data aggregation and reporting in Colorado. Read more about the eCQM solution and apply today .
SIM helps providers prepare for value-based payments
Get the full scoop on data collection efforts underway and what SIM data experts have learned from cohort-1 practices in the latest installment of Innovation Insights , the SIM podcast series. Leilani Russell, MPH, SIM data lead coordinator, talks about how practices have improved their ability to report clinical quality measures, which will help them negotiate value-based payment models. Follow SIM on SoundCloud to listen to all episodes of the series and check SIM’s YouTube channel for more media. 
Video features SIM practice successes
Using data to manage patient care is one of the many skills one SIM pediatrician gained during her work with SIM and the practice facilitator, whom she credits with guiding the team’s work. Listen to practice members and a SIM-funded practice facilitator talk about the value of using data more effectively in practice and using e-learning modules to improve care coordination efforts.
Building resilient communities in southwest Colorado
Mary Dengler-Frey, a regional health connector (RHC) at the Southwestern Colorado Area Health Education Center, is tackling three challenging problems: opioid addiction and substance abuse, diabetes and suicide. Mary draws on her experience as an architect to build infrastructure that will help providers expand access to care. “Though they seem disparate, there’s similarity in the complexity and the coordination of moving parts,” she says.  Learn more about Mary by reading a profile of her work and connect with the RHC in your region .
BHPs get SIM-funded training
While integrating behavioral and physical health in primary care settings can be a long, windy road with many challenges, it leads to better patient care and a more rewarding experience for care teams, say behavioral health providers (BHPs) who work in integrated care settings. More than 200 of these BHPs attended a recent SIM-funded training that was hosted with the Office of Behavioral Health Nov. 1. Providers, who completed the training, received an Integrated Behavioral Health (IBH) Certificate that aligns with the   Core Competencies for Behavioral Health Providers Working in Primary Care  and the IBH Best Practice Guidelines.
Caring for seniors: Tips, tools, resources
Caring for seniors requires a thoughtful, effective team approach that considers a patient’s stage of life as well as their unique wants and needs. A new, SIM-funded, e-learning module helps care teams optimize all members to ensure that patient care is tailored to these unique needs and balanced with individual lifestyle (e.g., physical and mental wellness, safe and healthy nutrition, physical strength and mobility, and access to a social network). Watch this video for guidance and visit the e-learning platform to participate in 15, free modules funded by SIM. Register using the “SIM” code and find out how these modules can help your care team integrate physical and behavioral health.
RHCs influence care in Colorado
The Statewide Social Network Analysis (SNA) report shows that regional health connectors (RHCs) are making meaningful, system-level connections in their regions to share resources and knowledge. A key finding: More than 93% of SIM cohort-1 practice survey respondents say that RHCs helped their practices connect with community resources to achieve their practice transformation goals.

As of June 2018, RHCs across the state reported 3,071 meaningful contacts with community based-organizations, government agencies, medical providers, behavioral health providers, payers, community members, practice transformation organizations and multi-sector groups. This is a metric of success for RHCs, who are partially funded by SIM to improve clinical-community linkages, remove barriers to health care and address factors that influence health. This data will be instrumental for sustainability conversations. 
Join the SIM effort to improve health
Learn more about and apply to become the child development systems integration specialist, a SIM-funded position with the Colorado Department of Public Health and Environment. This systems integration specialist will provide population health and health systems expertise to improve developmental and social-emotional screening, referral and intervention processes for children in Colorado. Contact Britt Hoerauf ( brittany.hoerauf@state.co.us) with questions.
Suggested reading
Digitization promises to make medical care easier and more efficient. But are screens coming between doctors and patients?
Colorado’s total health care costs for commercially insured individuals in 2016 increased two percentage points from 2015, according to a new multi-state benchmark analysis released today by the Network for Regional Healthcare Improvement (NRHI). Analysis by the Center for Improving Value in Health Care indicates that Colorado could save over $54 million annually if costs were brought down to the Colorado statewide median. Over $141 million in savings would be realized if total costs were reduced to the multi-state average.  
After four years of operating its mental healthcare network under one framework, Colorado is asking for mental healthcare providers to make their case to be part of a new statewide approach. Critics say the new system from the state’s Office of Behavioral Health would involve cutbacks in funding for several regions and changes in the way providers allocate money, and would break up the current mental health network’s four districts into seven.
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.