Health Innovations                                                                                  October 2017
SIM expands its reach
The Colorado State Innovation Model (SIM) continues to expand patient access to integrated physical and behavioral health with the addition of 156 practices in cohort-2 that started their work Sept. 15. The SIM initiative, which is funded by the Centers for Medicare & Medicaid Services, will release its application for the third and last cohort of practices Nov. 15. Please encourage primary care providers to apply for cohort 3, and tune in to our latest podcast, to hear a patient describe the value of receiving integrated care. 
A patient’s perspective on integrated care
Listen to Laura Carroll, a Health First Colorado client, talks about how integrated care has enhanced her family’s life in the latest episode of the SIM podcast series, Innovation Insights.

“That behavioral health piece is so very important and something that we’ve really been missing as a whole-health model so I’m excited that the state of Colorado is stepping up to do something about it.”

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SIM expands access to integrated care
The SIM team welcomed cohort-2 practices, which started their work Sept. 15 to expand patient access to integrated behavioral and physical health. The team is gearing up for the release of the application for SIM cohort 3 on Nov. 15. Stay tuned for more information and help the SIM team encourage practices to apply for this last chance to capitalize on federal funds in Colorado to help practices integrate behavioral and physical health and succeed in value-based payment models. Click here for the map of where SIM practice transformation is happening in Colorado. 
SIM engages consumers
The SIM team will start working with Arrow Performance Group (APG) to engage 500 healthcare consumers and community members, who will help identify and address key areas of healthcare concerns in the state. APG will conduct consumer outreach activities in at least two medically underserved regions to learn more about consumers' experiences accessing integrated healthcare and with healthcare delivery reform. The team will conduct focus groups, community forums, key informant interviews and surveys. The goal is to select and train 25 community leaders from the healthcare consumers group to provide a consumer voice in SIM healthcare transformation workgroups and meetings and participate in healthcare transformation efforts in their communities. The training shall ensure that the community leaders:
  • Can engage in and provide critical feedback about SIM activities and milestones
  • Participate in and provide critical feedback to the consumer engagement workgroup
  • Act in other leadership capacities
Colorado specialists, PCPs lead transformation efforts
RHC successes, overview
The Regional Health Connector (RHC) program, which is funded by SIM and managed by the Colorado Health Institute, has been heralded as a success by federal and state partners. Read a few of the highlights in this annual report, which includes local priorities, early success stories, lessons learned and next steps. Get more details from program staff , who share details of how RHCs are connecting healthcare providers with valuable community resources in a SIM podcast, and read a recent blog post by an RHC. 
Whole-person health: Why integration matters
Addressing fragmentation in healthcare is key to realizing why integrated care is so important, says Ben Miller, PsyD, in a recently released episode of Innovation Insights, a SIM podcast series. “Integration rights a pretty significant wrong in healthcare,” says Miller, an associate professor at the Colorado University School of Medicine and chief policy officer for the Well Being Trust in California. “It is the future of healthcare delivery.” Hear his discussion with SIM about why integrated care is so important, and how SIM providers are paving the way for better healthcare in Colorado and beyond. Subscribe to SIM Soundcloud and YouTube channels to see all SIM videos and podcasts, which help tell the SIM story.
2017 Colorado ACEs report released
This new report highlights state projects and efforts to identify and prevent short- and long-term consequences of early life stress through family-centered approaches, and provides a perspective on the inter-generational transmission of adversity, and a clear call to action. It taps data from the Adverse Childhood Experiences (ACEs) module of the Behavioral Risk Factor Surveillance System and a child health survey. Authors evaluate the effects of parental history of adversity on adult health and the health and well-being of their children. Read more!
SIM providers make strides
Cohort-1 practices are progressing along the IPAT integration continuum. Provider representatives report higher levels of coordination and integration of behavioral and physical health. Notable improvements include:
  • Improvement in the ability to report on clinical quality measures (CQMs) with confidence.
  • Improvement in the capture of data fields needed for CQM reporting.
  • Quarter-2 of 2017 is the first measurement period in which 100% of practices reported on at least one CQM.
  • Increased accomplishment of SIM milestones
  • Analysis of overall satisfaction and burnout showed positive scores: About 85% of respondents agreed/strongly agreed they are satisfied with their work.
Want more data? Check out the SIM data hub and listen to this podcast to learn about how SIM is using and collecting data from practices. 
Gap analysis, environmental scan IDs opportunities for sustainability
A new report will help the SIM team identify population-based behavioral health initiatives in the state that are focused on promotion and prevention as the team shifts more attention toward sustainability. The scan and gap analysis, which was conducted by Health Management Associates and funded by SIM, will inform a call to action with recommended strategies and actions to ensure the sustainability of SIM efforts to improve access to integrated care. 
Family engagement quality improvement: An implementation toolkit
Family engagement is an innovative approach grounded in mutually beneficial partnerships among health care providers, patients, and families. Ensuring that families are involved in all aspects of health care keeps families invested, ensures that care is appropriate, and meets the needs of each individual child.

The National Center for Medical Home Implementation conducted a nation-wide family engagement quality improvement project to enhance family engagement in the pediatric medical home. This Web-based toolkit provides tools and resources needed for implementing family engagement quality improvement projects in clinical practice or through multi-site learning collaboratives. Examples of resources included within this toolkit are Institutional Review Board applications, quality improvement change package, data collection instruments, and lessons learned tip sheet. Implementation of this project can also be used for Maintenance of Certification credits. All resources are customizable and free to download.

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Suggested reading
HIMSS Analytics released its 2016 Essentials Brief: Population Health Study, which provides a high-level view of how healthcare organizations are incorporating population health initiatives and leveraging information technology infrastructure to improve outcomes. 
U.S. hospitals and health care groups have experimented over the past decade with new management structures and alternative payment models to provide quality health care at lower cost. But physicians have been slow to embrace these for a host of reasons. Chief among them, research shows, is that they feel excluded from the process.
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.