Health Innovations                                                                                 February 2018
SIM helps practices empower patients
The Colorado State Innovation Model (SIM) closed its practice application for the third and final cohort that will start its work this summer to integrate behavioral and physical health and gain/hone skills to help practices succeed in alternative payment models. The first cohort of SIM practices will complete its work next month and we continue to tell stories about how SIM has helped primary care practice sites deliver integrated care that improves health outcomes and reduces or avoids healthcare costs. Listen to a recent podcast with a SIM cohort-1 practice care team that includes a patient’s perspective and learn how SIM practices are testing the theories of healthcare reform across the state and bringing the concepts of patient-centered care full-circle as illustrated in the second installment of the SIM blog. And during this Valentine’s Day check out #healthpolicyvalentines on Twitter and share health policy love.
Measuring success, proving value: A SIM journey
Practice transformation requires staff time, resources and a commitment to redesigning processes to ensure the delivery of patient-centered, team-based, integrated healthcare. As we approach the two-year mark for SIM cohort-1 practices that end their formal participation March 31, the team continues to gather and share stories of success.

“It’s been very valuable,” Cindy Mattingly, RN, BSN, manager of practice transformation for Rocky Mountain Health Plans, said about SIM practice implementation during the Jan. 18 Multi-Stakeholder Symposium (MSS). “It’s really exciting to see how all of this has grown and the value that you get by participating,” she added.

Mattingly joined representatives from SIM cohorts 1 and 2 practices, health plans that support SIM and practice transformation organizations (PTOs) at the MSS, which is designed to foster respectful discussion about practice transformation work and alternative payment models (APMs) that support it. This was the first MSS for cohort-2 practices and highlighted the need for more frequent discussions between practices and payers about how practices are evaluated, what payment support looks like and ways to develop closer partnerships.

SIM helps practices empower patients
Get an overview of the payment support package, hear more about the Multi-Payer Collaborative in Colorado and learn how the SIM initiative helps primary care practice sites succeed with alternative payment models (APMs) in this latest episode of Innovation Insights, a SIM podcast. Visit the SIM Soundcloud and YouTube channels for a list of all videos and podcasts published.
SIM releases eCQM solution, recruits for data governance committee
The SIM team will start testing a service that will help SIM practices extract electronic clinical quality measures (eCQMs) from electronic health records (EHRs) in a small pilot starting in April and May. The service will be rolled out to all SIM practices this summer, and it will ultimately be available to all Colorado practices. Details on the timeline for that release will be forthcoming. The SIM investment creates a technical and operational infrastructure that will extract eCQMs from EHRs once so they can be reported to different approved entities, a task that is frequently cited as a barrier to success with alternative payment models (APMs). It lays the foundation for ongoing state efforts and will help reduce administrative burden for SIM practices. To ensure success, the SIM team is creating a data governance committee that will create an infrastructure for eCQM data use. Apply by March 15 to participate.
SIM connects with consumers
A series of community meetings will be scheduled in metro Denver and southeast Colorado in March and April to engage patients in discussions about healthcare reform and how the integration of behavioral and physical health in primary care settings benefits them. These efforts will be orchestrated by Arrow Performance Group (with SIM funding) and led by community leaders. The SIM team, with guidance from its consumer engagement workgroup, picked two medically underserved regions for this work, which entails regular meetings and consumer interviews. Stay tuned for more information. 
SIM telehealth efforts move forward
The results from the telehealth/eConsult survey are in! Almost 200 responses provided urban and rural perspectives that represent several statewide telehealth/eConsult initiatives and highlight the main barriers to adoption. These included a lack of clarity surrounding billing and reimbursement, technology and workflow integration and an unknown return on investment. Survey results have helped SIM narrow the focus of its telehealth strategy and will lead to an options analysis using criteria that will assess risk, opportunity, sustainability and alignment with Medicaid efforts.
Challenges to adopting digital health
Recent studies suggest that digital health technologies offer many benefits to patients and healthcare providers, but there are challenges that prevent or delay adoption. Prime Health, a non-profit organization that promotes alignment between healthcare technology entrepreneurs and industry stakeholders, is interviewing Colorado healthcare representatives to understand barriers and align priorities between these two communities. SIM practices are encouraged to complete this short survey to help bridge the gap between theory and practical implementation of digital health technology.
Colorado TCPi practice recognized nationally
Representatives from SurgOne, P.C. (pictured here), a Denver-based comprehensive general surgery group in the Colorado Transforming Clinical Practice Initiative (TCPi), were recognized this week during the Centers for Medicare & Medicaid Services (CMS) national quality conference. The practice was also highlighted in a CMS newsletter for its cost-savings achieved with coaching and guidance from TCPI, a federally funded, governor’s office initiative, that resulted in approximately $1,000 saved per case. Read the newsletter story here for more details, read the SurgOne story and see TCPi cost savings to date.
RHC updates
Get more information on the regional health connector (RHC) website including:

Like the RHC page on Facebook, which is where we plan to share new stories and follow us on Twitter.
New state substance use, mental health service directory
The Office of Behavioral Health (OBH) released an online substance use disorder licensing and mental health designation application system and service directory in January. The Licensing and Designation Database and Electronic Records System ( LADDERS) replaces for those seeking substance use and mental health services in Colorado. With the rollout of LADDERS, OBH will no longer accept paper application submissions for licensing or designation processing, and all application payments will be made online through the system. OBH licensed and designated providers will need to:  

  • Verify agency information and make any necessary updates
  • Attend a scheduled trainings to receive more information and ask questions

Contact Lorey Bratten with questions.
New PCP leadership program
Primary Care Movers and Changers (PCMAC) is a new, advocacy-focused leadership training program that is free, and open to a wide range of primary care providers (PCPs), who practice in underserved metropolitan communities or are from underserved communities or backgrounds. The deadline to apply is March 15. 
QPP fast facts in 5 minutes
The Quality Payment Program (QPP) began Jan. 1, 2018, under the Medicare Access and CHIP Reauthorization Act (MACRA). This program is an effort to drive clinician engagement and enhance the quality, cost effectiveness and health of the population. The Colorado QPP Coalition has been formed to help clinicians and their practice teams successfully transition to the new program. As part of this work, the Colorado QPP Coalition releases its fast facts in 5 minutes each month. For more information visit the Colorado QPP website and stay tuned to the SIM newsletter for more updates.  
Suggested reading
Integrated behavioral health and primary care is a patient-centered approach designed to address a person’s physical, emotional, and social healthcare needs. Increasingly, practices are integrating care to help achieve the Quadruple Aim, yet no studies have examined, using qualitative methods, patients’
experiences of care in integrated settings. The purpose of this study was to examine patients’ experiences of care in community-based settings integrating behavioral health and primary care.
According to the CDC, one in five kids has been diagnosed with some form of a mental or emotional disorder. ABC 6 spoke with medical professionals about the warning signs parents need to be looking out for. In some instances, experts say those clues could be a lifesaver.
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.