Health Innovations                                                                               June 2019
SIM ends, but the work continues
The Colorado State Innovation Model (SIM) ends July 31 after four years of implementing an ambitious model to reform health care with the knowledge that groundwork has been laid for future success. SIM was intended to catalyze innovation across four pillars to expand patient access to integrated behavioral and physical health care and prepare providers for success with alternative payment models. It was an ambitious approach to SIM funding, and data shows that it is working as illustrated in stories below, through data published on the SIM website and in final evaluation reports, which will be available on the website in August along with the final SIM report to the Centers for Medicare and Medicaid Innovation. The SIM website will be available as an archive for at least one year, and stakeholders are encouraged to use resources as frequently as possible. The SIM office will continue working with the Governor’s Office of Saving People Money on Health Care, which recognizes integrated care as a key component to improving outcomes and reducing or avoiding unnecessary costs as noted below by Lieutenant Governor Dianne Primavera. Connections made by the SIM office paved the way for a more collaborative approach to health reform and we thank you for your support and participation in this work. You have been a lynchpin to SIM’s successes, and we hope that these newsletters have provided you with a bird’s eye view of how SIM funding has led to the creation of resources for providers from payment reform to certification for integrated settings, increased access to whole-person care for more than half a million people and the list goes on. We’d like to take this opportunity in this, our last SIM stakeholder newsletter, to thank you for your help, support and guidance. Please continue to champion this work and raise awareness of the value and need for integrated care in primary care settings. We see this as a new beginning and trust you to carry the torch! 
Deadline today: Participate in Primary Care Payment Reform Collaborative
Apply before the end of the day today (June 14) to participate on the Primary Care Payment Reform Collaborative led by the Colorado Division of Insurance (DOI). The collaborative, established by House Bill 19-1233, will develop strategies for increased investments in primary care to deliver the right care in the right place at the right time, and to help develop affordability standards. DOI encourages representatives from these groups to apply:
  • Health care providers, including primary care providers
  • Health care consumers
  • Employers that purchase health insurance for employees and employers that offer self-insured health benefit plans
  • Health insurers, including those that contract with HCPF as managed care entities
  • Experts in health insurance actuarial analysis

Data show that racial/ethnic minorities, immigrants, LGBTQ individuals and other marginalized communities often experience barriers in access to primary care in Colorado, which is one of the reasons DOI encourages members of these groups to participate. Read more online.
Men's mental health and wellness
New messaging for the Let’s Talk Colorado campaign focuses on men, who are at high risk for untreated mental health issues and suicide.
“We don’t go to primary care and we make jokes about this in our society — men don’t go to the doctor, we don’t stop and ask for directions and we definitely don’t go and talk to shrinks,” says Jason Vitello, who participated in a recent SIM podcast and talked about the need to change societal norms that have a negative effect on men’s health. “It’s not a laughing matter when you look at the numbers and what many are calling a crisis in public health.”

Hear more about the work SIM's metro local public health partners have done to customize messaging, which was prompted by the SIM-funded call-to-action report that identified a need for specific outreach to men, who are not as likely to seek the whole-person care they need. 
Addressing the 'ouch' factor
By addressing patients’ bodies and brains, SIM providers address what one patient advocate calls the 'ouch' factor, which influences outcomes and reduces or avoids unnecessary health care costs. “It’s uncomfortable to talk about and there are a lot of unknowns when it comes to our mental health,” says Laura Carroll, honorary patient representative on the SIM advisory board. “We’re just not comfortable talking about the ouches associated with mental health.” Read more in the SIM blog .
Asking the question: A simple step to improve veteran health
Stacy K. Syphers, the SIM-funded veteran health connector (VHC), is connecting military veterans in eastern Colorado with community resources to improve their health and wellness, and she’s developing a community-based plan to prevent suicide. One quick tip that she’s giving primary care providers is to ask patients if they’re veterans, which can influence health in myriad ways. Asking that one question could help care teams identify the source of a health issue more quickly and ensure better outcomes and the reduction of unnecessary costs. Hear more about this important work in the latest episode of the SIM podcast series, Innovation Insights, and subscribe to the SIM Soundcloud and YouTube channels for more podcasts and videos.
News state logo
The state is rolling out a new logo to replace the ‘triangle’ logo. State agencies have been asked to launch individual new logos during the next year, and SIM will switch its logo out in the coming month. See this new logo on the SIM website and read updated SIM branding guidelines for more information.
Final SIM-funded Multi-Stakeholder Symposium
Lieutenant Governor Dianne Primavera attended the last, SIM-funded Multi-Stakeholder Symposium (MSS) June 6 in Denver, and thanked attendees for their investment in effective health care reform. “Redesigning health care takes time, energy and financial support and the people in this room have helped thousands of providers start or progress along that journey,” Primavera said. “As a result, more than half a million more patients received whole-person care across that state and we want to see that number increase.”

These meetings prompted meaningful conversations between practices engaged in SIM and health plan representatives, who announced they will fund future meetings to continue conversations about payment reform. SIM funded the MSS to encourage representatives from SIM practices, health plans that support them and practice transformation organizations that coached practices to learn from each other, build closer partnerships, reflect on progress made to date and discuss challenges and successes. Read articles about how these meetings helped improve partnerships between health plan and provider representatives.
Stratus data refresh
SIM funded a data aggregation tool to help SIM practices use data in actionable ways and announced the last refresh for SIM practices. Data was updated in Stratus™ on May 30, and included the following payers: Anthem, Rocky Mountain Health Plans, United, Cigna, and Medicaid. Medicare data for practices participating in SIM are expected to be updated the first week of June. Stratus™ licenses for SIM-only practices will be deactivated on June 30, and this will be the final Stratus™ data update for those practices. Dual SIM/CPC+ and CPC+ only practices will continue to have access to Stratus™, as health plans have committed to support practices participating in CPC+ with the Stratus™ data aggregation tool until at least the end of the initiative in 2022. The SIM office encourages practices to take advantage of this opportunity and utilize the data available within Stratus™ before licenses are deactivated at the end of June. If you have any questions, please reach out to Elizabeth Mattes with the SIM office. Click here to log into your Stratus™ account and learn more about Stratus™ online.
Business curriculum for practices
Get help negotiating mutually beneficial contracts with commercial payers. Practice teams can access four of six, SIM-funded curricula and webinars, which provide an introduction to payer relationships and contracting, an overview of the most common reimbursement models used by health plans, strategies to use when contracting and tips for communicating effectively with health plans. Check the SIM practice resource page (link) for additional modules and contact Elizabeth Mattes with questions.  
New web page highlights resources for providers
Get a list of resources customized for SIM-funded health care teams to help support work after the initiative ends. Please share these resources with your colleagues as they are available to all providers, regardless of SIM participation, and will be available after SIM ends July 31. 
Free training for suicide prevention
The Suicide Prevention Resource Center is offering the free online course Locating and Understanding Data for Suicide Prevention. The course explores a variety of commonly used data sources for information on suicide deaths and attempts, suicidal ideation, and related factors—as well as new frontiers in suicide surveillance, such as interactive dashboards and real-time data collection.
Helping kids cope with anxiety and depression
Hear representatives from Sapphire Pediatrics, a SIM cohort-2 practice, talk about how a behavioral health provider helped an 11-year-old patient cope with anxiety and depression while losing more than 30 pounds in this episode of Innovation Insights, the SIM podcast series.
Educational series helps providers integrate care
A free ECHO series will focus on increasing provider competency in working with intellectual and developmental disability (IDD) dual diagnosis populations, who might be vulnerable to mental health issues. The series covers the evolution of dual diagnosis treatment, the diagnosis of mental health disorders in individuals with IDD, intervention considerations in dual diagnosis treatment and case discussions. Interested in more training opportunities? Be sure to check out the other free educational series from ECHO Colorado. SIM encourages professionals to also check the SIM-funded IDD module on the eLearning platform .
Successes from a regional health connector
Stephanie Salazar-Rodriguez, a Denver-based regional health connector, shares some of her successes connecting health care providers with community resources during the last three years in a story published by the Mile High Health Alliance. You can hear more about Salazar’s work in this SIM podcast.
Suggested reading
Mental illness is taking its toll on the American workforce. Benefits providers and disability insurance carriers are paying attention.
The eldest son of late comedian Robin Williams took part in a campaign to raise awareness about suicide nearly five years after his father took his own life.

Mental health disorders have been associated with increased combustible cigarette use among adolescents and adults. Less is known about the association between these disorders and e-cigarette use, which has recently emerged as a major public health concern. In this prospective cohort study, researchers used interview data to compare relative risk for initiation of e-cigarette and/or combustible cigarette use among adolescents with varying levels of externalizing and internalizing mental health problems.
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.