Health Innovations                                                                                 March 2019
Lieutenant Gov. thanks SIM practices for leadership
The last two SIM-funded Collaborative Learning Sessions were held in Broomfield and Grand Junction to acknowledge the work accomplished across the four pillars of the Colorado State Innovation Model (SIM) a federally funded, Governor’s office initiative. Lieutenant Governor Dianne Primavera thanked SIM practices for their work to improve the health of Coloradans, which sets the stage for continued success. “As we develop the Office of Saving People Money on Health Care, my team recognizes how important integrated care is to improving patient health and reducing or avoiding unnecessary health care costs,” she said.

Primavera acknowledged that the strides SIM-funded practice sites have made will help them succeed with alternative payment models that reward the value, not volume, of care delivered. 

“In Colorado we took an ambitious approach to health reform and SIM investments will pay dividends well after the initiative ends in July,” she explained and added, “We are counting on all of you to act as ambassadors for integrated care and appreciate all of the work that you do to provide the right care at the right time and in the right place.”
SIM practices benefit from eCQM solution
The SIM office recognizes the practice work entailed in submitting electronic clinical quality measures (eCQMs) and is funding an eCQM solution to help practices report measures while reducing the administrative burden of doing so. The solution has been called the first to leverage blockchain technology for HIPAA-compliant data aggregation and reporting in Colorado. Read more and apply.
TCPi to host APM summit
The Transforming Clinical Practice Initiative (TCPi), a federally funded, Governor’s office initiative that is managed by the SIM office, will host an Alternative Payment Model Summit March 18 to showcase TCPi practices and highlight trends in value-based payment contracts for specialty care providers. TCPi practice representatives will network with and learn from peers and hear from representatives from commercial health plans, the Colorado Business Group on Health, the Department of Health Care Policy & Financing and others. Stay tuned for more information about this event, which will be published through SIM channels.
SIM-funded work influences patient care
SIM cohort-1 practices reported several changes that were made to processes during their SIM-funded work as a direct result of patient input—from strategies to improve continuity of care and relationship between patients and providers/care teams to changes to front-office staffing and waiting areas. Patient feedback was collected through different venues including patient-family advisory councils. Get a list of changes practices made based on patient input and listen to a podcast with a SIM-funded practice and one of its patients, who talks about how process changes influenced her care on the new SIM patient engagement web page.
SIM funds e-Consults to expand patient access to care
SIM is investing $500,000 in e-Consults to build capacity within the provider community and increase patient access to specialty care in rural, frontier and underserved areas of the state. E-Consults enable health care providers to consult remotely with specialists through secure platforms to exchange health information and discuss patient care. Typically, e-Consults initiated in primary care settings and physicians involved in the consultations send written reports to a patient’s treating/requesting provider with recommended treatments or referrals for care delivery. SIM funds will help the University of Colorado School of Medicine and Mind Springs Health develop implementation plans to expand their e-Consult programs. Implementation plans will address program vision, alignment with organizational needs, governance and staffing models, workflow design, information technology, sustainability and program management. Development of these plans will support future growth beyond the initiative’s time frame. 
RHCs connect patients with the care they need
Regional health connectors (RHCs) workforce partially funded by SIM, bring resources to communities in Colorado by partnering with local organizations and medical practices. Douglas County RHC Laura Don helped start a monthly clinic in Castle Rock that offers free services to people without insurance. The Yahweh Health Clinic has grown through partnerships with Doctors Care (a SIM cohort-1 practice), the Metro Community Provider Network, Central Colorado Area Health Education Center, American Cancer Association and others. Don explains her RHC work in a new blog and talks about her ability to address the needs of what she describes as “a hidden population in need.” 
SIM blog
Read quick-hit snippets about lessons learned, successes and challenges associated with this federally funded health care reform initiative in the SIM blog and let us know what topics you'd like to see covered in future posts.
Depression-related training for providers
Primary care teams interested in learning more about integrating behavioral and physical health can take advantage of free e-learning modules funded by SIM. The two newest modules ( Men and Depression, and Obesity and Depression) are now available on the e-learning online platform. Register for a free account using the registration code "SIM" and find out how these modules can help your care team integrate physical and behavioral health. Click here for a flier with more information about the available modules.
Alert: SIM small grants fund deadline
March 30, 2019 is the deadline for practices that received small grants to invoice for funds. If the SIM office does not receive invoices by March 30, practices forfeit funds. Several reminders about this deadline have been sent to practices, and representatives can view this webinar for more information on how to invoice for funds. Contact Megan Comer ( ) as soon as possible with questions or concerns.
You’re invited: Discuss behavioral health challenges veterans face
Join the conversation April 2 (5:00 PM – 7:30 PM) about the importance of human connection and persistence in the fight against high rates of suicide among veterans. Attendees will see a screening of The Promise , a documentary, and hear an expert panel discussion on behavioral health challenges veterans face.

In related news, SIM is funding a veteran health connector (VHC) to engage veterans and community partners in northeast Colorado and begin development of a community-based Veteran Suicide Prevention Plan. The VHC is facilitating stronger relationships between veterans, local organizations and programs that serve veterans in their region. Stay tuned for an upcoming podcast featuring the SIM VHC.
Screening for adverse childhood experiences and trauma
As trauma-informed care continues to gain traction, more and more providers are beginning to screen patients for exposure to adverse childhood experiences (ACEs) and trauma. SIM-funded Jefferson Center for Mental Health has had success with its screenings as discussed during this SIM podcast . Variation exists regarding when and how to screen in adult and pediatric populations. This technical assistance tool includes approaches and considerations for trauma and ACES screenings. SIM funded a psychological trauma and an ACES learning module on the CU eLearning platform that can be accessed using the “SIM” code. Care teams are encouraged to investigate other modules that are customized for care teams that are integrating behavioral and physical health in primary care settings.
Suggested reading
Interesting story from the National Public Radio’s series " The Other Side of Anger."
Recently, Americans have seen their health care security become the subject of one of the longest political standoffs the country has seen. For most Americans, their objectives are simple: to be able to afford to take care of their families, keep them healthy, and know that no one — no Congress, no insurance company, no politician — will take that away. That’s where United States of Care, completing its first year of operations, is focusing work — affordable health care for every American that will be a durable legacy. Read the first annual report.
This new toolkit compiles evidence-based and promising models and resources to support organizations implementing mental health programs in rural communities. Learn how to develop, implement and evaluate a sustainable rural mental health program with this tool, which was created in partnership with the University of Minnesota Rural Health Research Center and the NORC Walsh Center for Rural Health Analysis.
Mental illness contributes more to disability adjusted life years than any other condition worldwide, with unipolar depression leading the way. And yet, prioritizing mental health among the assortment of concerns and actions of population health thinking remains a distant hope. There are many reasons for this, starting with the historical stigma around mental illness and continuing with our lack of understanding of brain processes—and therefore behaviors—at the cellular or molecular level. But perhaps one of the core reasons is that we do not keep in mind the extraordinary burden of death associated with mental health disorders. 
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.