Health Innovations                                                                                 April 2018
Paving the way for future success
The Colorado State Innovation Model (SIM) team is bolstered by and continues to seek stories of how this practice transformation work influences the lives of care teams as well as patients. Pictured to the left is Barbara Martin, RN, MSN, ACNP-BC, MPH, SIM director, with members of Tribal Royalty from the Ute Mountain Ute Tribe, Towaoc, CO. Martin shared some of SIM’s successes during a Colorado Commission of Indian Affairs meeting last month in Denver.

As we continue to tally successes and prepare for the third and final cohort of practices this summer, we invite you to help us tell the SIM story. Please take the time to read “ Whole-person health,” our new blog, tell us how integrated care has influenced you and share our stories on social media channels to expand awareness of the work SIM practices do to improve health and avoid or reduce unnecessary costs. As a sneak peek, the team will release a report next month, a call to action that showcases many months of research and collaboration from the SIM population health workgroup that will change the ways we discuss, identify and treat mental illness in Colorado. Actions scheduled in the report continue beyond the SIM initiative, which ends in July 2019, and are intended to galvanize organizations and individuals to collaborate in ways that will improve patient health and focus on vulnerable populations. Stay tuned for more information!
SIM practices benefit from eCQM solution
SIM practices will be the first to test a service that automatically extracts electronic clinical quality measures (eCQMs) from electronic health records (EHRs) in June and July. This technical and operational platform will extract eCQMs from EHRs once and report them to different approved entities, a task that is frequently cited as a barrier to success with alternative payment models. Learn more about this exciting work by listening to a new episode of the SIM podcast series, Innovation Insights.
SIM satisfaction
Most say the SIM initiative is ambitious in scope and approach. Those involved in implementation recognize the hard work and long hours it requires from practices. And it is with that backdrop that we share results from the most recent practice satisfaction survey, which shows that 94% of SIM practice representatives say the initiative has helped them integrate behavioral and physical healthcare, and rate the program highly two years running.

“It has given us a plan on how to better integrate behavioral health within our practice,” said one SIM practice representative. “We were on the path, but having the building blocks made it more tangible!” Get highlights from the report here and check out a few data points, which prove that the Colorado concept, albeit bold and ambitious, is working. A few examples: More cohort-1 and cohort-2 practices are submitting data, practice teams are more confident in their data quality and reporting ability and more screenings resulted in better patient diabetes control. See more data here.
TCPi empowers providers
The Transforming Clinical Practice initiative (TCPi) is helping healthcare teams improve patient outcomes and navigate provider compensation changes. This governor’s office initiative, which is funded by the Centers for Medicare & Medicaid Services, helps position providers for success with value-based payment models. A unique aspect of TCPi is the inclusion of specialists and behavioral health centers. More than 1,900 clinicians are participating in TCPi throughout Colorado, 87% of whom are specialists. Learn more about how TCPi helps providers in the newest episode of our podcast series Innovation Insights, and read more about the initiative on the website.
ACC Phase II update
The Department of Health Care Policy and Financing (HCPF) is committed to creating a high-performing, cost-effective Medicaid system that delivers quality services and improves the health of Coloradans through its Accountable Care Collaborative (ACC), which will leverage proven successes of Health First Colorado’s (Colorado’s Medicaid) member and provider experience. Learn more about ACC Phase II online , and participate in the informational webinars listed near the bottom of the page. The webinar on April 24 (12 p.m. to 1 p.m.) describes performance measurement in ACC Phase II, including key performance indicators and behavioral health incentive program. Register to attend as space is limited
Free care team training modules
SIM is increasing awareness of senior behavioral health issues during primary care visits with the new training module “Whole-Person Care for the Aging and Senior Patient.” The module addresses independent living, transportation and access to food for the integrated primary care team. Resources help primary care providers navigate these issues and provide seniors the highest levels of care.

This is one of nine SIM training modules that provide comprehensive, practical information about behavioral health integration in primary care practices. Use these modules in team meetings for educational purposes and relationship-building, which contributes to higher-quality patient care delivery. To access these modules, sign-up for a free account on the University of Colorado e-learning platform using the registration code “SIM.” 
Better opioid stewardship: A guidebook
The National Quality Forum’s recently published the National Quality Partners Playbook™: Opioid Stewardship, which supports healthcare organizations and clinicians across care settings and specialties safely manage patients’ pain. It includes concrete examples and tactics for implementation, identifies barriers and suggested solutions, and connects clinicians to important tools and resources that are applicable across care settings. Implementation examples are organized into basic, intermediate, and advanced levels of resources and expertise to identify opportunities for action. Read more and access the paid download here . A summary is also available on the website .
RHCs help the homeless
Three regional health connectors (RHCs) helped bring vital screenings to vulnerable residents in Adams, Arapahoe, and Douglas counties this past winter. Blood pressure screenings were among the many services that Tri-County Health Department provided to homeless individuals during the annual Point in Time Survey in the metro Denver area, thanks to the work of RHCs Meghan Prentiss, Kaitlin Wolff and Laura Don. Read the full story here.

This is just one example of how RHCs connect public health, human services, healthcare providers and other community groups to improve health. Connect with your local RHC to learn how he or she can help practices strengthen their partnerships with community resources. 
SIM small grants
The small grants application process was a highly competitive experience for 107 practices (out of 155 in the cohort) that submitted applications for a total of $1.25 million. Applications were reviewed by a panel of industry members, who recommended 38 applications for award. These practices will receive notification from the Department of Health Care policy and Financing (HCPF) by April 17, and will be contacted by the SIM office with instructions for next steps soon thereafter.

This process was different from the cohort-1 application in several ways, including the fact that there was one available funding stream ($1.25 million) from the Colorado Health Foundation. While cohort-1 had the opportunity to apply for two funding streams — from the Colorado Health Foundation and the Centers for Medicare and Medicaid Innovation — practices expressed frustration with the lengthy application process. As a result, the SIM team streamlined the small grants program and reinvested the federal funding stream into a larger achievement-based payment ($13,000 vs $5,000) to help cohorts-2 and 3 integrate physical and behavioral health. Another major change was that this application process was run by the HCPF procurement department.

While all cohort-2 and -3 practices receive more financial support for their practice transformation work, the shift in funds resulted in a smaller amount for small grant funds.

The SIM team appreciates the time and effort all practice teams invested in this highly competitive process and is investigating different ways to provide support. Learn more about the small grants for cohort 1 with detailed information about how funds were invested. Information for the cohort-3 small grant application process will be released in June.

All questions about small grants should be directed to Megan Comer, who has been promoted to the position of SIM small grants administrator. Megan, who has been an asset to the SIM team since August 2016, is uniquely qualified for this role. She takes the reins from Meg Quiat, who helped establish a successful small grant program and champion the work of SIM practices. Meg left the SIM team last month to pursue new opportunities, and we wish her well in her new endeavors. Please direct all questions regarding the cohort-2 application process to Megan: megan.comer@state.co.us.
Peer-learning on behavioral health in primary care practices
The ECHO Colorado series combines interactive learning and case-based discussions that allow health professionals to participate in a community where experts and peers share knowledge, experience and expertise using technology, not proximity, to connect. An upcoming series focuses on SIM behavioral health providers and will be held virtually on the fourth Tuesday of the month from 12 p.m. to 1 p.m. beginning April 24. Learn more and register here
Health Navigator Registry is live
Launching Spring 2018, the CDPHE Health Navigator Registry will be a public registry of unlicensed health navigators who have been trained and evaluated to have the knowledge, skills and behaviors that enable them to perform successfully in primary and behavioral health care organizations.

To learn more about the roles, relationships and responsibilities of a health navigator, read Lowry health navigators: A bridge between patients and providers . Contact Pat Uris with questions or comments. 
Acknowledging mental health month in May
The Well Being Trust is doing 30 day wellness challenge on Instagram prior to mental health awareness month in May. Join the conversation and take the challenge at: www.instagram.com/wellbeing_trust/ 

How is your organization recognizing mental health month in May? Send us your information and we’ll help promote it. Email us: Connor.holzkamp@state.co.us.
Suggested reading
Maternal or caregiver health can affect young children’s development. Children with depressed mothers have increased risk of developmental concerns or delays such as behavior problems and poor cognitive outcomes. Despite evidence that maternal depression is common and can negatively affect the development of young children, it is often undiagnosed and untreated. 
Continually escalating costs have prompted payers to seek ways to improve member health while reducing the rate of growth of healthcare claim expenditures. One such initiative is the integration of physical and behavioral healthcare. This report examines the potential cost savings of moving to integrated care.
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.