Health Innovations                                                                                  March 2018
Recognizing work well done
Colorado is unique in many ways compared with other states that received round 2 State Innovation Model (SIM) awards from the Centers for Medicare & Medicaid Services (CMS). In addition to choosing integrated care supported by public and private payers as its main goal, Colorado has the largest group of engaged stakeholders, many of whom gathered at the SIM All-Stakeholder Convening Feb. 22.

“Here in Colorado we continue to be pioneers with SIM,” said Donna Lynne, Colorado lieutenant governor and chief operating officer, who spoke to the crowd. “We made the integration of behavioral and physical health our priority and to do that you’ve got to get everyone at the table. I know how hard this process is.”

Recognizing value in the work SIM practices have done, stakeholders continue to shift their focus to sustainability and outlined ways the seven workgroups will help ensure that progress continues after July 2019, when the initiative ends. 
Ongoing support
A recent practice satisfaction survey shows that 94% of SIM practices say SIM has helped them integrate care and rate different aspects of the program.

“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.

While cohort-1 practices complete participation March 31, SIM will support aspects of integration work to ensure ongoing success of this concept, which has proven to be effective. A few examples: Data submission for cohort-1 and cohort-2 practices is on the rise, practices are more confident in their data quality and reporting ability and increased screenings resulted in better diabetes control. See more data here.

“We can now say to CMS and to later adopters, ‘Your patients are going to have better outcomes because of this work,’” Lynne told SIM stakeholders. “As you reflect on the last two years and how far we’ve come with SIM, you should all take a bow.”
Data governance assistance request
SIM practices will be the first to test a service that automatically extracts electronic clinical quality measures (eCQMs) from electronic health records (EHRs), which will be rolled out 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. Help ensure success by participating on the data governance committee that creates an infrastructure for eCQM data use. Tomorrow (March 15) is the last day to apply.
HIT investigators at work: CHITAS
Helping practices turn data into actionable information is the key role of clinical health information technology advisors (CHITAs), who work closely with SIM practice care teams and are cited a valuable benefit to SIM participation. Hear two CHITAs talk about how they help practices collect and use data to improve care, reduce or avoid costs and prepare practices for success with alternative payment models in the latest episode of the SIM podcast series Innovation Insights. Visit the SIM Soundcloud and YouTube channels for a list of all videos and podcasts published.
RHC develops special health district in CO
Learn what makes regional health connectors (RHCs) uniquely qualified to help connect healthcare providers with community resources. SIM provides 70% of the funding for this team of 21 professionals, who are deployed across the state. In this latest profile, you’ll meet Ashley Hill, who practiced law before moving to 80 acres of undeveloped land in Hartsel. She found a simpler life and a stark reality: Park county, her new home, had no permanent health clinics. Her first project is to improve access to care and has already succeeded in developing a special health district for Clear Creek, Gilpin and Park counties. Read the full story on the “RHCs at work” page
Seeking provider perspectives
How do providers and care teams use the screening, brief intervention, and referral to treatment (SBIRT) approach in integrated primary care practices? Answering that question is the main goal for a survey sent to practices and providers, who deliver integrated behavioral and physical health, this month. This research, which is led by the Office of Behavioral Health with SIM funding, will be used to develop training for care teams and entered into a confidential, state database for analysis. Findings will be disseminated without individual or practice identifiers. Timing for survey completion has been extended through the end of the month. If you work for a SIM practice and did not receive the email with the survey link, please contact us to resend the survey. All providers who work in integrated settings are eligible to complete the survey. Contact Janet Steinkamp ( janet.steinkamp@state.co.us) for more information. 
Psychological trauma education
Enhance or add to your skill sets for identifying a potential role psychologic trauma might have on a patient’s health and corresponding care plan with “ Psychological Trauma and the integrated care team,” a short educational module developed by the Office of Behavioral Health with SIM funding.

This short module illustrates the value and importance for all primary care team members to consider how psychological trauma influences patient health and act accordingly. Eight other SIM-funded modules 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. Sign-up for a free account using the “SIM” registration code to access these modules.
SIM policy briefs
The SIM policy workgroup published two issue briefs - One on suicide prevention and another on how access to broadband affects healthcare. Download these documents and share with your networks. If you have any questions please feel free to contact us.
Completing the SIM circle: Cohort-3 timeline
News about acceptance into the third and final cohort of SIM will be delivered May 1 to practices that applied. Accepted practices will start their work this summer to integrate physical and behavioral health in primary care settings and gain skills to succeed with alternative payment models. Full timeline available here.
Help reduce stigma around the mental health
Let's Talk Colorado , a SIM-funded media campaign created to reduce stigma related to mental illness and encourage patients to get the treatment they need, continues to expand its efforts across the state. So far, there have been more than 11 million impressions of the campaign through billboards, bus shelter posters, community newspapers, and Pandora streaming radio, according to quarter-1 metrics. Learn more ( www.letstalkco.org ), use hashtags #LetsTalkCo / #HablemosCo to join the discussion on Twitter and hear creators of the campaign talk about its value in the SIM podcast .
March QPP deadlines
Practices must submit their performance data before March 31 to avoid penalties and potentially earn a positive payment adjustment under the Medicare Incentive Payment System (MIPS), one of two options to participation in the Centers for Medicare & Medicaid System Quality Payment Program (QPP). SIM and TCPi practices are uniquely qualified for success in QPP due to the work they’re doing with their practice facilitators and clinical health information technology advisors. Get details on what practices need to submit for MIPS as well as advanced alternative payment models (the other track in QPP) through the Colorado QPP website.
Gubernatorial candidates talk about mental health
Mental Health Colorado invites Colorado’s gubernatorial candidates to share their views and answer questions about mental health and substance use policy on March 23 at the PPA Event Center (2105 Decatur St. Denver, CO). Learn more and register: www.mentalhealthcolorado.org/governor2018
Suggested reading
This two-page summary discusses the key takeaways of Professor Heckman’s latest research, “The Lifecycle Benefits of an Influential Early Childhood Program.” The research shows that high-quality birth-to-five programs for disadvantaged children can deliver a 13% per year return on investment—a rate substantially higher than the 7-10% return previously established for preschool programs serving 3- to 4-year-olds. Significant gains are realized through better outcomes in education, health, social behaviors, and employment.
While the healthcare industry becomes increasingly adept at applying clinical and claims data to improve care, it has largely ignored other data sources that provide the greatest opportunity to positively impact health and cost at scale. 
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.