Tracking SIM practice transformation efforts 
May 31, 2019
Sustaining SIM work in practices across the state

Providers say addressing mental health, substance use disorders, healthy behaviors and physical health in primary care settings is "the right way to deliver care." And when you listen to this podcast about a pediatric group that helped a patient lost 30-plus pounds while addressing anxiety and depression, it's easy to understand why. While the Colorado State Innovation Model (SIM) ends in July, thousands of providers across the state say they'll continue delivering whole-person care  that addresses patients' bodies and brains, as outlined in the last SIM blogand that is proof positive that this health reform approach worked. The team continues to hear how whole-person health helps patients live healthier lives, and SIM practices received cost and utilization reports that show how it affects the bottom line. With two months left in the initiative, the SIM office is pulling together a new resources page for providers to access tools and SIM-funded education that supports integrated care well into the future. You will receive one more newsletter but we want to take this opportunity to thank each and every one of your team members, practice transformation organizations and partners, who have improved patient care in Colorado by supporting SIM. The state took an ambitious approach to health reform and it will continue to pay off. 
New web page highlights SIM resources for providers

Get a list of resources 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.
Helping kids cope with anxiety and depression

Hear how one pediatric care team helped a patient cope with anxiety and depression while losing more than 30 pounds in the latest episode of Innovation Insights, the SIM podcast series.  Hint: Their secret weapon was a behavioral health provider.

Improving practice-payer relations: Final SIM-funded MSS

Don't miss the June 6 Multi-Stakeholder Symposium (MSS), which will once again feature a "World Café" event for SIM practice representatives to meet with health plans (payers) and discuss ways to partner more effectively with alternative payment models. Practice teams are strongly encouraged to attend this last, SIM-funded opportunity to talk directly with payer representatives and hear from Lieutenant Governor Dianne Primavera.  Register here and note the World Café (2-3 pm) is for limited to SIM cohort practices and payer representatives. Practice transformation organizations are encouraged to join at 3 pm. For context and background, read  a series of articles about past MSS events, and contact Elizabeth Mattes, SIM data management specialist, with questions.
Practice cost and utilization reports available
SIM practice cost and utilization reports, released earlier this month, are intended to provide practices engaged in SIM cohorts with actionable information about how frequently patient populations access certain services and compare health care costs with similar practices engaged in the initiative. An updated version of these reports will be released in June. Please contact Katie Matthews ( ) with Milliman or Nathan Drashner ( ) with the SIM office if you have questions.
Stratus™ data refresh

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. This is the final Stratus™ update for SIM-only practices, which will have their licenses deactivated June 30. The SIM office encourages practices to take advantage of this opportunity and use the data available within Stratus™ before licenses are deactivated. 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 Stratus™ until the end of that initiative in 2022. If you have any questions, please reach out to Elizabeth MattesSIM data management specialist. Click here to log into your Stratus™ account and learn more about Stratus™ online. 
Final CQM reports sent to health plans

Clinical Quality Measure (CQM) reports were sent to health plans that support SIM practices and will also be used for evaluation of the initiative. Practice representatives can access these reports by logging into the Shared Practice Learning Improvement Tool a nd are encouraged to discuss the reports with health plan representatives. More information is published on the  SIM website, and you can direct questions to Elizabeth Mattes .
Business curriculum for SIM 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 for these, and additional modules, and contact Elizabeth Mattes with questions.
Broadband expansion helps extend patient access to care

SIM will exceed its goal of expanding access to broadband services for 300 rural health care sites. Using SIM funding, the Colorado Telehealth Network (CTN) helps eligible sites apply to the Healthcare Connect Fund, a federal funding stream administered through the Universal Service Administrative Company (USAC) to reduce the cost of broadband expansion for rural health care sites. Through CTN's efforts, 222 sites received expanded broadband services between 2015 and 2018, an additional 102 sites received funding commitment letters from USAC to expand broadband services and 58 applications are pending. Stay tuned for the final number of sites that expanded broadband services during SIM.
Successful site visit with CMMI

SIM kicked off Mental Health Month with a final site visit with representatives from the Center for Medicare and Medicaid Innovation (CMMI) and the Office of the National Coordinator May 1-2. A series of presentations showcased success across the four pillars of practice transformation, population health, health information technology and payment reform, the group visited Mayfair Internal Medicine, a SIM cohort-2 practice in Denver and participated in a SIM celebration with stakeholders.

"We have been really impressed and have learned so much from the work in Colorado," said Dawn Alley, PhD, who directs the State and Population Health portfolio at CMMI. "It's exactly what we wanted from the SIM program"
Strength in numbers: High demand for anxiety class

When care team members at Associates in Family Medicine (AFM), West Office started seeing more patients presenting with anxiety symptoms, they created a group class for guidance and help. What they didn't expect was the number of staff members who'd want to attend, so they turned the patient content into a staff wellness program and 40 AFM employees signed up the first day the class, which has a 60-person limit, was announced. Read the full story about this SIM cohort-2 practice.
State executive visits SIM and TCPi practices
Lieutenant Governor Dianne Primavera (shown in the photo here) visited practices engaged in the Transforming Clinical Practice Initiative and SIM last month to hear how the two quality initiatives have helped care teams improve patient care and reduce or avoid unnecessary costs. Primavera and two members of her team met with health care professionals engaged in TCPi-funded work at San Luis Valley Health in Alamosa and with the La Plata Integrated Healthcare Clinic team in Cortez, a SIM cohort-2 practice. The visits were part of the Health Care Roadmap Trip. Read about the Roadmap to Saving Coloradans Money on Health Care released by the Office of Saving People Money on Health Care.

SIM hosted a successful convening to showcase work underway with e-Consult programs for representatives from the Office of the National Coordinator (ONC) and the Center for Medicare and Medicaid Innovation (CMMI), who were in Denver for the final SIM site visit. The convening highlighted work done by the University of Colorado School of Medicine and Mind Springs Health, which were awarded SIM funds, and by Denver Health representatives, who talked about their e-Consult program and work they've accomplished with funding from the Transforming Clinical Practice Initiative. ONC and CMMI representatives shared a national perspective and offered insights and possible solutions for technical challenges. As noted by attendees, the convening was a successful demonstration of the innovation and energy in Colorado that is focused on improving patient care.
SIM video illustrates value of integrated care

Listen to SIM stakeholders, providers and practice coaches talk about how the initiative has influenced health care in Colorado in a video released by SIM.
Caring for patients with IDD in primary care

Primary care teams interested in learning more about integrating behavioral and physical health for individuals with intellectual and developmental disabilities (I/DD) can take advantage of free modules funded by SIM.  Continuing medical education credits are available for those who qualify .   The latest module, Caring for Patients with IDD in Primary Care Settings, was released May 1, 2019. To view this module, or the entire Behavioral Health in Primary Care series , you must register an e-learning account with the University of Colorado.The registration code is "SIM".
Tracking the opioid crisis: What state strategies are working?

The opioid crisis, which kills 130 Americans daily, is one of the most urgent and complex crises facing state leaders. Read this report to learn about different policy strategies to combat the opioid crisis.
Aligning quality measures accross payers: Lessons from SIM

Drawing from the experiences of five State Innovation Model (SIM) award states, a new issue brief examines strategies used to develop common measure sets that align quality measures across private and public payers, thereby reducing administrative burdens on providers and giving focus to quality improvement efforts. The brief outlines alignment adoption strategies, measure set development and sustainability efforts, and provides a framework for other states considering future quality measure alignment projects.
Integrating a trauma-informed approach into SUD treatment

Experiencing trauma can correlate to health-risk behaviors, including substance use disorders (SUD), according to research. Register for a free webinar to learn how two providers operating in different settings incorporated a trauma-informed approach to care for treating SUD and how doing so shaped the experience of patients and staff. Register for the June 4 webinar from noon - 1:30 PM MDT
Get tips, tools about the QPP

Get details on the final rule for year 3 released by the Centers for Medicare & Medicaid Services in the latest installment of the Colorado Quality Payment Program (QPP) Coalition's "Fast Facts in 5 Minutes." The Coalition, which was formed in 2017 to help practice teams transition to value-based payment models, releases new resources monthly. Visit the web page for updates.
Suggested reading

A bill from U.S. Rep. Conor Lamb addressing veterans' mental health and wellness has unanimously passed the House.

Seeking mental health treatment: Chief shares his experience with PTSD
Chief Master Sgt. Eric Corvin, 49th Maintenance Group Quality Assurance superintendent, sought PTSD treatment with the 49th Medical Group at Holloman Air Force Base, N.M. He enrolled in a 12-week program, which focused on the many aspects of PTSD and ways of coming to terms with the issues it causes.

Behavioral health diagnoses ballooned over the past decade as more youths cope with mental health and substance abuse issues, according to a new analysis of private health insurance claims.

People who have a serious mental illness, or SMI, are at higher risk for other health problems. An SMI, such as depression or bipolar disorder, may make it hard for people to work or live on their own or to arrange for health care. These problems can be worse if language or cultural issues are barriers to receiving care.  In this study, the research team compared two types of care - integrated care and integrated care with a peer navigator. 

US institutions have a long history of segregating communities of color, concentrating resources in white communities, and designing systems that benefit white people. This leads to preventable differences in the health of our mouths, teeth, and gums, which are closely connected to our overall health.

Well Being Trust is led by clinical experts who've dedicated their lives and careers to improving the well-being of patients and communities. We know the challenges patients, practitioners, and health systems face when it comes to addressing mental health and substance use disorders. Just as importantly, we know there are solutions and opportunities for change, and we understand the nation must work together to transform the way mental health care is provided and ensure everyone has access to high quality care.

One doctor commits suicide in the U.S. every day -- the highest suicide rate of any profession. And the number of doctor suicides - 28 to 40 per 100,000 - is more than twice that of the general population, new research shows. The rate in the general population is 12.3 per 100,000.
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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.