Tracking SIM practice transformation efforts 
November 30, 2017
SIM expands its presence, extends access to integrated care

The Colorado State Innovation Model (SIM) team is pleased to report strong interest for the third and final SIM application, which is available through Jan. 10, 2018. As we prepare for cohort 3, we celebrate successes from cohort 1 and recognize the unique value that cohort-2 practices bring to the table, including expanded patient access to integrated physical and behavioral healthcare.
"We're at a critical juncture," Barbara Martin, RN, MSN, ACNP-BC, MPH, SIM director, told the SIM advisory board on Monday, "And we need to continue to forge new paths."
SIM practices are on the forefront of better healthcare, which was illustrated this week when Martin joined Governor John Hickenlooper for a visit to Pediatric Health Center
(Peak Vista), a cohort-1 practice in Colorado Springs (Pictured to the right). Members of the care team and executive staff shared a practical perspective on what it takes to deliver whole-person care that improves health outcomes and lowers healthcare costs.
"We're able to wrap care around our patients," said one of the physicians who led the governor on a clinic tour. "Kids [health] can be complicated. We want to make things simple here."
As the group toured the facility, care team members talked about the benefit of warm handoffs with behavioral health specialists, who complete a full picture of care. "The thing I love about this team is that it's innovative," Pam McManus, CEO, told Hickenlooper. "They are willing to try new things. It was the team that really made the difference."
Hickenlooper asked the care team questions about patients served, and the costs as well as the savings associated with integrating care. He noted his appreciation for practices that participate in the initiative, which is intended to pave the way for future healthcare reform. "The idea behind SIM was that we would create these cohorts [of people and practices] that would learn how to do this, prove it works and demonstrate its effectiveness and efficiency."
The data published on the SIM data hub show that integrating behavioral and physical health in primary care settings improves health outcomes and reduces or helps avoid healthcare costs.
The entire SIM team extends warm wishes for a happy holiday season and would like to take this opportunity to thank you for the work you do to deliver whole-person care that improves health outcomes. You are making a difference in the lives of Coloradans and we are proud to work with you on this important journey. 
Participate in the Medicaid APM survey

The Department of Health Care Policy & Financing (HCPF) is moving forward with implementation of an alternative payment model for primary care (APM). A survey to select measures in the model is open and available on the HCPF website, where you'll find pre-survey instructions, links to resources including the APM Survival Guide, and a short video demonstrating how to use the APM model. Please take the survey before it closes on Jan. 31, 2018.
SIM small grants update

The SIM small grants application for SIM cohort-2 practices has been delayed until mid-December due to new state rules regarding grants. We'll host the webinar (originally scheduled for Nov. 29) on Jan. 3 from 12:15 - 1:15 PM. Click here to register for the webinar, which will include tips on writing a successful proposal.

Please also listen to the SIM podcast about the small grants program,  tune in to the on-demand webinar about the application process, and contact Meg Quiat, SIM small grants administrator, ( ) with questions.
Help us spread the word

The application for the third and final SIM application will be available through Jan. 10, 2018. Please encourage your colleagues to apply for this governor's office initiative, share the press release in your newsletters and on your websites and spread the word about this valuable opportunity to help Colorado providers integrate care and succeed in value-based payment models. Click here to learn more. 
SIM telehealth efforts progress

The SIM team will send you a link to a survey Dec. 8 to gather information about the use of telehealth/e-consults to improve patient access to care and any barriers to the use of this technology. SIM is working with Health First Colorado (Medicaid) on an information request from providers, payers, and patients/patient advocacy groups to bolster the sustainability of SIM's telehealth efforts. Please provide input when you receive the survey and contact Laurel Broten ( ) for more information.
Reserve the date: SIM multi-stakeholder symposium

SIM cohorts 1 and 2 practices are encouraged to attend the SIM multi-stakeholder symposium Jan. 18 to build closer partnerships with health plan representatives, reflect on progress made to date and get updates from the SIM team. The meeting also provides representatives from SIM practices, health plans and practice transformation organizations an opportunity to discuss issues of mutual interest and hear different perspectives on challenging issues. More information, including the agenda and location, is coming soon. We look forward to seeing you in January! Click here to read more about previous MSS events
SIM rosters & NPIs - Critical for practice payment

It is critically important for SIM cohorts 1 and 2 practices to complete roster updates as soon as possible. This information helps ensure practice providers' individual national provider identifiers (NPIs) are correct, and it ensures that accurate cost and utilization data will be calculated and sent to your practice. The SIM office created the  SIM NPI Update & Attribution Fact Sheet  which outlines why this action is so important to SIM and to your practice. 
Implementing SBIRT

The Office of Behavioral Health (OBH), with funding from SIM, is assessing barriers to implementing the Screening Brief Intervention and Referral to Treatment (SBIRT) tool in primary care practices. OBH mailed a survey to behavioral health providers earlier this month. Responses will be captured without personal identifiers via fax software directly into aconfidential database for future analysis and findings will be disseminated without identifiers. Please participate in this study and help us identify barriers to using SBIRT. The SIM team appreciates your time and help with this effort.
HIT roadmap approved

The Colorado Health IT Roadmap was approved by the eHealth Commission and the governor's office. The effort, which was led by Office of eHealth Innovation (OeHI) and steered by the eHealth Commission, was developed with input from more than 1,000 stakeholders. SIM played a foundational role in this project, which is now in the transition planning and implementation phase and OeHI wants your help. Please complete a short survey (open from Nov. 27 to Dec. 8) to inform efforts that will leverage technology and improve care coordination across Colorado.
RHCs support Colorado practices

Regional health connectors (RHCs), a new state workforce that is partially funded by SIM, are connecting practice teams with valuable resources to help patients live healthier lives and are available to help your practice meet SIM goals. For example:
  • The RHC in Broomfield and Boulder counties helped a practice secure funding from a local hospital for Mental Health First Aid training for clergy and others working with youth in the church next door to the practice.
  • In Weld County, the RHC is helping patients with food insecurity issues by providing information about local food banks, emergency food boxes and mobile food pantries in the area with days, times and eligibility requirements to receive services.
  • The RHC from Mesa County connected practices to two telemedicine options so patients can get access to behavioral health treatment.
  • The RHC in Pueblo ensured that practices and community health centers have access to Screening Brief Intervention and Referral to Treatment trainings to help address substance abuse disorders.
  • The RHC in Denver has organized several events including a free health screening that is happening today. Click here to view the event flier.  
Meet the RHC who serves your practice by visiting the website read about RHC work in this annual report , and listen to the RHC podcast.
Survey to determine future offerings

TCPi contracts with MGMA and other business process experts to help practices with their internal business processes and prepare practices for value based payments. We are interested in hearing from you on what topics you would like to see for future workshops and webinars around business support for your practices. Please take 3 - 5 minutes to fill out this survey to better inform us of what is needed for future offerings. 

Workforce redesign

Redesigning integrated healthcare settings requires an evaluation of how the workforce is trained for work and partnerships. SIM is tackling this issue and developed eight core competencies for behavioral health clinicians in primary care settings. Watch this animated video to develop and deepen your skills
2018 Medicare Reimbursement: Final Rule

Discover how shifts in the healthcare landscape will affect your medical practice in 2018 and beyond. Register for the Dec. 12 webinar at 11:00 a.m. with Elizabeth Woodcock, national speaker, trainer and author, who will share emerging trends that pose opportunities and threats to your practice. She will include information about the release of the final rule for 2018 revisions to the Quality Payment Program and the Medicare Physician Fee Schedule for 2018. Register today. Space is limited. 
Suggested reading

This month, Health is Primary is promoting the importance of smoking cessation to prevent serious health problems. They are showing how smoking can cause both immediate and long-term health issues and how your primary care doctor can be an effective partner in helping you quit. 

Addressing compassion fatigue and burnout in integrated care
For the integrated care workforce, addressing the complex needs of individuals with numerous and serious behavioral and physical health difficulties increases staff risk of experiencing symptoms associated with burnout and compassion fatigue.

The Centers for Medicare & Medicaid Services Office of Minority Health released this Roadmap to Behavioral Health in partnership with Substance Abuse and Mental Health Services Administration. The guide offers important information about mental health and substance use disorder services, finding a behavioral health provider, defining behavioral health terms, receiving services, and following up on care. 
The road to affordability: How collaborations reduce costs, improve care
Elizabeth Mitchell, chief executive officer of the Network for Regional Healthcare Improvement, explores healthcare costs in this Health Affairs blog

Talking about suicide and asking about suicidal thoughts is hard, which is whyaudience members practiced at the Suicide Prevention Community Summit at Montezuma-Cortez High School.

This article highlights the health challenges in Southeast Colorado Springs and the ways in which Value Care Health clinic is making a difference for thousands of patients.
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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.