Colorado Medical Society

http://www.cms.org/articles/testing-new-models-of-care/

Testing new models of care

Thursday, September 01, 2016 12:26 PM

While an increasing number of health care professionals are talking about value-based reimbursement, about 100 practices participating in the Colorado State Innovation Model (SIM), an initiative funded by the Centers for Medicare & Medicaid Services (CMS), are taking steps to improve the quality of care and patient outcomes by integrating behavioral health and primary care with help from practice transformation coaches, small grants and other SIM-related support.

The first group of SIM practices started their work in February and the SIM application (www.practiceinnovationco.org/sim) for the second group of practices will be released this fall. The foundational work these SIM practices are completing has been described as a culture change that will be required to succeed in the new payment models that were introduced by the Medicare Access and CHIP Reauthorization Act, says Emilie Buscaj, MPH, PCMH, CCE, program manager, HealthTeamWorks.

“Practices see a need to prepare for payment reform, yet it’s difficult to justify the time necessary to address how this change will affect practice culture,” explains Buscaj, who manages practice facilitators, a coaching service that is included in the SIM transformation package of support. Practice facilitators meet with SIM practices twice a month to review progress toward SIM milestones and update practice improvement plans that help the practice move from volume- to value-based health care delivery. “Practice professionals are busy,” Buscaj adds. “Our goal is to prepare practices so they are able to address changes in the environment before it’s too late.”

SIM practices receive the following benefits to help support this transition:

Federal initiatives support innovation in the state
In addition to the SIM, Colorado primary care practices also have an opportunity to participate in the Comprehensive Primary Care Plus (CPC+) initiative from the federal CMS, which dovetails with SIM efforts underway.

Colorado was selected as one of 14 regions for the CPC+ initiative and the application was open from Aug. 1 through Sept. 15. Learn more about SIM, the differences between SIM benefits to support behavioral health integration and the CPC+ initiative by reading a series of frequently-asked questions with answers (www.colorado.gov/healthinnovation/cpc-sim) from SIM subject matter experts. 

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