Testing States


Colorado

Click Here for Updated State Plan
State's SIM website

  • By 2015, provide network access to more than 400 hospitals, behavioral health providers, clinics, and other providers throughout rural and urban Colorado. (p.5)
  • Enhanced connectivity through Health Information Technology (HIT) and state Health Information Exchanges (HIEs), will build upon and expand the Comprehensive Primary Care initiative (CPCi) centralized data hub that integrates clinical and claims data, and use other sources of shared information. (p.7)
  • Overseen by the Governor’s Office, the state SIM office will provide planning and oversight and will manage HIT contracts for tasks, such as the provision of technical assistance to practices, done at the regional level. The state SIM office also will manage the contract for a centralized data hub with the State Designated Entity (SDE), Colorado Regional Health Information Organization (CORHIO). (p.40)
  • The SDE will support the SIM initiative in the following ways:  Provide administration support for coordination and oversight of the SIM HIT proposed programs.  Facilitate HIT architecture development supporting SIM clinical and cost data hub.  Oversee data governance through statewide expert workgroups and committees. Create, distribute, and vendor selection for additional technology investments.  Distribute funding to the HIT partners supporting Colorado’s SIM proposal. (p.41)

Connecticut

Click Here for Full State Plan
State's SIM website

  • A common provider scorecard based on the Medicare ACO reports plus peds, behavioral health and health equity measures is planned. Similarly, CT will work with all plans to develop a uniform set of measures for all plans to use to determine practices' shared savings. A consistent survey of consumer experience will also be developed to be used for all practices. (p. 41)
  • CT does not currently have a statewide HIE (Health Information Exchange), but the SIM proposal includes provision for building integration of the high level of electronic medical records (EMRs) operating in hospitals and private practices, development of extensive data-sharing agreements, and better data sharing between clinicians and community. Enhanced data sharing will allow for improved public health disease registries and various mobile apps. An all-payer claims database (APCD) is under development but because current state law prohibits the sharing of much commercial data, the State is committed to seeking statutory changes to allow necessary data exchange. (p. 58)

Delaware

Click Here for Full State Plan
State's SIM website

  • Delaware Health Information Network (DHIN, HIE) provides Admit Discharge Transfer (ADT) notifications which support providers in coordinating care. (p. 14)
  • DHIN aggregate common measures to provide one integrated view of provider performance across all payers, with single access point for reports. (p. 14, 25)
  • Expand clinical information in DHIN from ambulatory providers, nursing homes, and home care facilities. (p. 25)
  • Build on existing and planned investment in Medicaid/State-employee claims databased to create multi-payer data warehouse (government, commercial, and non-reimbursable claims). (p. 25-26)
  • Develop consumer engagement tools (e.g., portal, mobile apps) to enable patients to access health information, building on Meaningful Use. (p. 26)

Idaho

Click Here for Full State Plan
State's SIM website

  • Improve care coordination through adoption and use of EHRs and HIE connections among the 180 Model Test PCMHs, and across the Medical Neighborhood. (p. 4)
  • Idaho’s proposal include significant investment in connecting PCMHs to the Idaho Health Data Exchange (IHDE), enhancing care coordination through improved sharing of patient information. This Model Test also includes technical assistance to improve practices’ use of EHRs. EHRs in primary care settings are proving to be an essential tool to quality and care coordination. (p. 5)
  • Build a statewide data analytics system. Grant funds will support data collection training at the PCMH level, and development of a state-wide data analytics system to track, analyze and report feedback to individual providers on selected performance and outcome measures to improve their practice. The data analytics system will also report to the RCs on regional population management metrics which will be used to identify and address regional population management issues. (p. 6)
  • The HIT Plan calls for the development and/or expansion of EHR and IHDE technology to support: 1) statewide data collection and performance analysis needed to improve quality and establish value-based payments; 2) shared data to facilitate coordinated care, and; 3) patient portals to increase patient–provider communication and patient self-management. Telehealth technology will also be developed to expand access to healthcare and extend the healthcare work force in underserved areas, and to integrate behavioral health with PCMHs. Finally, the HIT plan will coordinate with Idaho’s new Time Sensitive Emergency (TSE) system to leverage improved care coordination for people who experience trauma, stroke or heart attack. (p. 16)

Iowa

Click Here for Full State Plan
State's SIM website

  • Data collection and analysis efforts will focus around existing data such as the Behavioral Risk Factor Surveillance Survey (BRFSS), hospital discharge data, and additional data collection efforts when required. Whenever possible, LPHAs will facilitate the connection between ACOs and other community-based health improvement efforts. (p. 3-4)
  • Medicaid is using the AssessMyHealth HRA tool10 developed by Treo Solutions.11 The tool collects information about members’ self-activation, social determinants of health (SDH), and basic clinical risk information that a provider can integrate into an individualized plan of care (p. 4).
  • The 2013 Iowa Health and Wellness Plan (IHAWP) legislation establishes a framework for exchange of member health information to improve care and reduce costs. DHS is required to provide the health care claims data of attributed members to each ACO. (Every ACO contract contains a HIPAA-compliant business associate agreement to protect patient confidentiality). The Medicaid environment is a safe place for ACOs to share data and identify efficiencies without the legal concern of collective bargaining for rate setting that can be found with the private market. (p. 16)
  • IME’s HIT planning and roadmap centers around four goals central to supporting the health of Medicaid populations and Iowa’s overall reform goals. These goals and objectives, as articulated in IME’s State Medicaid HIT Plan (SMHP)17 most recently submitted and approved by CMS, are to: 1) increase provider adoption of electronic health records and health information exchange; 2) improve administrative efficiencies and contain costs; 3) improve quality outcomes for members; and 4) improve member wellness. Health Information Exchange Information. (p. 18)

Michigan

Click Here for Full State Plan
State's SIM website

  • Health Information Technology uses a collaborative approach to data exchange promotes shared public-private state-level services and data infrastructure (p. 14-18)

New York

Click Here for Full State Plan
State's SIM website

  • SIM funds will allow for a new Patient Portal and for creation of an All Payer Claims Database. NY supports an award-winning Open Data Initiative. A common set of system indicators will be developed for all payers, providers and regions. A common scorecard is in draft. (p. 20)

Ohio

Click Here for Full State Plan
State's SIM website

  • The Governor’s Office of Health Transformation is coordinating the development of a dynamic HIT infrastructure that connects clinical and population health ecosystems and improves overall health system performance. (p. 15)
  • Connect siloed and disparate health registries to enterprise health and human services (HHS) data warehouse. (p. 16)
  • Expand data gateway to connect external systems to state’s enterprise data warehouse. (p. 17)
  • Use case management and assessment tool to connect to enterprise data warehouse to allow case managers access to claims, clinical, and demographic information; enable predictive analytics. (p. 17)
  • Health IT Council will be developed to coordinate broader, statewide HIT/HIE plan.
  • Ohio HIT Plan Activities. (p. 18)

Rhode Island

State's SIM website
Click Here for Full State Plan
  • This proposal seeks to use health information technology in two ways: to improve the State’s ability to collect, analyze, and report data and to impact care delivery at the provider level. (p. 26)
  • This proposal seeks $3,000,000 to modernize state data management, analytics, and information technology. With those funds, we will develop and implement an enterprise wide technical architecture that leverages, aligns, and integrates existing systems such as the Executive Office of Health and Human Services’ (EOHHS) Data Warehouse and Medicaid Management Information System, the State’s new eligibility and enrollment system, the All Payer Claims Database, and public health data sets. (p. 3)
  • We are proposing to use $6.8 million to support our Health Information Infrastructure through the following initiatives: Health Care Quality Measurement, Reporting and Feedback System, Statewide Common Provider Directory, Patient engagement tools, and the All Payer Claims database (APCD). (p. 17-19)
  • The current State HIT Coordinator and a HIT specialist funded with this grant, will assure communication, coordination, and alignment across the various governing bodies. (p. 16)

Tennessee

Click Here for Full State Plan
State's SIM website

  • Tennessee Hospital Association will provide analysis of episode performance to hospitals for internal use and to inform conversations between hospitals and other providers involved in an episode; display through web-based tool. (p. 9)
  • Current All Payers Claims Database (APCD) law to conduct healthcare utilization analysis (p. 15). Generate gaps in care analyses, patient risk scores, and patient prioritization functionality through payers claims data. (p. 17)
  • Build statewide HIE framework starting with real-time and daily batch Admitting/Discharge/Transfer (ADT) data collected from hospitals and EDs and sent to a care coordination interface for PCPs. (p. 16)
  • MCOs collaborate to leverage the state’s Medicaid Management Information System (MMIS) capabilities to create and maintain electronic data interfaces with all hospitals. (p. 16)
  • Development of provider-facing portal that includes single sign-on capability and role-based access for providers to connect all SIM-related provider interfaces. (p. 17)
  • Behavioral health providers participating in the Health Homes program will be eligible for upgrades to their current EHR systems. (p. 18)

Washington

Click Here for Full State Plan
State's SIM website

  • Development of a statewide shared core performance data set of 51 measures, including non-traditional data such as emergency department use, criminal justice involvement, and housing. To be publicly reported at county, plan, hospital, and clinician levels. Above-average uptake of electronic medical records in WA State, but augmenting Health Information Exchange with standards-based interoperability requirements. (p.27-28)
  • Adding incentives to get physical care-linked electronic health records to BH providers. Will link administration, claims and clinical data sets. (p. 17)

Design States


American Samoa

More to come...

Arizona:
Click Here for Full State Plan
State's SIM website

  • Accelerate use of HIT/HIE in the delivery system. (p. 7, pp. 15-19)
  • Develop formal electronic exchange of information (including IT infrastructure) necessary to improve care coordination for individuals that transition to/from qualified health plans (QHPs) and Medicaid. (p. 10)
  • Leveraging Health Information Technology (HIT) solutions for delivery system reform (p. 15) to expand opportunities for the use of electronic measures and data reporting. (p. 24)

California

More to come...

District of Columbia

More to come...

Hawaii:
Click Here for Full State Plan
State's SIM website

  • The statewide HIE network is expanding services to enable providers to share information. (p. 3, pp. 10-11)
  • The state plans to build data planning, aggregation, and dissemination capabilities to help public and private stakeholders assess and improve population health. (p.11)

Kentucky
Click Here for Full State Plan
State's SIM website
  • New MMS system will be flexible, modular, and provide near real-time interfaces and access to information, and will interface with the other systems within the QHI framework and enable automation of Kentucky’s data reporting to CMS. (p. 11)
  • The APCD will support three key objectives: improve public health and quality of care delivery, support health care reform initiatives, and provide a foundation for transparency in cost and delivery of health care. The APCD will provide the necessary information repository to catalog and measure the utilization and outcomes of all health care in Kentucky, and will help integrate predictive modeling capabilities into health care projections. (p. 11)
  • Kentucky Health Information Exchange (KHIE): Supports transition to electronic health records (EHRs) within CHFS and with private providers via KHIE. Works with all KY providers to connect their EHR systems to the state for the exchange of patient clinical information. KHIE has on-boarded over 800 provider locations/points of care, and 80% of Kentucky hospitals are currently live on KHIE, which has also successfully completed interfaces to the KY Immunization & Cancer Registries, CDC/BioSense and National Electronic Disease Surveillance System. Forthcoming work of KHIE, which will be incorporated in the Model Design as appropriate, involves development of an individually accessible patient portal/personal health record (PHR). (p. 11)

Illinois
Click Here for Full State Plan
State's SIM website

  • The various population health datasets, such as the Behavioral Risk Factor Surveillance System (BRFSS), the Hospital Discharge Dataset, I-Query, and PopHealth, will be key resources for tracking performance on CMS Core Measures and for monitoring overall population health. (p. 3)
  • Illinois has invested significant resources in health information technology as a powerful strategy to achieve the Triple Aim. The Innovation Plan leverages these initial investments to accelerate the adoption of health IT among a wide range of health providers and incentivize them to use IT to achieve clinical integration and improve population health. (p. 14)
  • Health Information Technology Plan contains the following strategies/components: Governance and current state of health IT adoption/use, Policy levers to accelerate standards-based, interoperable technology, Using data and analytics, telehealth and remote monitoring to improve care, Federal investments in IL for interoperable health/human service IT infrastructure, Integration of public health IT systems in Plan for Pop Health, Leveraging of health IT to implement common quality and cost measures across payers, and Engaging long-term care, behavioral health providers and patients. (See p. 14-18)

Maryland:
State's SIM website

More to come....

Montana

More to come...

Nevada
Click Here for Full State Plan
State's SIM website

  • The Division will assess the availability and reliability of data needed using HealtHIE, which is a not-for-profit statewide community-based health information exchange (HIE). This initiative will capitalize on the Division's electronic health record (EHR) program that went "live" on August 6, 2012. It includes incentive payments for Eligible Professionals (EP), Eligible Hospitals (EH), and critical access hospitals (CAH) for Adopt/Implement/Upgrade (AIU) and Meaningful Use (MU). As of June I 0, 2014, the Nevada DHCFP reported payments to 340 providers and 27 hospitals, with incentive payments totaling more than $34 million. (p. 10)
  • The State's executive leadership team will direct the planning and oversight of design and development activities and utilize policy and regulatory levers to accelerate standards based health information technology adoption to facilitate improvement in delivery system care. Effective communication, planning and project management will be used for promoting patient engagement and shared-decision making; and for developing multi-payer strategies to enable and expand the use of health information technology to make data driven decisions to coordinate and improve care across the state. (p. 10)

New Hampshire:
Click Here for Full State Plan
State's SIM website

  • SIM Model Design will focus on mechanisms to increase the collection, exchange, and use of data. (p. 3-4), such as improving registries and disease surveillance. (p. 9)
  • Population health improvements will be data driven and initially target tobacco use, obesity, and diabetes, as well as be guided by the State Health Improvement Plan (SHIP). (p. 7)

New Jersey

More to come...

New Mexico
Click Here for Full State Plan
State's SIM website

  • Reports and analyses based on APCD data will improve health care quality and reduce costs. Standardized metrics can generate provider performance data that will inform the development of alternative payment models. (p. 7)

Commonwealth of the Northern Mariana Islands

More to come...

Oklahoma
Click Here for Full State Plan
State's SIM website


  • In phase 3, stakeholders will identify strategies to increase adoption levels of Electronic Health Records (EHR) and attainment of Meaningful Use (MU) among providers; initiate planning for the development of a Value-Based Analytics Tool (VBA) for healthcare data analysis; determine benchmarks aimed at improving clinical and population health outcomes; and identify potential savings across multi-payer structures. (p. 1)
  • Objectives and strategies will be focused on reducing primary healthcare cost drivers, as well as reducing access to care barriers and other challenges to be identified through a gap analysis. The gap analysis will be accomplished by integrating data across a number of surveillance sets that include both quantitative and qualitative data. Relevant data sets and reports used for the gap analysis will include, but are not limited to, the 2014 Oklahoma State of the State’s Health Report, hospital and county health assessments, OHIP community chats and tribal consultations, OHIP Business Survey information, workforce data, medical claims data and health information exchange (HIE) data. (p. 4)
  • Consultants and the OSIM staff will mobilize key stakeholders to determine the benefits, feasibility, and sustainability of developing a Value-Based Analytics tool (VBA) to increase health systems data transparency by providing statewide population-based information on patient demographics, diagnoses, procedures and use of hospital services, as well as enhancing the collection of medical school, continuing education, and health workforce data. The VBA will provide opportunities to measure population and public health, social determinants of health, and provide analytics for the development of more targeted culturally and linguistically appropriate care. The VBA will also enable a shift from responding to episodes of care to emphasizing whole-person, population-based care with a focus on wellness. (p. 8-9)
  • In order to achieve statewide health transformation, the OSIM will focus its efforts on two Health Information Technology (HIT) areas: leverage public and private partners to design a VBA to act as a common service quality and cost measure instrument used for monitoring and reporting across providers and payers; and to strengthen acceleration and adoption of EHR and MU to create a robust, interoperable health IT-oriented environment. (p. 11)


Pennsylvania
Click Here for Full State Plan
State's SIM website


  • Pennsylvania will leverage SIM to: 1) further strategic collaboration among State agencies by developing a unified HIT strategy; 2) significantly increase use of HIT by providing incentives and technical assistance to providers in rural areas, providers with high Medicaid volume and those not eligible for Meaningful Use incentives to adopt electronic health records (EHRs), connect to a regional health information exchange (HIE), and use telemedicine as appropriate; 3) streamline the flow of information by helping providers efficiently report and access performance data; and 4) inform performance improvement and accountability through implementation of analytical tools and dissemination of performance data. (p. 12)
  • To promote accountability, the Pennsylvania Health Care Cost Containment Counsel (PHC4) will provide regional reports using both population health and provider-supplied clinical data enabling the Steering Committees to track change, and identify and address issues. (p. 4-5)
  • To enable localities to easily identify available resources, DOH is currently developing extensive geo-mapping databases that will enable consumers and providers to enter geographic information and receive community-based resource information. The geo-mapping program is initially focusing on chronic conditions, Accountable Provider Organizations (APO) and PCMH locations, pharmacy networks and super-utilizer communities with an overlay of Care Management Teams (CMT). (p. 5)


Puerto Rico

More to come...

Utah

More to come...

Virginia

More to come...

West Virginia
Click Here for Full State Plan
State's SIM website


  • Integrated Care and Use of HIT: Advance evidence-informed clinical decision making using electronic health record (EHR) decision support, shared decision making tools, and provider quality and cost data at the point-of-care; Improve consumer-directed care decisions. Objectives: Encourage care coordination across settings using health information exchange tools and data availability to care teams (claims and clinical data) to assist in measuring utilization, outcomes, cost and effectiveness of clinical interventions; Promote use of population-based data to understand practice sub-populations, panel, and individual risk, and to inform care coordination. (see table, p. 7for interventions and targeted outcomes).
  • WV will leverage the infrastructure and analytic resources of a new Medicaid data warehouse with business intelligence tools; the WV Medical Institute, a Medicare Quality Improvement Organization (QIO); the schools of public health; and consultants to analyze multi-payer administrative and clinical data to inform the design process. A comprehensive state HIT plan will be developed through a structured project management process to harmonize the Medicaid state health information technology plan (SMHP), the WVHIN’s operational plan, the State Office of Technology strategic plan and those of providers to support the new SIM model. (p. 10)


Wisconsin
Click Here for Full State Plan
State's SIM website

  • Wisconsin will develop a HIT Plan focused on: 1) creating incentives, policies, and other strategies to close the remaining gaps in existing data sets; 2) establishing mechanisms to consolidate and streamline reporting, abstraction, and retrieval of clinical and administrative data for providers, payers, and purchasers, thereby leading to reduced administrative burden and cost; 3) supporting expanded access to more comprehensive data with analytic services and supports, particularly for smaller provider practices; 4) linking clinical, administrative and socioeconomic data to better identify cost-drivers, challenges and opportunities related to the targeted interventions; and 5) ensuring coordination of effort across all existing statewide data assets. (p. 10)
  • Wisconsin’s HIT plan will also provide a pathway for providers to adopt best practices, including 1) opportunities to enable telehealth and remote patient monitoring to advance the health improvement priorities; 2) consideration of incentives to promote HIT adoption and interoperability by providers not currently eligible for the Medicaid and Medicare EHR Incentive Programs (e.g., behavioral health and long term care); and 3) technical assistance and analytic support to ensure that available data can be transformed into actionable information at the point of care. (p. 10)