Testing States

Colorado

Click Here for Updated State Plan
State's SIM website

  • Based on the social determinants of health model, the Colorado SIM proposal leverages the efforts of public health to support the clinical health transformation. (p.1)
  • Our state agencies are collaborating to support progress on the social determinants of health. CDPHE, the Department of Human Services (CDHS), and the Department of Health Care Policy and Financing (HCPF) are collaborating to align system infrastructure, integrate health services in Colorado, and work together to address social determinants of health. (p.11)
  • In order to adequately address the broad context of the social determinants of health, Colorado is taking a “life stages” approach that targets resources, programs, services, and quality measurement based on critical points in life, beginning at pre-conception and progressing to older adulthood. This initiative is based on the Brookings Institute’s “Social Genome Project” framework and crosses social, economic, and cultural contexts to acknowledge the physical, social, and emotional developments throughout the life cycle that affect chronic disease and long-term health risks. (p.11)

Connecticut

Click Here for Full State Plan
State's SIM website

  • Measures of health equity at the community and clinical levels will be developed and publicly reported. (p.3)
  • The Health Enhancement Communities are coalition-based efforts to improve health disparities. (p.7)

Delaware

Click Here for Full State Plan
State's SIM website

  • Develop community-specific datasets that quantify and assess local health needs and track health performance/outcomes over time. (p. 5)
  • Cross-agency collaboration to address social determinants of health. (p. 8)

Iowa

Click Here for Full State Plan
State's SIM website

  • Plan introduction notes - Health disparities were especially high related to income, race, and ethnicity, with 68.5% of low-income adults unable to access recommended primary care, a rate about 25% higher than the overall state total and a primary driver for Iowa’s Medicaid expansion. Rural access to care issue. (p. 1)
  • Addressing disparities between rural and urban areas is a significant reason for implementing Accountable Care Organizations (ACOs), and the Iowa Medicaid Enterprise (IME) expects that ACOs will naturally facilitate a focus on the areas of greatest need, while capitalizing on local strengths. One of three mechanisms for accelerating transformation - supporting the ACO delivery system to integrate with communities and social services to address the social determinants of health (p. 6).
  • The SIM Initiative will address the SDH in three ways: first, by developing improved community infrastructure and linkages through community-based transformation activities, as well as integration from public health to support healthy lifestyles (as described in Part 1); second, through practice transformation activities that provide healthcare providers and systems with the knowledge and tools to evaluate the SDH and address them as a routine part of the healthcare encounter; and third, through developing risk adjustment payment structures that provide additional resources for members significantly impacted by the SDH (described further in Part 3) The State also plans to focus efforts by issuing SDH grants at the community level as a means to accelerate capacity of these teams to address SDH issues specific to their communities. (p. 49)

Michigan

Click Here for Full State Plan
State's SIM website

  • Focus on low income and minority groups. (p.1)

Ohio

Click Here for Full State Plan
State's SIM website

  • PCMH’s are incentivized to work with episode accountable providers to increase quality and manage costs, as well as community-based and public health resources to address social determinants of health. (p. 12)

Tennessee

Click Here for Full State Plan
State's SIM website

  • Patient Centered Medical Homes: reward providers for addressing social and behavioral determinants of health (asthma, tobacco, social services). (p. 4)
  • Long Term Services and Support Payment and Delivery Reform, including Nursing Facility services and Home and Community Based Services for seniors and adults with physical, intellectual and developmental disabilities. (p. 10-12)

Design States


American Samoa

More to come...

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

  • The delivery system for American Indians is among the most fragmented. The Plan will enhance and expand American Indian Health Program (AIHP) care coordination infrastructure and data sharing capacity, and create member health literacy material for American Indians. (p. 10-11)
  • AHCCCS has already established a tribal consultation process. The State has discussed care coordination for the American Indian population in tribal consultation and connected its effort to the national Improving Patient Care initiative. (p. 21)

California

More to come...

District of Columbia

More to come...

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

  • Plan stratifies payment to encourage attention to disparities. (p. 3)
  • The Population Health Plan (PHP) will address health disparities and the underlying social determinants of health. (p. 3)

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

  • The Model Design will incorporate specific analysis of the projected impact of proposed interventions on health disparities across the Commonwealth. (p. 18)

Illinois
Click Here for Full State Plan
State's SIM website
  • The overarching goal of Illinois’ Plan for Improving Population Health (Plan for Pop Health) is to consider the health outcomes of the entire population and focus on reducing health disparities. (p. 2)
  • Telehealth and remote patient monitoring are critical tools used to enable care coordination,
    address disparities and improve outcomes. (p. 16)

Maryland:
State's SIM website

More to come....

Montana

More to come...

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

More to come...

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

  • RHCE improvement initiatives to ensure that issues needing a broader perspective, for example addressing disparities in health, are addressed and that transparency and accountability are maintained. (p. 6)

New Jersey

More to come...

New Mexico

Click Here for Full State Plan
State's SIM website

  • Project ECHO at the University of New Mexico (UNM) to improve access to specialty care for rural and underserved individuals, and PLACE MATTERS programs through the New Mexico Health Equity Partnership (NMHEP) to address the social conditions that lead to poor health. (p. 4)

Commonwealth of the Northern Mariana Islands

More to come...

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

  • The analysis and presentation of data will be stratified to highlight health disparities and the impacts of social determinants on health status. (p. 4)
  • OSIM seeks to accomplish the health system triple aim of better health, better care, and lower costs across Oklahoma populations, including populations that lack access to care and are most impacted by socioeconomic inequities and disparities. (p. 16)

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

  • Health disparities listed as one of the core population measurements. (p. 19). For performance improvement targets, see table on p. 22.
  • The stakeholder-oriented process uses evidence-based practices occurring locally to address health disparities as well as state and local health priorities. (p. 2)

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

More to come...

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

  • As part of the development of aligned health improvement priorities, Wisconsin proposes to build on these efforts to develop a plan to close two major gaps: access to care and a lack of care coordination between behavioral health and medical care. (p. 5-6)