Testing States


Connecticut

Click Here for Full State Plan
State's SIM website

  • An "Underservice Monitoring" effort aimed at assuring that shared savings programs do not result in under-service: cost-shifting, less than ideal care levels or other cost-cutting steps with negative health impacts. An Equity and Access Council, including consumers, will guard against this risk. (p. 20)
  • Very high level of consumer involvement in all governing entities related to SIM. (p. 34-35)

Idaho

Click Here for Full State Plan
State's SIM website

  • The Idaho Healthcare Coalition (IHC), established by Governor Otter through executive order, and composed of key stakeholders from around the state, will guide the statewide implementation of the model. (p. 9)
  • Idaho’s 2014 legislature also passed two concurrent resolutions that promote key aspects of Idaho’s healthcare system transformation. First, HCR046 recognizes the importance of telehealth in a rural state like Idaho, directing IDHW to convene a Telehealth Council. A second concurrent resolution (HCR 049) directs IDHW to convene a workgroup to study collection of hospital discharge data and to study creation of a comprehensive system of healthcare data, including inpatient, outpatient and other care services. (p. 13-14)

Iowa

Click Here for Full State Plan
State's SIM website

  • ACOs envisioned in the SIM include all three major payers – Wellmark, Medicaid, and Medicare, covering 86% of Iowans. (p. 3)
  • Through SIM, Iowa will seek a waiver to move Medicaid fee for service into the PCCM model of assignment so that all of the Medicaid population is assigned a PCP of their choice. (p. 8)
  • As part of regulatory powers - IDPH will investigate opportunities to align Certificate of Need application questions that would support strategies in this proposal. (p. 17)
  • The ACO TA strategy moves these systems into a community setting that focuses on the goals and measures of the Population Health Improvement Plan. This approach promotes relation-ship building with community partners, including local public health (LPH), Maternal and Child Health Agencies (MCH) agencies and the newly formed Community Care teams. Presently, LPH/MCH agencies do not have a clear role in the ACO infrastructure. Through this delivery system transformation, LPH/MCH agencies will have the opportunity to be innovative and respon-sive by aligning with the ACOs and coming together to define what they could offer to the ACO, therefore reducing the number of contractual agreement ACOs would have to make with LPH/MCH agencies. We propose a venue in which the local agencies would actively participate in the development of the integration into primary care and ACOs. One of the venues proposed to create this integration will be the community level learning collaborative that will bring community healthcare leaders together to create community level responses. (p. 48)

New York

Click Here for Full State Plan
State's SIM website

  • NY's concept of overall SIM governance is notable. SIM is linked with the new Medicaid waiver and reports to the Legislature and Governor. Within SIM efforts, there are several workgroups: Population Health, Access to Care, Integrated Care, Pay for Value, Workforce and Health Information Technology/ Measurement/Evaluation. (p. 18)

Washington

Click Here for Full State Plan
State's SIM website

  • Project management through the State's Medicaid and Public Employee Board, with a public-private coordinating council. (p. 4) Requested $92.4 M, awarded $64.9 M.


Design States


American Samoa

More to come...


Arizona:

Click Here for Full State Plan

State's SIM website

  • M&E plan will continually monitor based on a set of Key Performance Indicators (KPIs). (pp. 24-28)

California

More to come...

District of Columbia

More to come...

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


Maryland:
State's SIM website

More to come....

Montana

More to come....

New Jersey

More to come...

New Mexico
Click Here for Full State Plan
State's SIM website
  • New Mexico will explore how the Centennial Rewards model can be expanded to other system payers and populations. One possibility is to adopt the program for the NM State Risk Management Division to incentivize state employees to improve their overall health, leading to a healthier workforce, improved job performance and reduced costs. (p. 6)

Commonwealth of the Northern Mariana Islands

More to come...

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


Puerto Rico

More to come...

Utah

More to come...

Virginia

More to come...

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

  • The SVC LC will serve as the primary advisory council, collaborating partner and lead convener of private sector health care systems and purchasers throughout the award period. The SVC is a cross-section of major health care leaders representing all areas of the state, including national and local health plans, health care systems, providers and associations, employers and employer health care purchasing organizations, the DHS (Medicaid, mental health, long term care, public health), state employee health benefits, Wisconsin’s statewide health information exchange, all-payer administrative data database, quality reporting and technical assistance organizations, and other private sector organizations promoting health care transformation and payment reform. (p. 11)