Supporting Statewide Initiatives
Working together as a state we can accelerate improvement in health, health care and lower cost.
CIVHC has participated in several statewide initiatives including informing the work of the Colorado Commission on Affordable Care, In addition, CIVHC supports the Colorado State Innovation Model and the Transforming Clinical Practice Initiative (TCPi), two Center for Medicare and Medicaid Innovation programs, by providing data analytics and insights. Scroll down to learn more about SIM and TCPi.
Colorado State Innovation Model (SIM)
In 2012, the Center for Medicare and Medicaid Innovation (CMMI) launched the ambitious State Innovation Model (SIM) to improve health care and lower costs across the nation. Colorado is one of 25 states implementing a plan to improve the health of 80 percent of Coloradans by 2019.
The Colorado All Payer Claims Database (CO APCD) is one of the sources for data and analytics for the Colorado SIM effort and provides guidance on ways to benchmark and measure success based on claims in the CO APCD. In collaboration with the SIM Office, CIVHC developed innovative ways, or “proxy” quality measures, that use the CO APCD to assess how integrated behavioral and physical health influences patient health and cost of care.
Spot Analysis: SIM Measures
Released: April 2017
Using nationally accepted specifications, methodologies were established using health insurance claims across Medicare, Medicaid and commercial payers in the CO APCD, creating claims-based quality measures. These quality measures allow benchmarking between payers and providers across the entire state, helping to identify opportunities to create targeted, meaningful interventions that improve population health, improve care, and lower costs for Colorado. The four part series explores these measures and how the information gleaned can impact Coloradans.
Featured Change Agent: Colorado State Innovation Model
In 2012, the Center for Medicare and Medicaid Innovation (CMMI) launched an ambitious demonstration initiative designed to transform the health care system at the state level by building new, scalable models. The federal goal of the State Innovation Model (SIM) is to improve care and lower costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) by funding large-scale demonstrations sponsored by individual state governments.
The theory behind SIM is that in addition to having regulatory and policy authority, state governments can create coalitions of stakeholders from every aspect of the health care system, across individuals, payers, providers, government, nonprofits, and health data aggregators. These coalitions will then design and implement State Health Innovation Plans (SHIP), meeting the specific needs of residents and building on projects already operating in each state.
Through SIM, CMMI is hoping to demonstrate new financing and delivery models that spur reform beyond the services and programs used by Medicare, Medicaid, and CHIP beneficiaries and bring about comprehensive improvements in public health and the system as a whole.
Click to view the full Change Agent profile.
Transforming Clinical Practices Initiative (TCPI)
During their workday, most providers are focused on seeing patients and have little time to improve the business side of their practice. However, a program from CMMI is working to help clinicians transform their practices by making organizational changes. The Transforming Clinical Practice Initiative (TCPI) provides network support, education, and technical assistance with Health Information Technology to practices nationwide.
In 2015, Colorado was awarded $11 million dollars to take part in TCPI and CIVHC is one of the partners that provides data and analytics to support evidence-based changes that help providers improve outcomes for their patients while lowering costs.