Denver, Colo., March 20, 2017
Media contact: Connor Holzkamp, 303.691.7842,

SIM recruits practices to integrate behavioral, physical health and test APMs
There are less than two weeks left to apply for the Colorado State Innovation Model (SIM), a federal initiative that helps healthcare providers integrate behavioral and physical health in primary care settings and test alternative payment models (APMs). The application for cohort 2 closes at midnight on March 31.

This recruitment process will add at least 150 practices to cohort 1, which includes 92 primary care practice sites and four bidirectional behavioral health homes that serve approximately 320,000 attributed patients.

 “A focus on both behavioral and physical health are important to the health of patients and the ability of providers to succeed in a changing healthcare landscape,” says Gov. Hickenlooper. “The SIM initiative is helping patients lead more productive lives, and guiding practices through new models.”

Integrated healthcare has been shown to improve outcomes, reduce costs and enhance provider morale. The SIM initiative, which is funded by the Centers for Medicare & Medicaid Services, provides guidance and support to primary care practice sites that progress along an integrated care path continuum that might start with referrals to external behavioral health or primary care providers and could lead to co-location of professionals.

“There are significant results associated with integrating behavioral and physical health in primary care settings, including decreases in patient depression and stress levels, enhanced quality of life and lower rates of hospitalization,” says Barbara Martin, NP, RN, MSN, ACNP-BC, MPH, director, SIM.

Continuous improvement
Colorado was one of 11 states selected for SIM model test awards funded by the Centers for Medicare & Medicaid Services, and it was the only state to focus on integrated care with public and private payers as its primary goal. The state will receive $65 million from the Center for Medicare and Medicaid Innovation to implement and test its proposed model for healthcare innovation.

“In many ways this is pioneering work,” says Donna Lynne, Lt. Governor, who was involved with care integration efforts at Kaiser Foundation Health Plan, and appreciates the value of helping patients access the care they need where and when they need it. “We have the willpower and willingness to be innovative in Colorado and appreciate the fact that SIM providers are leaders in this space.”

Healthcare innovators
Delivering integrated care necessitates process and staff changes, which is why SIM provides practice facilitators and clinical health information technology advisors, who provide guidance in addition to a menu of benefits outlined below. SIM also created a new workforce in the form of regional health connectors, who connect practices with community resources, and partners with local public health agencies to reduce stigma and help connect patients to the care they need.

“We think it’s the best way to deliver good care,” says Brian Gablehouse, MD, Peak Pediatrics, Boulder, who participates in cohort 1.

Kate Drackett, LCSW, case manager, Juniper Family Medicine, Grand Junction, agrees. “We wanted to offer behavioral health support at the time of a doctor’s appointment, not as a separate, co-located service. Because of SIM we were able to offer that service … I can be there in the moment for our patients when they need us.”

Capitalizing on full health potential
During its four-year time frame, which ends in 2019, SIM will help 400 practice sites and four bidirectional health homes engage in this work to integrate behavioral and physical health in primary care settings.

“We have learned a great deal about what it takes to offer integrated care during the first year of SIM implementation, and have modified the program to ensure sustainability,” Martin explains. “This type of practice transformation requires a lot of work yet providers realize that without addressing the behavioral health needs of our patients, we’re really not addressing their full health potential.”

SIM practices receive the following supports:

  • Achievement-based payments of up to $13,000 for meeting key activities and milestones
  • Small grants of up to $40,000 that help practices operationalize integration efforts
  • Practice facilitators who visit the practice each month
  • Clinical health information technology advisors who visit the practice each month
  • Regional health connectors who identify and help practices tap into community resourceLocal public health agencies that address stigma associated with behavioral health issues and help create community resources
  • Broadband access to expand telehealth and enhance health information technology infrastructure
  • Business support that help sustain integration efforts

Additional resources:

The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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