State Innovation Models Initiative: Model Test Awards Round Two

The State Innovation Models Initiative Model Test Awards provided financial and technical support for states to test and evaluate multi-payer health system transformation models. States must have  implemented a proposal capable of creating statewide health transformation for the majority of care within the state.

Select anywhere on the map below to view the interactive version

 

State Innovation Models Testing Round Two Map

 

Eleven states were awarded Model Test Awards in Round Two (List)

Colorado

State website

Funding Amount: Up to $65 million.

Description: Colorado’s plan created a system of clinic-based and public health supports to spur innovation. Funding assisted Colorado in integrating physical and behavioral health care in more than 400 primary care practices and community mental health centers comprised of approximately 1,600 primary care providers and established a partnership between their public health, behavioral health and primary care sectors. Colorado provided access to integrated primary care and behavioral health services in coordinated community systems by:

  • Applying value-based payment structures.
  • Expanding information technology efforts, including telehealth.
  • Implementing regional health connectors.

 

Connecticut

State website

Funding Amount: Up to $45 million.

Description: Connecticut’s plan utilized several statewide and targeted interventions to: (1) improve population health; (2) strengthen primary care; (3) promote value-based payment and insurance design; and (4) obtain multi-payer alignment on quality, healthy equity, and care experience measures. Connecticut has:

  • Implemented a Medicaid Quality Improvement Shared Savings Program (MQISSP). Primary care providers participating in the MQISSP benefited from programs designed to enhance primary care capacity in the state, including learning collaboratives to foster continuous learning.
  • Implemented Health Enhancement Communities and Prevention Service Centers focused on improving population health.
  • Expanded inter-professional training, enhanced primary care capacity through additional residency programs, and increased community health worker training to ensure the health care workforce could support the transformation efforts.

 

Delaware

State website

Funding Amount: Up to $35 million.

Description: Delaware has:

  • Supported ten community-based population health programs (Health Communities).
  • Developed an IT infrastructure to support a cross-payer scorecard of core measures available to providers with related tools for patient engagement and price and quality transparency.
  • Engaged payers in the development of a pay-for-value model and a total-cost-of-care model for providers (including independent PCPs), with the goal of attributing all Delawareans to a primary care provider during the performance period.
  • Offered technical assistance to providers focusing on models of integrated, team-based care and transition to value-based payment models.
  • Implemented workforce development strategies to build competencies and address the current workforce and also developed educational programs to address the needs of model participants.

 

Idaho

State website

Funding Amount: Up to $39,683,813.

Description: Idaho achieved state-wide health care system transformation that delivered integrated, efficient and effective primary care services through patient-centered medical homes (PCMH). Idaho has:

  • Built 180 Nationally Recognized PCMH practices, including 75 Virtual PCMHs, by the end of the Model Test.
  • Supported providers through expanded connectivity via electronic health exchange.
  • Aligned the support of public and private payers to accelerate practice transformation.

 

Iowa

State website

Funding Amount: Up to $43,079,573.

Description: Iowa’s plan for health system transformation was built upon the ACO model that covered the state’s expanded Medicaid population, called the Iowa Health and Wellness Plan. Iowa has:

  •  Aligned with quality measures and payment methodology (shared savings and calculation of total cost of care) utilized by the Wellmark commercial ACOs.
  • Worked with the same data analytics contractor as Wellmark so that provider organizations had consistent and usable data to transform their practice from volume-based reimbursement to value-based reimbursement.
  • By the end of the performance period, the Medicaid ACOs was accountable for the long term care and behavioral health services of their attributed patients.
  • Integrated community-based resources into the ACOs by providing technical assistance through various partners.
  • Leveraged and spread existing community transformation initiatives focused on the social determinants of health.

 

Michigan

State website

Funding Amount: Up to $69,999,580.

Description: To implement its Blueprint for Health Innovation, Michigan has:

  • Created Accountable Systems of Care (ASC), which were networks of providers that utilized patient-centered medical homes supported by payment models that aligned incentives.
  • Supported ASCs through Community Health Innovation Regions (CHIRs), cross-sector partnerships that addressed population health and connected patients with relevant community services.
  • Tested whether ASCs working with CHIRs could achieve better health outcomes at lower cost for three targeted populations of patients: those with adverse birth outcomes, frequent emergency department users, and those with multiple chronic conditions.
  • Delivered technical assistance, workforce training, quality improvement skills, and data analytics to providers throughout the state.

 

New York

State website

Funding Amount: Up to $99.9 million.

Description: New York has:

  • Adopted a tiered Advanced Primary Care (APC) model for primary care that included behavioral and population health, and be complemented by a strong workforce and engaged consumers, with supportive payment and common metrics.
  • Instituted a state-wide program of regionally-based primary care practice transformation that helped practices across New York adopt and used the APC model.
  • Expanded the use of value-based payments so that 80% of New Yorkers were receiving value-based care by 2020.
  • Supported performance improvement and capacity expansion in primary care by expanding New York’s primary care workforce through innovations in professional education and training.
  • Integrated APC with population health through Public Health Consultants funded to work with regional Population Health Improvement Program contractors.
  • Developed a common scorecard, shared quality metrics and enhanced analytics to assure that delivery system and payment models supported three-part aim objectives.
  • Provided state-funded health information technology, including greatly enhanced capacities to exchange clinical data and an all-payer database.

 

Rhode Island

State website

Funding Amount: Up to $20 million.

Description: Rhode Island has:

  • Implemented a population health plan based on the results of community health assessments, including the integration of primary care and behavioral health.
  • Expanded the use of health homes by providers in the state.
  • Established a Transformation Network that provided technical assistance and analytical capabilities to payers and providers participating in the value-based models.
  • Augmented its HIT infrastructure to include an all-payer claims database, statewide health care quality measurement, patient engagement tools, and state data management and analytics.

 

Ohio

State website

Funding Amount: Up to $75 million.

Description: Ohio transformed the state’s health care system by rapidly scaling the use of patient-centered medical homes (PCMHs) and episode-based models and by developing cross-cutting infrastructure that supported implementation and sustaining of operations. Ohio has:

  • Launched 50 episodes of care.
  • Geographically expanded PCMHs, reaching statewide coverage by 2018.
  • Incorporated population health measures into regulatory and payment systems in order to use those measures to align population health priorities across clinical services, public health programs, and community-based initiatives.

 

Tennessee

State website

Funding Amount: Up to $65 million.

Description: Tennessee executed multi-payer payment and delivery reform strategies. Tennessee has:

  • Developed pediatric and adult PCMHs and health homes that integrated value-based behavioral and primary care services for people with Severe and Persistent Mental Illness.
  • Implemented 75 episodes of care.
  • Implemented quality and acuity-based payment and delivery system reform for long-term services and support (LTSS), that targeted nursing facility services and home and community based services for seniors and adults with physical, intellectual and developmental disabilities.
  • Developed a statewide plan for improving population health that addressed disparities and state-specific population health needs.

 

Washington

State website

Funding Amount: Up to $64,997,973.

Description: The Healthier Washington project moved health care purchasing from volume to value, improved health of state residents, and delivered coordinated whole-person care. Washington has:

  • Implemented regionally organized Accountable Communities of Health.
  • Created a “support hub” for practice transformation.
  • Redesigned payment, through shared savings and total cost of care models in collaboration with delivery system and payer partners.
  • Enhanced analytics, interoperability and measurement.
  • Created a public-private leadership council with a dedicated interagency team and legislative oversight.

Evaluations

Latest Evaluation Reports

Two Pager: Findings-At-A-Glance - Model Test Awards Round Two Final Annual Report (PDF)

Prior Evaluation Reports

Two Pager: Findings-At-A-Glance - Model Test Awards Round Two Third Annual Report (PDF)

State Innovation Models Initiative: Model Test Awards Round Two Second Annual Report (PDF)

State Innovation Models Initiative: Model Test Awards Round Two First Annual Report (PDF)

Additional Information

Last updated on:
09/15/2022