Patient engagement

SIM-funded practice teams are motivated by the fact that integrating behavioral and physical health in primary care practice sites improves patient outcomes and reduces or avoids unnecessary costs. The following stories prove this to be true. From patient podcasts to stories from care teams, you’ll see how delivering integrated care improves patient outcomes, enhances care team morale and helps practices succeed with alternative payment models. Colorado was the only SIM state to select integrated care to help practices succeed with APMs and SIM data (both qualitative and quantitative) proves this approach works.


Patient perspectives

Check out two episodes below from the SIM podcast series, Innovation Insights, that tell the story of integrated care from the patient perspective.


Engaging patients

Cohort-1 practices that were accepted into the Colorado State Innovation Model (SIM) report making the following changes to practice processes during their work in the initiative:
 
Categorical description of change made based on feedback Number of SIM practices making reported changes
Changes to front office staffing and waiting areas 33
Refinements to risk stratification methodology 1
Changes in the development or use of the plan of care for patients at high risk  6
Changes to medication management strategies  4
Changes to self-management support strategies  12
Coordination of care with mental health and behavioral health providers  16
Using community-based self-management support and wellness resources  17
Strategies to improve continuity of care and relationship between patients and providers/care team 30
Tracking and follow-up from hospitals and diagnostic studies 6
Transition of care from hospitals and subacute care          11
Follow-up from ED visits  14
Coordination of care with specialists  13
Physical layout or decorations of the clinic  14