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Throughout the initiative, SIM practices have requested a different payment model that would support practice transformation efforts while health plans have requested more information about the work entailed to provide whole-person care.
To help health plans understand the work required for practices to transform care and participate in SIM, the Colorado team created a “good standing” report for SIM primary care practices in cohorts 2 and 3. Practices achieve good standing by successfully completing identified building blocks (based on the Bodenheimer building blocks of high-performing primary care practices) and achieving key milestones in the SIM framework, which was created with the Multi-Payer Collaborative. SIM will provide annual good standing reports to practices and health plans that support them in the initiative.
Good standing reports will be distributed to health plans annually while practices and their coaches receive reports every six months, so they have the opportunity to evaluate their work and to course-correct before the good standing report is disseminated to health plans at the end of the year. Receiving good standing reports helps health plans see what practice transformation efforts entail and identify where practices succeed and struggle, so they can continue to work effectively with practices. If practice sites are not in good standing, health plans might determine how that affects their programs and the payment a practice receives.