What is SIM?

Between February, 2015 and January 2019, the State of Colorado will receive up to $65 million from the Center for Medicare and Medicaid Innovation (CMMI) to implement and test its State Health Care Innovation Plan.

Colorado’s plan, entitled “The Colorado Framework,” creates a system of clinic-based and public health supports to spur innovation. The state will improve the health of Coloradans by: (1) providing access to integrated primary care and behavioral health services in coordinated community systems; (2) applying value-based payment structures; (3) expanding information technology efforts, including telehealth; and (4) finalizing a statewide plan to improve population health. Funding will assist 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. In addition, the state will work to establish a partnership between their public health, behavioral health and primary care sectors.

SIM Abstract

The Colorado State Innovation Model touches nearly every aspect of our health system, setting the stage for a sweeping transformation that will help us accelerate our progress toward the Triple Aim of lower costs, better care and improved population health. It will also allow us to reach our goal of becoming the healthiest state.

Our vision is bold. Central to transforming the Colorado health system is the integration of behavioral health and primary care, a necessary step in our accelerated achievement of the Triple Aim. Our integration efforts will be supported by an improved public health infrastructure. In turn, behavioral health integration will improve population health by addressing behavioral factors that often impede the management of chronic health problems, especially obesity, smoking and diabetes. Improving access to behavioral health services and programs for most Coloradans is the cornerstone of the Colorado transformation effort.

Under our plan, we will offer truly integrated physical and behavioral health care. A broad range of public health programs will extend health care, including disease prevention, on a population-wide scale. Payment systems will evolve to ensure that our new model of care is sustainable for the long haul. Data will be used effectively and securely to support innovation. And Coloradans will be at the center, with the power and opportunity to make the best choices possible for their own health.

Our vision is attainable, particularly because we are building on important work that is already underway. And Coloradans know how to work together to accomplish big projects. Today, stakeholders throughout the state and from the full spectrum of the health community are on board to collaborate on our SIM proposal. Key partners include eight leading commercial payers and primary care providers covering the majority of the state population.

There is urgency in our work. While we have a strong, collaborative foundation, health costs continue to rise, patients receive fragmented care and key population metrics must be improved. SIM will allow Colorado to strengthen our efforts in primary and behavioral care and broaden our reach to most Coloradans.

The overarching goal of Colorado SIM is to improve the health of Coloradans by providing access to integrated primary care and behavioral health services in coordinated community systems, with value-based payment structures, for 80 percent of state residents by 2019. There is strong evidence that treating physical health, mental health and substance use disorders together will help us take aim at the ever-increasing burden of chronic disease. Our plan, called The Colorado Framework, creates a system of supports, both clinic-based and through expanded public health efforts, to spur integration.

But while integrated care is necessary, it is not sufficient to achieving the healthiest state possible. We recognize that health outcomes are strongly impacted by social, economic and environmental factors. Based on the social determinants of health model, the Colorado SIM proposal leverages the efforts of public health to support the clinical health transformation. We will focus on 12 core population health target areas.

The resources from SIM will help us integrate physical and behavioral health care in more than 400 primary care practices and community mental health centers (CMHCs) with about 1,600 primary care providers; bring the majority of payers into shared risk and savings programs by 2019; expand information technology efforts, including telehealth; launch a robust evaluation program that measures both processes and outcomes; and finalize our statewide plan to improve population health.

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