|May 29, 2018
CMS Releases SIM Report
The report, the fourth of five that are planned, examines ongoing implementation efforts (through 2017) and provides impact estimates based on the most recent available data on costs and utilization for Medicaid beneficiaries after the first and second performance years (2014-2016, depending on the state).
The SIM initiative is testing the ability of state governments to transform their health systems into value-based payment systems.
For Round 1, the Center for Medicare and Medicaid Innovation awarded $33 million to $45 million per state in 2013 to six model test states: Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont.
Maine created patient-centered medical homes and behavioral health homes. Maine also implemented an integrated care model through accountable care organizations. In Maine, only between 15 and 17 percent of Medicaid patients were involved in an integrated care model.
The report found, among other findings, care coordination improved in most of the value-based payment models (VPM). However, these improvements generally did not result in fewer emergency department visits or hospitalizations, lower expenditures or improved quality of care for patients served by VPM-participating providers during the early SIM test period.
The report cited the use of Maine’s health information exchange (HIE). In Maine, Medicaid care managers and providers participating in Maine’s behavioral health homes have used emergency department and hospital notifications offered through the HIE to develop work flows.
MHA Contact: David Winslow
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