SIM PEDIATRIC PRACTICES UPDA DATE COHORT 1 COLORADO SIM GOAL Goal: - PowerPoint PPT Presentation

SIM PEDIATRIC PRACTICES UPDA DATE COHORT 1

COLORADO SIM GOAL Goal: Improve the health of Coloradans by providing access to integrated physical & behavioral health care services in coordinated systems, with value-based payment structures, for 80% of Colorado residents by 2019. 2

SIM APPROACH 80% of Coloradans Public have Access to Integrated Care Health Payment Practice Population HIT Reform Transformation Health Secure and Development and Support for Engaging Consumers efficient use of implementation practices as they communities in technology across of value-based accept new prevention, health and non- payment models payment models education, and health sectors in that incentive and integrate improving access order to advance integration and behavioral and to integrated Behavior integration and improve quality physical health care. improving health. al Health of care. care. Providers 3

PRACTICE CHARACTERISTICS PRACTICES BY POPULATION SERVED Mixed ▪ CPC Practices: 32 Pediatrics Only No Pediatrician ▪ School Based Health Centers: 3 9% ▪ Residency Programs: 5 21% ▪ FQHCs or Look-Alikes: 11 ▪ Average Medicaid %: 31% ▪ Average Medicare %: 14% ▪ Total Annual Patient Visits Between All Practices: 626,856 ▪ Total Providers: 909 70% 4

PRACTICE AFFILIATION No System Affiliation Listed 47 Associates in Family Medicine 5 Boulder Community Health 6 Centura Health 6 Children's Hospital 1 Colorado Springs Health Partners 5 Denver Health 4 Kaiser 1 Northwest Colorado Visiting Nurse Association 1 Peak Vista 1 Primary Care Partners 3 Rocky Mountain Youth Clinics 5 Salud 7 University of Colorado Health 6 Valley View 2 5

PRACTICE MAP ▪ Rural Practices: 30 Visit: https://www.colorado.gov/healthinnovation/sim-practice-transformation 6

PAYER SUPPORT FOR SIM PRACTICES 7

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SIM UPDATES SMALL PRACTICE GRANTS + = ~ $3 million $3 million ~ $6 Million Practice Transformation Fund (to be distributed across all SIM cohorts) 9

COLORADO INITIATIVE ALIGNMENT Program Characteristics Evidence Now SIM TCPI CPC+ (AHRQ) (CMS) (CMS) (CMS) Duration 4 years 4 years 4 years 5 years 2015 – 2019 2/1/15 – 1/31/19 10/2015 – 9/2019 1/1/2016-12/31/2021 Provider/Practice 200 sites in Colorado, 50 400 primary care 2,000 providers Up to 20 regions and Recruitment Goals in New Mexico practice sites; recruited in year 1 5,000 practices; 4 Community Mental (2016); participation for estimated 20,000 Health Centers up to 3.5 years providers Overview Building infrastructure Support states in Federal investment to Advance primary care within primary care developing and testing support clinician medical home model practices to adopt state-led, multi-payer practices through aimed at strengthening Patient Centered health care payment and nationwide, primary care through Outcome Research service delivery models collaborative, and peer- regionally-based, multi- findings, beginning with that will improve health based learning networks payer payment reform cardiovascular disease system performance, that facilitate practice and care delivery (CVD) increase quality of care, transformation transformation and decrease costs for all state residents Colorado PTN will prepare clinicians to be successful with new models of compensation that require new models of care delivery 10

CURRENT TIMELINES CPC + SIM Oct-Nov Aug – Sept 2/1/16 2/1/17 2016 2016 Kick Off of Initial 100 practices Application for Selection of 150 Cohort 2 on-boarded Cohort 2 Cohort 2 Practices 11

GUIDING PRINCIPLES ▪ Integration of behavioral health and primary care, coordinated with community resources to improve health outcomes and reduce healthcare costs ▪ Multi-stakeholder approach to implementing healthcare reform and innovation in Colorado ▪ Opportunity to create meaningful change and practice transformation in primary care and behavioral health settings 12

NEXT STEPS ▪ SIM Cohort 2 Application ▪ Revise/simplify SIM application for practices applying to CPC+ ▪ Submit Colorado proposal to CMS ▪ Areas of potential operational alignment ▪ Develop messaging for practices ▪ Benefits of participating in both initiatives ▪ Transparency around knowns and unknowns 13

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