CMS announced $665 million more in funding for its State Innovation Model program in December 2014. The announcement also indicated11 more states have joined the program.
The CMS Innovation Center, instated by the Patient Protection and Affordable Care Act, was installed to drive innovation in the payment market for Medicare, Medicaid and CHIP programs. This includes more efficient systems, particularly in the IT realm. To receive funding, states are required to shape a strategic plan, including plans to achieve better health and better care while lowering costs, according to an article in the Journal of the American Medical Association.
The plan has been met with considerable success — each Model Test state has devised a plan to transition at least 80 percent of payments from fee-for-service to value-based reimbursement, according to the article.
Here are five things to know about the State Innovation Model program.
1. There are now 17 Model Test states. Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont were selected in April 2012. Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee and Washington were selected in December 2014. The states will receive funding, technical assistance and evaluations from CMS during the program. Additionally, 11 other states received Model Design awards, which provides funding to improve existing State Health Care Innovation Plans.
2. Model Test states have to integrate community-based services. Model Test states have to develop a plan to effectively integrate public health, community-based and behavioral health services across the healthcare continuum. They are also required to have a public health focus.
3. The program has provided nearly $1 billion in funding to date. CMS announced it would provide $665 million to help states transform their public and private healthcare delivery systems in December 2014. This is the second round of funding through the CMS Innovation Center — the first provided $300 million in funding to 25 states, 6 of which were Model Test states, the rest of which were Model Design award states, according to CMS.
4. SIM has partnered with 38 states and territories since 2012. Programs funded have been the implementation of new payment, delivery, population health and health IT technologies. The program has worked with 34 states, Washington, D.C. and three territories in some capacity since its launch, according to CMS.
5. The program will receive a detailed evaluation of its success by an outside firm. The program has shown initial signs of success in several ways. A collaborative and comprehensive strategy seems to apply in multiple sectors of the health system. States hold a considerable amount of leverage in both the payer and purchaser markets, and the federal agencies working with them do best when they work collaboratively.