California will receive up to $3 million to design health care payment and service delivery models that will improve health care quality and lower costs, Secretary of Health and Human Services Sylvia M. Burwell announced this week.
Nationwide, 28 states, three territories and the District of Columbia will receive more than $665 million in Affordable Care Act funding through a program called State Innovation Model Awards to design and test new health care payment and service delivery models.
Combined with similar awards released in early 2013, more than half of the states (34 states, three territories and the District of Columbia) representing nearly two thirds of the population are participating in comprehensive state-based innovation efforts to transform health systems.
“We are committed to partnering with California to advance the goals we all share: better care, smarter spending, and, ultimately, healthier people,” said Burwell. “We’re seeing states do some very innovative things when it comes to improving the ways we deliver care, pay providers, and distribute information. These funds will support states in integrating and coordinating the many elements of health care—including Medicaid, Medicare, public health, and private health care delivery systems—to the benefit of patients, businesses, and taxpayers alike.”
State Innovation Model funds will support states in planning or implementing a customized, fully developed proposal capable of creating statewide health transformation. Example initiatives include:
• Improving primary care through patient-centered medical homes, building upon current Accountable Care Organization models or integrating primary care and behavioral health services.
• Providing technical assistance and data to health care providers and payers that are working to advance models of integrated, team-based care, or transition to value-based payment models.
• Creating unified quality measure score cards that health care payers and providers can use to align quality improvement and value based payment methodologies.
• Expanding the adoption of health information technology to improve patient care.
• Fostering partnerships between public, behavioral, and primary health care providers.
• Strengthening the health care workforce through educational programs, inter-professional training, primary care residencies and community health worker training.
The awards include both states that are designing plans and strategies for statewide innovation and states that are taking the next step of to testing and implementing comprehensive statewide health transformation plans.
Nearly $43 million in State Innovation Model Design Awards will support 17 states, including California, three territories, and the District of Columbia to create and refine proposals for comprehensive health care transformation.
More than $622 million in State Innovation Model Test Awards will support 11 states—Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee and Washington—in implementing their State Health Care Innovation Plans. These states join six previous round one Model Test awardees: Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont.
States will engage a broad group of stakeholders including health care providers and systems, long-term service and support providers, commercial payers, state hospital and medical associations, tribal communities and consumer advocacy organizations. Transformation efforts supported by this initiative must improve health, improve care and lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries. In addition, the Center for Medical and Services will identify best practices among state-led transformations that are potentially scalable to all states.
The State Innovation Models initiative is one part of an overall effort to help lower costs and improve care through the Affordable Care Act. Initiatives like Accountable Care Organizations, the Partnership for Patients and others have helped reduce hospital readmissions under Medicare by nearly 8 percent between 2007 and 2013—translating into 150,000 fewer readmissions—and quality improvements have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013, according to preliminary estimates.
To learn more about other innovative models being tested by the CMS Innovation Center, visit: innovation.cms.gov.
