State Innovation Model

Friday, September 01, 2017 12:53 PM
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Mapping the way to better health care in Colorado

by Heather Grimshaw, Communications Manager, SIM

Every practice in Colorado can benefit from the investments made by the Colorado State Innovation Model (SIM), which will work with 400 primary care practice sites and four community mental health centers during its four-year time frame.

The application for the third and last cohort will be released this winter, but every health care provider in the state can benefit from infrastructure and resources funded by SIM, which is funded by the Centers for Medicare and Medicaid Services, to help integrate behavioral and physical health in primary care settings and to test alternative payment models.

The initiative has made strides in its first year and a half. Customized practice facilitation and clinical health information technology advisors are working with practices across Colorado to improve process efficiency and effectiveness and to help quality improvement teams collect, report and use practice data in actionable ways so providers can deliver the type of integrated – or whole-person care – that improves health outcomes and reduces cost.

It requires an investment of time, energy and practice resources that resonate with clinicians, who value the type of support that enables them to deliver the type of care that patients need.

“You recognize that you can do a better job taking care of your patients if you are able to incorporate mental health into your practice,” says Glenn Madrid, MD, a family physician with Primary Care Partners in Grand Junction that is part of SIM cohort 1. “For me it’s been personally rejuvenating. It’s rewarding to be able to do a better job taking care of the whole individual.”

Providers recognize that integrated care is the best way to improve health outcomes and lower costs, and initial data collected by Milliman, an actuarial firm that is charting return-on-investment (ROI) for SIM, shows correlated cost savings and cost avoidance for SIM practice sites in their first six months of the program. The SIM team will release more data on this ROI in coming months.

Expanding the SIM circle

In addition to helping practice sites integrate behavioral and physical health in sustainable ways, the SIM initiative has invested in a new health workforce of 21 regional health connectors, who are located across the state and help practices identify and tap into community resources that benefit patients. See the regional distribution of SIM resources across Colorado in the regional map above.

The initiative has also funded the work of eight local public health agencies (LPHAs) and two behavioral health transformation collaboratives (BHTCs). Resources provided by LPHAs, BHTCs and RHCs, which are working to address mental health stigma and to improve access and connect providers with community health resources, are available to all providers in the state. Learn more about these resources, which include “Let’s Talk Colorado,” a stigma-reduction campaign – and ways your practice can benefit from them – during short SIM podcasts ( with LPHA and RHC representatives.

While many practices assign different team members to research community resources, “RHCs are fully-funded to do that work,” explained Ashlie Brown, SIM extension service director at the Colorado Health Institute. Get a few examples of the meaningful work that RHCs are doing across the state (, such as identifying resources for LGBTQ youth as well as patients with childhood obesity that save care teams time and provide patients and families with help and support.

Practical work

The 94 practices in SIM cohort 1, which started their practice transformation work in 2016, will be joined by approximately 150 practices accepted for cohort 2 that start their work in September. The second cohort includes a diverse group that is made up of private solo or group practices (about 38 percent) and runs the gamut from school-based health centers and rural health clinics to hospital- or health-system-owned facilities that will follow a streamlined set of practice transformation milestones and will report on a set of clinical quality measures that were aligned with other initiatives to reduce provider burnout (link in resources).

The application for SIM cohort 3, the last cohort in this federally funded initiative, will be released this winter. Sign up for the SIM newsletter (link below) to get more information about how SIM practices are integrating care, updated data from the first two cohorts and the release date for the SIM cohort 3 application.


•    SIM website:

•    SIM aligns clinical quality measures:

•    RHCs:

•    SIM podcast series with RHCs, LPHAs, Let’s Talk Colorado representatives and more:

•    Let’s Talk Colorado:

Posted in: Colorado Medicine | Practice Evolution | Practice Redesign | Medical Neighborhood/PCMH


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