Innovative payment model shows early progress, CMS says

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A federal initiative to transform healthcare delivery and payment at the state levels has shown “promising progress,” according to a report released Wednesday.

The first round of the Center for Medicare & Medicaid Innovation's State Innovation Models, which launched in 2013, gave funding to Arkansas, Massachusetts, Maine, Minnesota, Oregon, and Vermont to implement plans to “accelerate system transformation.” Those plans include the expansion of multi-payer payment models and delivery systems, strengthening health information technology and improving workforce development.

Wednesday's report, the second annual evaluation for the first round of SIM tests, found “notable progress” in general healthcare transformation in the six states that received awards, including successful engagement of payer, provider and patient communities, and implementation of delivery and payment reforms.

The most significant changes noted in the report occurred in areas where public and private payers coordinated to accelerate transformation, Patrick Conway, M.D., CMS principal deputy administrator and chief medical officer, noted in a blog post.

Conway offered Vermont's Accountable Care Organization-focused SIM initiative as an example, stating that about half of eligible beneficiaries in the state were participating in an ACO as of late 2014.

Challenges faced by the test states participating in the SIM initiative include garnering provider buy-in to payment reforms, aligning health data system with providers' needs and promoting multi-payer participation, the report found.

“It remains too early to attribute specific quantitative results directly to the SIM Initiative,” Conway wrote. “However, analyses based on Medicare and commercial populations show that states were making progress on health outcomes, such as declines in emergency room visits and inpatient readmissions through models pre-dating SIM and models upon which SIM efforts are expanding.”