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Volume 9

November 2nd, 2016

“People who say it cannot be done should not interrupt
those who are doing it.”

-George Bernard Shaw

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SIM News

SIM-Related Stories and News Releases

Registration Open for Iowa SIM Learning Community!
You’ve saved the date, now it is time to save your seat at the State Innovation Models (SIM) Learning Community!  The SIM Learning Community will be hosted on November 9th at the Meadows Events & Conference Center in Altoona, IA. This event will be a great opportunity to hear from healthcare leaders and stakeholders from across the state, as well get an update on the national aims of SIM and hear about the next steps envisioned for Iowa.  In addition to learning sessions, attendees will also participate in active round-table discussions.  These discussions will help solidify the information shared by speakers and provide participants the chance to share information back, looking at local practices, resources, and needed connections. Check out the content and speaker information below to get a quick glance at the information you can look forward to at the SIM event:
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The Quality Payment Program Overview Fact Sheet
Quality Payment Program
On October 14, 2016, the Department of Health and Human Services (HHS) issued its final rule with comment period implementing the Quality Payment Program that is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program improves Medicare by helping you focus on care quality and the one thing that matters most — making patients healthier. MACRA ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years. If you participate in Medicare, you are part of the dedicated team of clinicians who serve more than 55 million of the country’s most vulnerable Americans. The Quality Payment Program’s purpose is to provide new tools and resources to help you give your patients the best possible, highest-value care
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SIM Resources

SIM Tools and Information 

Telligen QPP News
Your MACRA QPP News: Keeping you up-to-date on the nitty-gritty details of the MACRA QPP rule. Telligen is actively monitoring the QPP rule-making process in advance of the CMS final rule expected in November. 

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Areas for Medicare Alignment in Multi-Payer Models under the State Innovation Models Initiative
The goal of the State Innovation Models (SIM) initiative is to test the ability of state governments to accelerate health transformation resulting in better care, smarter spending and healthier people. On April 10, 2015, we issued guidance to SIM States on the submission of state proposals for Medicare alignment in their state multi-payer models, applicable for SIM Round 1 and Round 2 Test States. In that guidance, we indicated that in certain instances we will consider states’ proposals for Medicare’s alignment with proposed multi-payer payment and service delivery models and that we would assess the proposals with consideration of the following principles: 1) patient-centered, 2) accountable for total cost of care, 3) transformative, 4) broad-based, 5) feasible to implement and 6) feasible to evaluate.
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Learning from Others

Model Programs & Promising Practices
No Time to Read CMS' Massive MACRA Final Rule?
American Academy of Family Physicians
When HHS released CMS' final rule ( addressing implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) on Oct. 14, family physicians across the country became slightly less anxious about their future. At least they would have some guidance as to what was expected of them during the nation's transition to value-based payment models.
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Using community health workers to reduce readmission rates
Modern Healthcare
At the University of Maryland St. Joseph Medical Center, a 232-bed hospital in Towson, a quarter of high-risk patients were hospitalized again within 30 days. So the hospital began deploying community health workers tasked with helping these patients address pressing nonclinical issues after they leave the hospital.
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Calendar and Events

What's going on?

Third SIM Learning Community
November 9th, Des Moines, Iowa

Free Prediabetes & the National Diabetes
Prevention Program Webinar
Thursday, November 17 at 12:00 PM CST

Rebalancing Health Care in the Heartland
Iowa Rural Health Association
December 1st, Des Moines, Iowa

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