Medicaid and Public Health Partnerships

Center for Medicare and Medicaid Innovation (CMMI)

The Center for Medicare and Medicaid Innovation (CMMI), with Centers for Medicare and Medicaid Services (CMS), supports the development and testing of innovative healthcare payment and service delivery models. ASTHO is one of several national organizations receiving funding from the CDC to provide capacity building support for State Innovation Models (SIM) Grantees through a variety of technical assistance (TA).

State Innovation Models (SIM) Initiative

The SIM Initiative, funded by CMS, tests the ability of state governments to accelerate health transformation using the full range of regulatory and policy levers available to improve health, improve care and lower costs for the state's citizens, including Medicare, Medicaid and Children's Health Insurance Program (CHIP) beneficiaries. Under the SIM project, states are encouraged to develop sustainable models of multi-payer payment and delivery reform.

ASTHO Responds to CMS Request for Information on Potential Round Three of SIM Funding
ASTHO provided comments in response to a Request for Information released by CMS on a potential Round Three of SIM funding published in September 2016. In the letter, ASTHO supported additional SIM funding to develop infrastructure for health transformation and recommended that future opportunities should require and encourage greater engagement of state and territorial health agencies. The letter also included additional recommendations on measure alignment, care interventions to be tested, and coordinated efforts between the CDC and CMS.

ASTHO SIM Wikispace
ASTHO has developed a new Wikispace for the SIM Initiative to share best practices and materials with ASTHO membership and their leadership teams. Each of the Round One Design States' Health Care Innovation Plans were reviewed and organized by eight focus areas: prevention and population health; financing population health; transforming clinical care; health disparities; behavioral health; data and information technology; workforce; and other. The SIM Wikispace allows users to browse by focus area or to review summaries of each states' Health Care Innovation Plan, with links to the full plans. Information about Round Two of the initiative will be added as it becomes available.

SIM Round 2 Funding Awards
On December 16, 2014, CMMI announced the recipients of the Round Two SIM Initiative Model Test and Design Awards. Over $622 million in Model Test awards will support 11 states that are ready to implement their State Health Care Innovation Plans and over $42 million in Model Design awards will support 21 awardees (including 17 states, three territories, and the District of Columbia) in designing or further refining State Health Care Innovation Plans. Including Round Two awardees and six Round One Model Test states (Minnesota, Vermont, Massachusetts, Maine, Oregon, and Arkansas), now over half of states representing 61 percent of the U.S. population will be working in efforts to support comprehensive state-based innovations in health system transformation.

SIM Population Measures
The SIM Round 2 FOA, issued on May 22, 2014, requires the inclusion of a Plan for Improving Population Health for Model Design Plans or Model Test Plans. CMMI requests that the goals, objectives, and strategies of the Plan for Improving Population Health aligns with population health metrics developed by CMMI/CDC.

SIM Round Two Testing States and the Intersection with Public Health Issue Brief
ASTHO interviewed eight of the 11 SIM Round Two testing states between January-February 2015 in order to understand the role state public health would play in the implementation of these states’ healthcare innovation plans. This issue brief summarizes the general themes gathered from these interviews and also provides additional examples which highlight several of these models based on states’ current or proposed work.

ASTHO's Partnership with CMMI

ASTHO, in collaboration with several national organizations, forged a partnership with CMMI in providing recommendations to the types of population health models that should be implemented for maximum impact on population health and health care costs. 

In 2011, ASTHO submitted a letter to CMMI detailing the key principles and recommendations for the types of population health models that could achieve substantial results in terms of population health improvements and health care cost savings.

Health Care Innovation Awards

The second round of Health Care Innovation Awards are funding grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program (CHIP), particularly those with the highest health care needs.

CMMI announced the first batch of prospective recipients for the Health Care Innovation Awards Round Two on May 22, 2014 and the second batch on July 9, 2014. The cumulative 39 awards will be implemented in 27 states and the District of Columbia spanning a wide range of patient populations, from children to the elderly, across the care continuum.

CMS Medicare Learning Network (MLN) Provider Association Partnership

ASTHO is a partner of the CMS MLN Provider Association Partnership, which serves as an opportunity for organizations to connect with other stakeholders representing national healthcare provider associations, federations, organizations, and societies representing healthcare providers, professionals, and support staff.