CMS has invested $960 million in the creation of the State Innovation Models initiative to support state-based healthcare transformation. The funding was allocated in two phases: roughly $300 million was awarded in 2013 for design and testing of projects and another $660 million in 2014 to support the state-led efforts to improve delivery systems and payment models across Medicare, Medicaid and the Children’s Health Insurance Program.
“State innovation plans will focus on integrating approaches to healthcare and expanding access to care, driven by the pressing need to improve outcomes and control healthcare costs,” Kaveh Safavi M.D, global managing director of Accenture’s health practice, said in a statement. “Integrating healthcare and human services—starting with the data they gather and the outcomes they achieve—will break down data silos to make operations and information more transparent and coordinated while aligning federal resources to eliminate gaps.”
Accenture’s analysis of the state innovation plans found the top five projected investment areas by the states currently participating in the program are as follows:
Patient-centered medical homes – All 25 states are investing in patient-centered medical homes in order to strengthen primary care integration with specialists and community health workers. Most will also integrate physical and behavioral care.
Lower-cost labor models – All 25 states are targeting investment in low-cost, community health workers to shift labor costs to more appropriate caregivers. Some states are mobilizing human services “navigators” as liaisons between primary care coordinators and social service programs. Others are mobilizing cross-sector partners, such as business and community organizations, for health and wellness initiatives.
Telehealth – The 19 states seeking to expand use of virtual care technology, such as telehealth and remote monitoring, have a common goal of treating more patients without adding healthcare workers and facilities. Some are also focusing on improving reporting and evaluation of health data, for instance, using geographic information systems (GIS) to match resources to hotspots of chronic disease.
Self-service tools – Fifteen states are offering patient portals and other digital tools to reduce administrative costs while improving self-care, expanding access to electronic health records (EHRs) and information on value-based health choices and access to care delivery options.
All-payer claims databases – An estimated 14 states are pursuing statewide data aggregation and analytics to reduce redundancy, improve insights into population health, and foster integration of health data with human services data, with a goal of designing more effective intervention and wellness programs to reduce long-term healthcare costs.