Colorado Awarded $65 Million Grant to Improve Physical and Behavioral Health Care Integration

The state is one of 11 to receive federal State Innovation Model (SIM) funding to enhance patient care for individuals receiving both physical and behavioral health services.

The state of Colorado is now fine-tuning plans to implement a set of comprehensive programs that will improve health care for individuals with mental and behavioral health conditions. Last year, the state submitted a plan to the Centers for Medicare & Medicaid Services (CMS) for a SIM award, and in mid-December learned that it was selected to receive funding to carry out its plan. The award amount is $65 million.

A significant focus of the state’s SIM plan is to improve care coordination for individuals who receive care from a variety of provider locations — helping providers to have timely and efficient information about their patients after they are seen by other providers or hospitals across the community or state. Health information technologies, such as electronic health records (EHRs), health information exchange (HIE) and telehealth are anticipated to play an important role in such care coordination improvements.

The Need for Better Integration of Behavioral and Physical Health

Health care professionals agree that care coordination for shared patients could be greatly improved between physical and behavioral health providers. Behavioral health patients in particular tend to have multiple conditions and are in the care of multiple providers who don’t always communicate effectively. The costs of this disjointed care can be measured in both quality of care and dollars. And there’s not an easy fix to this problem.

Large Complex Problem Calls for a Collaborative Statewide Plan

Coordination between physical and behavioral health providers is such an enormous challenge that the Centers for Medicare and Medicaid Innovation (CMMI) have awarded more than $660 million to states that found innovative strategies for improving behavioral health care through an early round of planning grants. The current grant award given to Colorado builds on a $2 million planning grant received in 2013 and allows the statewide plan to be implemented over a four-year period.

A great deal of coordination and collaboration was required to pull off a plan of this magnitude. The group of stakeholders that worked together in Colorado includes state government, insurers, public health agencies, hospitals, office-based providers, health information exchanges (HIEs), data organizations, and patients themselves.

“CORHIO is proud to be a part of the State Innovative Model project and to contribute to this important work that will dramatically improve health care in Colorado,” says Morgan Honea, CORHIO CEO. “The level of collaboration required for this type of comprehensive planning is a testament to how committed Colorado health care professionals are to improving the health of patients in our state.”

Comprehensive Program for Care Improvement

The SIM program’s main vision is to transform health care delivery to improve care and lower costs. Similar to the Medicaid Health Homes approach, SIM aims to give patients access to integrated care in whatever setting is their medical home. The plan identifies more than 400 primary care practices, community mental health centers, and federally qualified health centers that will work together to integrate care.

The project also involves plans for outcomes-based payment models, public health support, practice transformation support services, data and reporting, telehealth, health information exchange, and policy and regulatory enhancements.

Health Information Technology and Analytics Infrastructure

Health information technology will provide the technical backbone of the SIM project, with a data hub to measure and analyze clinical measures, costs and population health improvements. CORHIO was part of the development team for the SIM application and one of the 100 organizations who submitted a letter of support, including the HIE on the Western slope, Quality Health Network. Both organizations are planning how to best support the project’s clinical data and quality measures initiatives.

“Health information technology is a vital component of the State Innovation Model in Colorado,” says Kate Kiefert, State HIT Coordinator and Colorado Health Implementation Coordinator. “The state’s two HIEs, the APCD, and public health systems will play an integral part in providing data to support integrated physical and behavioral care across the community and medical settings.”

For More Information

National information from CMS: http://innovation.cms.gov/initiatives/State-Innovations/

Local information from the Office of the Governor: www.coloradoSIM.org