Next Steps for the State Innovation Models Initiative
Request for Information
The State Innovation Models (SIM) Initiative was launched in 2013 to test the ability of state governments to use their policy and regulatory levers to accelerate healthcare transformation efforts in their states, with a primary goal to transform over 80 percent of payments to providers into innovative payments and service delivery models. SIM has supported over 38 states, territories, and the District of Columbia in two rounds of awards. The Centers for Medicare & Medicaid Services (CMS) has set ambitious goals for health system transformation, and we recognize that much of this transformation will ultimately occur at the state and community level. Our investment in SIM is a recognition of the important role states play as a locus for change to accelerate transformation, and their unique leverage point to implement models consistent with the proposed Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Section 1115A of the Social Security Act, as enacted by section 3021 of the Affordable Care Act, authorizes the Center for Medicare & Medicaid Innovation to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries. CMS is issuing this Request for Information (RFI) to obtain input on the design and future direction of the SIM Initiative.
CMS is seeking input from all interested parties on the following concepts related to the evolution of the SIM Initiative:
1. Partnering with states to implement delivery and payment models across multiple payers in a state that could qualify as Advanced Alternative Payment Models (APMs) or Advanced Other Payer APMs under the proposed QPP, making it easier for eligible clinicians in a state to become qualifying APM participants and earn the APM incentive;
2. Implementing financial accountability for health outcomes for an entire state's population;
3. Assessing the impact of specific care interventions across multiple states; and
4. Facilitating alignment of state and federal payment and service delivery reform efforts, and streamlining interactions between the Federal government and states.
Comment Submission Process
Comments must be submitted electronically no later than October 28, 2016.
For more information, please refer to the RFI found at:https://innovation.cms.gov/Files/x/sim-rfi.pdf.
For specific questions not answered in this fact sheet please send an email to: SIM.RFI@cms.hhs.gov with “RFI” in the subject line.