Page 16 - Delaware Medical Journal - May/June 2018
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Year 4 of the State Innovation Model Grant: An Update on Initiatives and Results
Nancy Fan, MD
In 2014, Delaware, through the Delaware Health Care Commission (DHCC), was the recipient of a $34 million, four-year State Innovation Model (SIM) grant from the Center for Medicare & Medicaid Innovation (CMMI). By engaging stakeholders at all levels of health care, this grant was viewed as the start of a pathway to improve health care in Delaware by increasing quality and access, while decreasing cost and the administrative burden for providers.
The two graphics on page 145 illustrate the current year 4 budget and initiatives targeted for funding. I will defer to other articles
in this issue of the Delaware Medical Journal to discuss tools
and solutions related to some of the listed initiatives, such as the concept of benchmarking costs and the development of the Common Scorecard. In this article, I will discuss in detail the programs related to population health, which are Practice Transformation, Behavioral Health Integration, and the Primary Care Initiative.
PRACTICE TRANSFORMATION
Collective groan? Catch phrases like “pay for value,” “care coordination,” and “qualimetrics” swarm around physicians like cascading ocean waves in the tsunami of health care “reform.” Recognizing that health care professionals and practices would initiatives DHCC implemented was to provide a framework for this concept of practice transformation.
greater reimbursement success in the future — now, under the present value-based payment model. The milestones were developed by the Clinical Committee of the Delaware Center for Health Innovation (DCHI) and are listed in the sidebar on page 146.
Four vendors were selected to provide support to primary care practices through assessment of needs and resources, practice coaching, and the development of sustainable infrastructure for practices. These vendors are the New Jersey Association of
Family Physicians, the Medical Society of Delaware, Remedy,
129 practice sites with 293 physicians and 131 other primary care providers included in the initiative. The majority of the practices
While the grant initially targeted up to 50 percent of primary care practices to be on track for a value-based payment model, due to provide funding directly to practices. Unfortunately, I believe this
The Delaware Health Care Commission
The Delaware Health Care Commission (DHCC) was created in 1990 by the Delaware General Assembly to address
the need for affordable access to health care in Delaware. Reflective of the initial goal to develop innovative health care policy outside the usual government process, DHCC incorporates a collaborative, consensus-building approach to highlight and initiate pilot programs that may be models for larger change in the delivery of health care in Delaware.
Since its beginning, DHCC has also assumed the administration of multiple programs, such as the Delaware Institute for Medical Education and Research (DIMER),
the Delaware Institute for Dental Education and Research (DIDER), the Health Resources Board, the State Loan Repayment Program, the development of the Delaware Health Information Network (DHIN), and, most recently, the implementation of the Health Insurance Marketplace and the State Innovation Model (SIM) grant.
The composition of the Board reflects the balance between public and private sectors, as well as the executive and legislative branches of state government. Current Board commissioners include: Nancy Fan, MD, Chair; Kara Odom-Walker, MD, Secretary of Health and Social Services; Jan Lee, MD, Executive Director of
DHIN; Richard Eisenberger, Secretary of Finance; Josette Manning, Esq., Secretary of the Department of Services for Children, Youth and Their Families; Trinidad Navarro, Insurance Commissioner; Theodore Becker, Mayor of the City of Lewes; Dennis Rockford, President of the Maritime Exchange for the Delaware River and Bay; Edmondo Robinson, MD, Senior Vice President and Executive Director for Wilmington Hospital, Christiana Care Health System; and Kathleen Matt, PhD, Dean, College of Health Sciences, University of Delaware.
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Del Med J | May/June 2018 | Vol. 90 | No. 5
