Jessamy Taylor, MPP
Can states create multi-payer health care transformation that both results in improved health and costs less? The Center for Medicare & Medicaid Innovation (within CMS, the Centers for Medicare & Medicaid Services) is expecting the answer to be a resounding "yes." At a time of wide agreement that health care consumes too much of federal and state budgets for limited value, the State Innovation Model (SIM) initiative is funding six states (Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont) to test models to improve health and health care and to lower costs. SIM testing states are deploying strategies like accountable care organizations, other shared savings/shared risk models, health homes, bundled payments for episodes of care, and pay for performance programs and are working with Medicaid, Medicare, commercial insurers, state employee health programs, and self-insured payers to varying degrees.
This Forum session explored the early experiences of this cohort of six states and their common and individual challenges related to payer, provider, and consumer engagement as well as data analytics and data sharing, among others. The efforts of Arkansas and Vermont were discussed in detail.
Milbank Memorial Fund, "Preparing for Multi-Payer Health Care Transformation: Common Issues from SIM Test States," January 2014.
Sharon Silow-Carroll and JoAnn Lamphere, "State Innovation Models: Early Experiences and Challenges of an Initiative to Advance Broad Health System Reform," The Commonwealth Fund, Issue Brief, September 2013.