Goals of the Iowa SIM Program


The Iowa SIM Grant is testing the sustainability of targeted care delivery improvement linked to value-based payment reform to improve population health.  The state believes these efforts will reduce healthcare costs while also improving quality by integrating population health strategies and targeted use of community resources that recognize social determinant data that impact individual health outcomes.

Iowa SIM Goals for Award Year 3

1. Healthcare costs are reduced while quality is improved with value based payment models by: 

  • Provider participation and covered lives participation in value-based purchasing reaches 45% in Iowa. 
  • Reduce the Total Cost of Care for Wellmark and Medicaid population by 8% below projected targets. 

2. Patients are empowered and supported to be healthier by: 

  • Reduced rate of potentially preventable readmissions in Iowa by 6% 
  • Reduced rate of potentially preventable ED visits in Iowa by 10% 
  • Reduced rate of Hospital Acquired Conditions by a 10% reduction in Clostridium Difficile and All Cause Harm 

3. Iowa increases the number of provider organizations financially successful in Alternative Payment contracts from the 2015 baselines (those that share in savings and incentives for each payer) 

  • Baseline: Wellmark - 11/13 received shared savings, Medicaid - 5/5 received incentives, and Medicare - overall 23% percent of ACOs in the Midwest received shared savings. 
The project will reach beyond the grant period itself. The grant provides vital, early support necessary to organize leadership, define the vision, engage key stakeholders, implement programs, and attain enough critical mass so that transformation is inevitable because the healthcare marketplace has been re-defined. Through the SIM grant, Iowa is building a platform of systems and policies that will be mature enough to move and grow even after the SIM funding support falls away.