Delivery System Reform


Delivery system transformation activities for SIM include supporting and equipping the system to adopt an ACO payment model and sustain its use. SIM provides technical assistance and tools to assist with this transformation. 

 

Some of the tools include: 

Statewide Alert Notification (SWAN):

Supports providers in APM models and MCOs in managing the health of their population. The SWAN system is infrastructure established by SIM to aid providers engaged in VBP to improve care coordination for members during critical transitions (admissions, discharges, and transfers). Getting the right information to the right provider in a timely manner also reduces unnecessary spending within the healthcare system and helps providers focus on population health strategies like reducing preventable readmissions, reducing medication errors and improving follow-up after inpatient visit measures. 
 

Statewide Strategy Plans:

Statewide Strategy Plans are consensus and guidance documents that outline unifying goals and actions to be taken to address an identified priority heath issue, promote alignment of resources and efforts, and advance the health and wellness of all Iowans. The state plans are developed through a cross-sector, collaborative process, convening key partners and stakeholders from across the healthcare continuum.  The plans are designed to establish a statewide standard of care, complement one another, and support statewide and local community action to achieve community-applied, population-based health.
 

Community and Clinical Care (C3) Initiatives:

These are multi-sector groups of stakeholders that include both traditional (clinical-based healthcare) providers, other community based providers and public health organizations implementing innovative strategies and referral processes to meet the clinical and social needs of a defined population. The C3s ensure that population-based prevention and treatment activities are implemented in alignment with required tactics from Iowa’s Statewide Strategy Plans.
 

Community Scorecards:

A tool created to provide community-level data that can be used to align communities and health systems to thrive in a population-based reimbursement model. Community scorecards contain valuable state and local data for comparison and benchmarking, leading the way for building local capacity for healthcare transformation and community-based quality improvement. Community scorecards will be developed for: 1) existing C3 pilots and, 2) healthcare systems receiving SIM Technical Assistance outside of the C3 areas. The Iowa Healthcare Collaborative (IHC) working with key SIM partners will manage and facilitate the community scorecards.
 

Technical Assistance:

These are designed to expand community level execution to improve care and healthcare collaboration across stakeholder groups. SIM TA will guide local changes needed to address healthcare quality and improve access to accountable and affordable healthcare for Iowans.  Lead by The Iowa Healthcare Collaborative (IHC) to drive clinical improvements that impact the local environment and accelerate statewide change.
 
Delivery System Reform and Payment Reform work together to align incentives and motivate systems to engage in transformation. Together, these components represent the Delivery System Reform Model for transformation.
 
Iowa’s SIM augments the comprehensive care coordination-focused projects that have been established, continuing to build infrastructure based on those supportive foundations, the SIM initiatives are intended to compliment and reinforce additional efforts that are already underway in Iowa and funded by both federal and state partners. SIM staff will maintain an inventory of other transformative efforts and make every effort to minimize duplication and avoid market confusion.