New Jersey State Innovation Model (SIM)
In February 2015, Rutgers Center for State Health Policy (CSHP) received a one-year, $3 million State Innovation Model (SIM) design award on behalf of the State of New Jersey. The cooperative agreement, #1G1CMS331386-01, was funded by the Center for Medicare and Medicaid Innovation (CMMI) from February 1, 2015 through May 31, 2016.
The goals of the SIM were to design payment and service delivery models to reduce Medicare, Medicaid, and CHIP program expenditures while preserving or enhancing quality of care. Specific activities in the NJ SIM were targeted at 1) improving birth outcomes through smoking cessation efforts, particularly among pregnant women; 2) advancing behavioral and physical health integration strategies; and 3) addressing Medicaid cost/value, especially for high-cost patients.
SIM project activities were organized under nine components: 1) Population Health Improvement Plan; 2) Health Care Delivery System Transformation Plan; 3) Payment and/or Service Delivery Model; 4) Leveraging Regulatory Authority; 5) Health Information Technology; 6) Stakeholder Engagement; 7) Quality Metric Alignment; 8) Monitoring and Evaluation Plan; and 9) Alignment with State and Federal Innovation. This project culminated in the submission of a State Health System Innovation Plan to CMMI.
Foci of Activities
- Advance the implementation of Healthy New Jersey 2020
- Conduct an environmental scan of the NJ delivery system, including a survey of primary care physicians
- Optimize the implementation of the Vital Information Platform (VIP) & coordination with health IT strategies
- Align quality metrics across payers and delivery system to improve quality and reduce redundancy
- Facilitate and inform implementation of the Medicaid ACOs
- Support Behavioral Health Home pilot initiatives
- Design Delivery System Transformation Resource Center to accelerate innovation efforts, particularly with regard to advancing patient centered primary care strategies
Project Governance and Partnerships
The NJ SIM was overseen by a Steering Committee charged with supporting the execution of the project activities and comprised of representatives of the Office of the Governor and NJ Departments of Health (DOH), Human Services (DHS) and Banking & Insurance (DOBI). Other partners contributing to the NJ SIM included the Department of Family Medicine and Community Health at Robert Wood Johnson Medical School, Central Jersey Family Health Consortium, New Jersey Healthcare Quality Institute, The Center for Health Incentives and Behavioral Economics, Leonard Davis Institute at the University of Pennsylvania, and The Center for Health, Pharmaceutical Law & Policy, Seton Hall University School of Law.
To learn more about the New Jersey State Innovation Model (SIM) Design Award please contact Margaret Koller, Executive Director, at firstname.lastname@example.org or 848-932-4655.
What is SIM?
Sponsored by the Center for Medicare and Medicaid Innovation (CMMI), the State Innovation Models (SIM) Initiative provides financial and technical support to states for the development and testing of state-led, multi-payer health care payment and service delivery models that will improve health system performance, increase quality of care, and decrease costs for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries—and for all residents of participating states. For more information visit: http://innovation.cms.gov/initiatives/state-innovations.
What is the difference between the SIM Model Testing Award, the SIM Model Design Award, and the State Healthcare Innovation Plan?
The SIM Model Design award is a 1-year planning grant. New Jersey was one of 21 states that received this award. The Model Design award recipients engage a diverse group of stakeholders, including public and commercial payers, providers and consumers, to develop a State Healthcare Innovation Plan. States receiving Model Design awards under the State Innovation Models initiative have twelve months to submit their State Health Care Innovation Plans to CMS. The SIM Model Testing award is an implementation grant which would fund the implementation of parts of the State Healthcare Innovation Plan.
What is the State Healthcare Innovation Plan?
A State Health Care Innovation Plan is a proposal that describes a state’s strategy to use all of the levers available to it to transform its health care delivery system through multi-payer payment reform and other state-led initiatives. The State Healthcare Innovation Plan was the main deliverable for this planning grant. For more information visit: http://innovation.cms.gov/initiatives/state-innovations.
Learn More about the SIM Design Award
Contact Margaret Koller, Executive Director, at email@example.com or 848-932-4655.