Colorado State Innovation Model (SIM) 2017 Frequently Asked Questions (FAQs) for Cohort 2 Request for Applications (RFAs)
(1) When will the Colorado State Innovation Model (SIM) Cohort 2 application be available? The SIM Cohort 2 application will be open from s February 15—March 31 (11:59 PM MST), 2017.
(2) What is the SIM Practice Request for Application (RFA) and what are the submission requirements? This RFA is a solicitation notice for primary care practices in Colorado to submit an application to be considered for inclusion in the second cohort of the SIM initiative. The RFA packet describes SIM, benefits and expectations of participation, required and preferred practice qualifications, and the review process and instructions for completing and submitting the application. Interested applicants should reference the RFA Packet that outlines practice eligibility. If an applicant fails to submit all of the required documents as outlined within the RFA packet or does not meet the requirements for SIM, the practice site will be considered ineligible.
(3) Why is the University of Colorado issuing a SIM Practice RFA? There is an interagency agreement between the SIM Office and the University of Colorado (the University), which provides staff and expertise to convene and facilitate practice transformation services that are an integral part of SIM. The University will oversee the process of collecting the primary care practice responses to the RFA and convene a multi-stakeholder Application Review Committee that will conduct a comprehensive, thorough, complete and impartial review of each practice application received. Recommendations will then be made to the SIM Office, which will make the final decision on which practices are included in the second cohort to receive practice transformation support beginning in the fall of 2017.
(4) Who should I contact with questions about the SIM Practice RFA? For questions related to the application and the SIM RFA please contact University staff:
[email protected]
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(5) What are the minimum requirements a practice must meet in order to be eligible to participate in SIM? To be eligible and fully considered for inclusion in SIM, a practice site must meet the following criteria:
Applying practice sites must be physically located in Colorado.
Individual practice sites must complete and submit the application in its entirety before close of business on the posted deadline date.
Healthcare systems/multi-site organizations or other sponsoring organizations can assist practices in preparing their applications, but some sections should be completed by the practice staff. In particular, narrative questions in the application should be completed by a lead clinician or another key leader from the practice.
As defined by the Institute of Medicine, primary care is the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.
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An applying primary care practice site must be capable of providing a majority of its patients comprehensive primary, preventive, chronic, and urgent care.
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‘Non-traditional’ practices that provide a full range of primary care services and otherwise meet the requirements will be considered. This could include schoolbased clinics, local public health clinics, practices providing primary care services to specified groups of patients, and others (family medicine, general internal medicine, and primary care pediatrics are considered ‘traditional’ primary care).
Applicant practices that are not clearly traditional primary care practices but representatives believe the practices provide primary care services will be considered on a case-by-case basis and might be required to provide additional information (such as billing information) to substantiate the comprehensive primary care services delivered. Decisions on eligibility in such cases will be made by a committee convened by the University and the SIM Office.
(6) How does SIM define a practice? For the purposes of SIM a practice is defined as a physical location. Some practices have one tax identification number (TIN), with multiple locations. For purposes of SIM, a practice with one TIN and five locations would be considered five practices. In this example, each practice would be required to submit a separate application.
(7) Are “non-traditional” primary care practices eligible to participate in SIM? ‘Non-traditional’ practices that provide a full range of primary care services and otherwise meet the requirements can be considered. This could include school-based clinics, local public health clinics, practices providing primary care services to specified groups of patients (such as women’s health clinics), and others. Applicant practices that are not clearly traditional primary care practices but representatives believe they provide primary care services will be considered on a
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case-by-case basis and might be required to provide additional information (such as billing information) to substantiate the fact that comprehensive primary care services are provided. Decisions on eligibility in such cases will be made by a committee convened by the University and the SIM Office.
(8) How will practices be selected? A multi-stakeholder application review committee will conduct a comprehensive, thorough, complete and impartial review of each practice application received. Recommendations will then be made to the SIM Office, which will make the final decision on which practices are included in the second cohort to receive practice transformation support beginning in the fall of 2017.
(9) What funding support is available to practices that participate in SIM Cohort 2? Each practice participating in SIM Cohort 2 is eligible to receive ‘achievement-based payments’ of up to $13,000. Additionally, small grant funds will be available through the Colorado Health Foundation of up to $40,000 during the course of the two-year time frame.
(10) What are the primary benefits to participating practices beyond financial compensation? There are numerous non-financial benefits to participating practices, including:
In-office consultation
Business services support
Tools and consulting to help practices prepare and adapt to new payment models
Practice facilitators (PFs) who help implement ongoing change and quality improvement processes
Clinical Health Information Technology Advisors (CHITAs) to support practice data capacity, identify HIT resources, assist with workflow for data collection, reporting, validation and analysis and support to use that data to guide improvement priorities
Regional health connectors (RHCs) located in the community, who connect practices and clinicians to resources on multiple levels among the various components of the health and healthcare delivery system
Participation in collaborative learning sessions with your peers from other practices working on similar issues in an “all teach/all learn environment”
Performance Improvement, Part IV of board recertification requirements:
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Family medicine
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Pediatrics
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Internal medicine
Maintenance of Certification (MOC) and Continuing Medical Education (CME) credits available: o
Performance improvement activities in practices
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Participation at collaborative learning sessions
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Participation in e-learning modules
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Potential to reduce the total cost of care, reduction of inappropriate use of medical services and a cost-savings in big-ticket items like emergency room visits and hospitalization, which help practices participating in value-based payment models
Improvement in patient and provider satisfaction by reducing access barriers, improving communication and enabling providers to have better connection to resources to help patients with behavioral health issues.
(11) If my practice previously applied to participate in SIM Cohort 1, do I still have to fill out a new application for SIM Cohort 2?
Yes, all practices that applied to participate in SIM Cohort 1 will need to complete new applications for SIM Cohort 2.
(12) How many practices do you anticipate participating in SIM Cohort 2?
We hope to accept up to 150 additional practices for participation in SIM Cohort 2.
(13) Can I apply if I am part of a healthcare system or multi-site organization? Yes, practices that are part of a healthcare system or multi-site organization are eligible to apply for SIM Cohort 2.
(14) What are the requirements for SIM Cohort 2 practices?
Identifying a cross-functional quality improvement team to implement improvements based on the SIM Building Blocks
Completing a set of practice assessments to identify key areas for improvement
Collecting, reporting, and reviewing SIM Clinical Quality Measures (CQMs) on a quarterly basis
Attending two collaborative learning sessions per year
Participating in SIM evaluation activities
Achieving selected SIM milestones
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