STATE INNOVATION MODEL (SIM) FAQS

What does the SIM Grant mean to me?

You may currently serve multiple roles in health care delivery. You may be a consumer of health care or consumer advocate, a health care provider, or member of the health care work force, a Payer reimbursing the cost of health services, a member of an industry association, or a public health official or policymaker for health care services. Your roles in any of these facets of health care delivery also make you a stakeholder in the development of a Nevada State Health System Innovation Plan (SHSIP). A successful SHSIP will require broad stakeholder input and engagement during the spring and early summer months of 2015. You are strongly encouraged to provide recommendations for health care reform through a variety of ways, including attendance at stakeholder focus groups, completing an Online Survey, and participating in work groups and community meetings. Visit the DHCFP web site for up to date information on stakeholder engagement opportunities. We are seeking your input to identify short-term and long-term strategies for health care delivery and payment reform that are consistent with the Governor's seven health objectives, evidence-based, focused on Nevada's needs, and provide clear definition of success.

 

What is the objective of the State Innovation Model (SIM) Grant?

The objective of this grant is to design a plan for transforming the healthcare delivery and payment system in Nevada. To accomplish this objective, the Centers for Medicare and Medicaid Services (CMS) awarded the Nevada Department of Health and Human Services (DHHS) Division of Health Care Financing and Policy (DHCFP) a $2 million State Innovation Model (SIM) Design grant. The grant provides financing and technical assistance from CMS to DHHS to develop a SHSIP. The SHSIP will provide a roadmap for Nevadans to:

  • Gain greater access to care
  • Gain improved health status
  • Reform healthcare delivery and payment systems
  • Contain healthcare costs while increasing healthcare value


Reforming the healthcare delivery and payment system requires new payment strategies, such as Value-Based Purchasing, which recognizes high quality health care as evidenced by certain performance measures.
In subsequent years the SHSIP may be considered by CMS for additional funding to implement and test the model(s) outlined in the plan.

 

Is the SIM Grant only for Medicaid?

No, it is all across the state of Nevada; a multi-payer healthcare payment and service delivery model that will improve health system performance, increase quality of care, and decrease costs for all payers and for all residents of Nevada.

 

Will there be a third round of SIM Grant funding?

At this time, CMS anticipates that there won't be funding for a round three of SIM Grant funding. CMS has offered to work with us regarding finding additional funding, through grants and other resources, after the SIM Grant period is over at the end of January 2016.

 

Do you have an idea at this point as to what you will be designing for the plan?

For now, we are planning a "phased in" approach; we will start with children (0-17), 65+ and then those in between (18-64). We are exploring the ideas of a Multi-Payer Collaborative, Patient Centered Medical Homes (PCMH), and Value-Based Purchasing (VBP). We also know that anything that we plan has to be sustainable far after the grant period.

 

What is the timeline of the SIM Grant?

The grant period began on February 1, 2015 and runs for twelve (12) months. The primary goals in the first three months of the grant period are to conduct stakeholder sessions, formulate work groups, collect and review survey responses, and conduct community meetings. The primary goal in the second three months of the grant period is to facilitate work group meetings. During the remainder of the grant period DHCFP will continue to engage stakeholders and work groups to assess stakeholder readiness to implement the recommended models, and finalize the design plan for submission to CMS.

 

What opportunities are available for me to provide input or participate in meetings?

There are several ways stakeholders can share their vision for health care delivery and payment system reforms, including completing an Online Survey, attending community meetings, stakeholder update meetings, online presentations, participating in work groups and task forces, or by submitting recommendations by email to Rates@dhcfp.nv.gov. All stakeholders are encouraged to complete the Online Survey. In addition, the DHCFP web site publishes information on SIM Grant activities, such as dates, times, and locations of stakeholder meetings and webinars, summaries of stakeholder meetings, and links to the Online Survey and email address. Visit the DHCFP web site regularly for updates on SIM Grant meetings and activities.

 

What will my responsibilities be if I am appointed to a work group or task force?

While critical, the participant role in the workgroup and taskforce forums is advisory in nature. The members will be appointed by DHCFP. The workgroup and taskforce members will recommend feasible multi-payer health care payment and service delivery models for potential inclusion in the SHSIP. Each of the forums will have defined goals, activities, and deliverables. We have developed a Project Charter for each of these forums.

These Project Charters serve several purposes:

  • Identifies the goals and activities of the stakeholder focus group
  • Establishes the roles, responsibilities, and expectations of the participants who are participating on behalf of and with the executive support of their organization
  • Upon signoff, provides authorization of the participant to participate in focus group
  • Serves as the point of reference for documentation and work product of the focus group
  • Establishes agreement of the deliverables between DHCFP and the focus group members

 

I want to make recommendations for health care reform. How do I submit ideas?

Please complete an Online Survey or submit a completed Innovative Care Comments Form, which can be accessed from the DHCFP web site. Or you can send an email to Rates@dhcfp.nv.gov with your recommendations.
Last Edited: 5/9/2016