STATE INNOVATIVE MODEL (SIM) PROGRAM - GUIDING PRINCIPLES


Models considered for this initiative must apply these guiding principles

  • Integrated providers and networks, including virtual and/or technology based, across the care continuum collaborating on patient-focused, high quality health care.
  • Payments to providers and/or service vendors are tied to value and performance that lead to better outcomes and controlled costs.
  • Every patient has a provider who is responsible for ensuring the patient has the services needed based on reasonable care parameters.
  • Providers are evaluated on individual episodes of care and accountable for populated based measures of quality, service and cost.
  • Patients are engaged in their care and treatment decisions.
  • Data is widely available and used to measure and improve quality.
  • Care delivery is unified to eliminate medically underserved and health care shortage areas.
  • The number of specialist and available network providers is appropriate to the needs of the population.
  • Economic incentives are used to recognize high performance and results among providers.
  • Data is used as a basis of management and performance.
  • Technology is used to minimize administrative burden, reduce administrative costs, and promote improved outcomes.
  • State and federal regulations and statutes should promote quality, performance, and service delivery while not creating barriers and/or inefficiencies that are incongruent to these principles.

    Last Edited: 3/24/2016