Utah State Innovation Model (USIM)

Utah State Innovation Model Design Briefing Document

The CMS Innovation Center created the State Innovation Models initiative for states/entities that are prepared for or committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. The Innovation Center is interested in testing innovative payment and service delivery models that have the potential to lower costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), while maintaining or improving quality of care for program beneficiaries. The goal is to create multi-payer models with a broad mission to improve health, improve care, and decrease costs for beneficiaries of Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). There has been two rounds and Utah has received both Round 1 and Round 2 funding for planning and design. The Round Two Model Design award recipients (21) will design or further refine State Health Care Innovation Plans. The Model Design award recipients will engage a diverse group of stakeholders, including public and commercial payers, providers and consumers, to develop a State Health Care Innovation Plan.


Round 1 (2013 – 2014) Approximately $950,000 was awarded to the Utah Department of Health and the University of Utah under the direction of Greg Bell, Lieutenant Governor and Deborah Turner, Project Director. Policy level stakeholders were brought together to work in 5 work groups (Health Care Work Force, Health Information Technology, Prevention and Wellness, Payment Reform, and Health Care Quality and Safety). In follow up the 2014 Governor's Health Summit focused on " R4 - Value Based Care: Right Care at the Right Time for the Right Reason at the Right Cost". Individual breakout sessions focused on Value Based Care Strategies, Behavioral Health Integration, Advance Care Planning and Community Health Outreach and wellness.

Round 2 ( 2015 – 2016) A $2,000,000 cooperative agreement was awarded to Utah on February 1, 2015 with funding made available June 11, 2015 to continue designing health innovation transformations in behavioral health integration, obesity and diabetes and advance care planning. Iona Thraen ACSW PhD serves as the Primary Investigator for the initiative. Approximately 78% was awarded through nine contracts to various partners (Biomedical Informatics Department, UU; Commission on Aging, UU; HealthInsight; Social Research Institute, UU; Utah Hospital Association; Utah Health Information Network; Utah Medical Education Council; Utah Partnership for Improving Quality; and Utah Telehealth Network) to continue design efforts. A department wide health information survey and retreat was held on July 10, 2015 aimed at integrating the results into the UDOH Strategic Goals and the Federal HIT Roadmap. A formal kick off meeting for the Utah State Innovation Model (USIM) is scheduled for September 10, 2015.

States receiving a State Innovation Model Design Cooperative Agreement will have twelve months to submit their State Health Care Innovation Plans to CMMI. For Utah, this will be an operational plan (version 2 of the Utah State Innovation Plan) with the above stated priorities addressing the cross-cutting issues of health information technology, value based purchasing and policies, delivery system transformation, stakeholder engagement and quality measurement.

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