CMS State Innovation Model (SIM) Design Award - Arizona

Arizona will engage a diverse group of stakeholders, including public and commercial payers, providers and consumers, to develop a State Health Care Innovation Plan. States receiving Model Design awards under the State Innovation Models initiative will have twelve months to submit their State Health Care Innovation Plans to CMS. 

Tens of thousands of providers will benefit from the variety of strategies Arizona will employ, including expanding the use of Health Information Technology and data sharing among various fragmented entities. The Arizona SIM Initiative, in addition to providing support for enhanced access to data, will also provide funding to accelerate organizations’ ability to enter into modernized payment structures. Arizona expects these efforts, in conjunction with the state’s State Health Improvement Plan, will improve individual and population health and increase payer and provider accountability for outcomes and costs.

In July 2015, Arizona submitted an application for the CMS State Innovation Model Funding. The Arizona State Innovation Model (SIM) Initiative will accelerate the state’s delivery system transformation towards a value-based integrated model that focuses on whole person health in all settings and regardless of coverage source. Arizona will undertake transformation of the health care delivery system using three overarching strategies:

• 1) Facilitating Integration and Decreasing System Fragmentation
• 2) Improving Care Coordination
• 3) Driving Payment Reform. Arizona will distribute almost 90% of the $85.7 million in SIM funding through largely competitive processes to community partners engaged in delivery system transformation.

The SIM Initiative will begin by focusing on critical populations including individuals with serious mental illness (SMI) or who have other significant medical and behavioral health needs (super-utilizers), individuals dually eligible for Medicare and Medicaid, individuals transitioning from the justice system, members moving between Qualified Health Plans (QHPs) and Medicaid health plans, and the American Indian population. The initiative will improve care for all of Arizona’s 1.5 million AHCCCS enrollees (including 150,000 American Indians enrolled in Medicaid), tens of thousands of Arizonans transitioning between AHCCCS and QHPs, the estimated 100,000 individuals who transition from incarceration to AHCCCS every year, and, ultimately, a significant number of Medicare beneficiaries and commercially-insured individuals. As evidenced by over 55 letters of support from community partners, the Arizona SIM strategy will be a statewide collaborative effort towards transforming the health care delivery system for all Arizonans.