CMS State Innovation Model (SIM) Design Award - Wisconsin

Program Location: 
Madison, WI
Payer Type: 
Grant
Payers: 
Medicaid
Description: 

Wisconsin has received a $2.5 million State Innovation Models (SIM) award from the federal Centers for Medicare and Medicaid Services (CMS) Innovation Center to develop a comprehensive State Health Care Innovation Plan. The award will allow DHS and its partners to enhance and accelerate multi-stakeholder, collaborative statewide quality improvement and payment reform efforts that are already underway.

One of DHS’s primary partners is the Statewide Value Committee (SVC), which is comprised of leaders from more than 30 organizations representing both private and public sector health care and employer organizations that are seeking to realize greater value in health care faster by better aligning efforts and incentives to deliver better quality care at lower cost.

The Wisconsin Department of Health Services listed that the Wisconsin SHIP will:

  • Identify health care services with the greatest variation in quality and cost effectiveness
  • Identify major cost drivers
  • Identify clinical conditions with the most severe disparities in health outcomes
  • Establish and analyze a focused set of quality and cost measures
  • Improve dissemination and implementation of best practice

The State Heath Care Innovation Plan will include a Population Health Improvement Plan (PHIP), Health Information Technology (HIT) Plan, and Actuarial Certified Financial Analysis. It will also focus on behavioral health (including substance abuse and misuse) as a targeted priority health care issue. Behavioral health has been widely identified nationally as a driver of health care costs. With the award money, Wisconsin hopes to develop a plan to close two major gaps in behavioral health care: access to care and a lack of care coordination between behavioral health and medical care. The award period began February 1, 2015, and extends through January 31, 2016. The SHIP will include a value-based payment and/or service delivery model. 

Payment Model: 

CMS granted the state of Wisconsin $2,494,290 to develop a State Health Care Innovation Plan. 

Last updated September 2015
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