The CMS State Innovation Models Initiative and Improved Health Information Technology and Care Management Capabilities of Physician Practices

Overview

Journal Med Care Res Rev

Specialty Health Services

Date 2020 Jan 23

PMID 31967494

Citations 5

Authors

Zosha K Kandel

Diane R Rittenhouse

Salma Bibi

Taressa K Fraze

Stephen M Shortell

Hector P Rodriguez

Affiliations

Soon will be listed here.

Abstract

The Centers for Medicare and Medicaid Services' (CMS) State Innovation Models (SIMs) initiative funded 17 states to implement health care payment and delivery system reforms to improve health system performance. Whether SIM improved health information technology (HIT) and care management capabilities of physician practices, however, remains unclear. National surveys of physician practices ( = 2,722) from 2012 to 2013 and 2017 to 2018 were linked. Multivariable regression estimated differential adoption of 10 HIT functions and chronic care management processes (CMPs) based on SIM award status (SIM Round 1, SIM Round 2, or non-SIM). HIT and CMP capabilities improved equally for practices in SIM Round 1 (5.3 vs. 6.8 capabilities, < .001), SIM Round 2 (4.7 vs. 7.0 capabilities, < .001), and non-SIM (4.2 vs. 6.3 capabilities, < .001) states. The CMS SIM Initiative did not accelerate the adoption of ten foundational physician practice capabilities beyond national trends.

Citing Articles

COVID-19 Impacts on Primary Care Clinic Care Management Processes.

Solberg L, Carlin C, Peterson K Ann Fam Med. 2023; 21(1):40-45.

PMID: 36690491 PMC: 9870648. DOI: 10.1370/afm.2910.

Effect of State-Led Delivery System and Payment Reforms on Population-Level Detection and Management of Diabetes.

Rodriguez H, Fulton B, Phillips A, Rubio K Diabetes Care. 2022; 45(10):2255-2263.

PMID: 35972261 PMC: 9643138. DOI: 10.2337/dc21-2425.

Adoption of Patient-Reported Outcomes by Health Systems and Physician Practices in the USA.

Rodriguez H, Kyalwazi M, Lewis V, Rubio K, Shortell S J Gen Intern Med. 2022; 37(15):3885-3892.

PMID: 35484368 PMC: 9640524. DOI: 10.1007/s11606-022-07631-0.

Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.

Brown T, Hurley V, Rodriguez H BMJ Open. 2021; 11(11):e053121.

PMID: 34836905 PMC: 8628342. DOI: 10.1136/bmjopen-2021-053121.

Power and Purchasing: Why Strategic Purchasing Fails.

Greer S, Klasa K, van Ginneken E Milbank Q. 2020; 98(3):975-1020.

PMID: 32749005 PMC: 7482378. DOI: 10.1111/1468-0009.12471.

References

Kissam S, Beil H, Cousart C, Greenwald L, Lloyd J . States Encouraging Value-Based Payment: Lessons From CMS's State Innovation Models Initiative. Milbank Q. 2019; 97(2):506-542. PMC: 6554499. DOI: 10.1111/1468-0009.12380. View

Rodriguez H, Knox M, Hurley V, Rittenhouse D, Shortell S . The Use of Enhanced Appointment Access Strategies by Medical Practices. Med Care. 2016; 54(6):632-8. DOI: 10.1097/MLR.0000000000000527. View

Holtrop J, Potworowski G, Fitzpatrick L, Kowalk A, Green L . Understanding effective care management implementation in primary care: a macrocognition perspective analysis. Implement Sci. 2015; 10:122. PMC: 4545994. DOI: 10.1186/s13012-015-0316-z. View

Bates D, Saria S, Ohno-Machado L, Shah A, Escobar G . Big data in health care: using analytics to identify and manage high-risk and high-cost patients. Health Aff (Millwood). 2014; 33(7):1123-31. DOI: 10.1377/hlthaff.2014.0041. View

Holtrop J, Potworowski G, Fitzpatrick L, Kowalk A, Green L . Effect of care management program structure on implementation: a normalization process theory analysis. BMC Health Serv Res. 2016; 16(a):386. PMC: 4986276. DOI: 10.1186/s12913-016-1613-1. View

Gold M, McLaughlin C . Assessing HITECH Implementation and Lessons: 5 Years Later. Milbank Q. 2016; 94(3):654-87. PMC: 5020152. DOI: 10.1111/1468-0009.12214. View

McInnes D, Brown J, Hays R, Gallagher P, Ralston J, Hugh M . Development and evaluation of CAHPS questions to assess the impact of health information technology on patient experiences with ambulatory care. Med Care. 2012; 50 Suppl:S11-9. PMC: 3525454. DOI: 10.1097/MLR.0b013e3182610a50. View

Casalino L, Gillies R, Shortell S, Schmittdiel J, Bodenheimer T, Robinson J . External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. JAMA. 2003; 289(4):434-41. DOI: 10.1001/jama.289.4.434. View

Tomoaia-Cotisel A, Farrell T, Solberg L, Berry C, Calman N, Cronholm P . Implementation of Care Management: An Analysis of Recent AHRQ Research. Med Care Res Rev. 2016; 75(1):46-65. PMC: 7177185. DOI: 10.1177/1077558716673459. View

10.

Peikes D, Swankoski K, Hoag S, Duda N, Coopersmith J, Taylor E . The Effects of a Primary Care Transformation Initiative on Primary Care Physician Burnout and Workplace Experience. J Gen Intern Med. 2018; 34(1):49-57. PMC: 6318185. DOI: 10.1007/s11606-018-4545-0. View

11.

Bishop T, Ramsay P, Casalino L, Bao Y, Pincus H, Shortell S . Care Management Processes Used Less Often For Depression Than For Other Chronic Conditions In US Primary Care Practices. Health Aff (Millwood). 2016; 35(3):394-400. DOI: 10.1377/hlthaff.2015.1068. View

12.

Beil H, Feinberg R, Patel S, Romaire M . Behavioral Health Integration With Primary Care: Implementation Experience and Impacts From the State Innovation Model Round 1 States. Milbank Q. 2019; 97(2):543-582. PMC: 6554552. DOI: 10.1111/1468-0009.12379. View

13.

Shi Y, Scanlon D, Kang R, McHugh M, Greene J, Christianson J . The longitudinal impact of Aligning Forces for Quality on measures of population health, quality and experience of care, and cost of care. Am J Manag Care. 2016; 22(12 Suppl):s373-81. View

14.

Katon W . The comorbidity of diabetes mellitus and depression. Am J Med. 2008; 121(11 Suppl 2):S8-15. PMC: 2717744. DOI: 10.1016/j.amjmed.2008.09.008. View

15.

Miake-Lye I, Chuang E, Rodriguez H, Kominski G, Yano E, Shortell S . Random or predictable?: Adoption patterns of chronic care management practices in physician organizations. Implement Sci. 2017; 12(1):106. PMC: 5571615. DOI: 10.1186/s13012-017-0639-z. View

16.

Song Z, Lee T . The era of delivery system reform begins. JAMA. 2013; 309(1):35-6. PMC: 3557522. DOI: 10.1001/jama.2012.96870. View

17.

Denham A, Veazie P . Did Medicaid expansion matter in states with generous Medicaid?. Am J Manag Care. 2019; 25(3):129-134. View

18.

Rodriguez H, McClellan S, Bibi S, Casalino L, Ramsay P, Shortell S . Increased Use of Care Management Processes and Expanded Health Information Technology Functions by Practice Ownership and Medicaid Revenue. Med Care Res Rev. 2015; 73(3):308-28. DOI: 10.1177/1077558715613233. View

19.

Rittenhouse D, Ramsay P, Casalino L, McClellan S, Kandel Z, Shortell S . Increased Health Information Technology Adoption and Use Among Small Primary Care Physician Practices Over Time: A National Cohort Study. Ann Fam Med. 2017; 15(1):56-62. PMC: 5217844. DOI: 10.1370/afm.1992. View

20.

Smith K, Bir A, Freeman N, Koethe B, Cohen J, Day T . Impact Of Health Care Delivery System Innovations On Total Cost Of Care. Health Aff (Millwood). 2017; 36(3):509-515. DOI: 10.1377/hlthaff.2016.1308. View