5 Investment Priorities for the State Health Innovation Plans

Analysis of State Health Innovation Plans (SHIPs), funded by CMS, shows a variety of emerging approaches to healthcare reform, according to a report from Accenture.

In total, CMS invested $960 million in the State Innovation Models initiative allocated in 2 phases: $300 million awarded in 2013 for design and testing of pilots, and $660 million in 2014 to support efforts to improve delivery systems and payment models across Medicare, Medicaid, and the Children’s Health Insurance Program.

“State innovation plans will focus on integrating approaches to healthcare and expanding access to care, driven by the pressing need to improve outcomes and control healthcare costs,” Kaveh Safavi MD, global managing director of Accenture’s health practice, said in a statement. “Integrating healthcare and human services—starting with the data they gather and the outcomes they achieve—will break down data silos to make operations and information more transparent and coordinated while aligning federal resources to eliminate gaps.”

A total of 9 states are in pre-testing and testing phases and 16 have completed model designs. SHIPs look beyond healthcare to behavioral and social aspects to improve health outcomes, and Accenture has identified 3 forces of change that can positively transform health delivery: the transition from dependence to empowered digital citizen; the move from care management to community care; and the shift from data silos to seamless insight.

“States are exploring exciting ways of delivering person-centered care and services that will dramatically change care delivery,” according to the Accenture report. “Yet there is work to do to implement and scale states’ strategies.”

The top 5 projected investment areas by states currently participating in the State Innovation Models initiative are:

• Patient-centered medical homes All 25 states are investing in patient-centered medical homes in order to strengthen primary care integration with specialists and community health workers.
• Lower-cost labor models All 25 states are targeting investment in low-cost, community health workers to shift labor costs to more appropriate caregivers.
• Telehealth The 19 states seeking to expand use of virtual care technology, such as telehealth and remote monitoring, have a common goal of treating more patients without adding healthcare workers and facilities.
• Self-service tools Fifteen states are offering patient portals and other digital tools to reduce administrative costs while improving self-care, expanding access to electronic health records, and providing information on value-based health choices and access to care delivery options.
• All-payer claims databases An estimated 14 states are pursuing statewide data aggregation and analytics with a goal of designing more effective intervention and wellness programs to reduce long-term healthcare costs.

“These initiatives taking hold across the country are part of the shift from an essentially outdated healthcare system to the evolution of family and community-centered care models and a real convergence of health and human services,” Dr Safavi added.