State Innovation Model (SIM)

Awarded $43.1 million over a four year period to support statewide health system transformation, Iowa was one of 11 states to be awarded Federal State Innovation Model (SIM) Grant Funding.  The grant was used to align and transform Iowa’s delivery system to a system heavily focused on population health.

During the SIM Grant our vision was to test statewide transformation efforts that would ensure “Iowans experience better health and have access to accountable and affordable healthcare in every community”. Through the SIM program, Iowa focused on two primary drivers; Aligning payers in value based purchasing (VBP) to effectively move the healthcare system from volume to value and equipping providers to engage in population health needs and focus on value outcomes. Together, these approaches ensured robust, statewide healthcare transformation to set the guiding principles for an environment where providers will transition to being paid on value outcomes over the volume of services provided. This approach also opened the door for communities and health systems to begin working together to produce healthier people in a system that is affordable and sustainable. 

Goals of the Iowa SIM Program 

The Iowa SIM Grant tested the sustainability of targeted care delivery improvement linked to value-based payment reform to improve population health.  The state believed these efforts would reduce healthcare costs while also improving quality by integrating population health strategies and targeted use of community resources and social determinant of health data directly tied to meaningful impacts on individual health outcomes

1. Healthcare costs are reduced while quality is improved with value based payment models

2. Patients are empowered and supported to be healthier

3. Iowa increases the number of provider organizations financially successful in Alternative Payment contracts

Implemented processes will reach beyond the grant period itself. The grant provided vital, early support necessary to organize leadership, define the vision, engage key stakeholders, implement programs, and attain enough critical mass so that transformation is inevitable in this newly defined healthcare marketplace. Through the SIM grant, Iowa has begun building a platform of systems and policies that will continue to move and grow even after the SIM funding support falls away.

Transformation in the Iowa health care system required a broad vision and is was certainly a complicated task. In the post SIM environment, payers, providers, communities and government agencies recognize that “healthcare” is inclusive of the broader definition of health; considerations of healthcare now include supporting services and activities that focus on keeping people well, lowering healthcare risk and the prevalence of chronic disease more than ever before. Guiding framework has been built that will allow providers to have access to and the ability to use Health Information Technology data to make better care decisions, target risk within their assigned populations, take action during transitions of care, and follow-up on clinical and social care referrals.

Governor's Healthcare Innovation and Visioning Roundtable

The purpose of the Governor's Healthcare Innovation and Visioning Roundtable is to engage leaders around the state to develop consensus and transform how the healthcare system operates to best serve the needs of all Iowans.  It will identify and prioritize elements necessary for reform, such as specific payment models, infrastructure support and policy and regulatory shifts necessary to fuel progress. The group will bring recommendations forward that will inform key healthcare market actors as well as recommendations to Governor Reynolds and her administration regarding necessary steps to implement reform for Iowans that is both cost-effective and improves the health of our citizens. The Roundtable is a 2 year commitment for invited leaders that will help Iowa plan beyond the SIM grant to develop a post-SIM sustainability work plan and will be open to the public. The state will engage the national expertise of Health Management Associates (HMA) to guide Iowa in this planning effort. HMA will help facilitate the Roundtable discussions that are relevant to Iowa and assist the group in gaining national insight where needed into the conversations. Access additional information on the Governor’s Healthcare Innovation and Visioning Round Table HERE

Information Resources

SIM Operational Plans