Arizona SIM Strategy

1. Arizona SIM Strategy

2. SIM Overview • CMS established State Innovation Model (SIM) Initiative for multi-payer efforts around payment reform and health system transformation. • Goal is to achieve statewide transformation for the preponderance of care delivered within the state and: • Improve health • Transform delivery system • Lower costs Reaching across Arizona to provide comprehensive quality health care for those in need

3. SIM Overview – Delivery System Reform • CMS has identified goals for delivery system transformation – states must work toward engaging providers in: Reaching across Arizona to provide comprehensive quality health care for those in need

4. SIM Overview (ctd.) • States may apply for design or test initiatives • 2013 awards: • 6 states received total of $250 million for model tests • 3 states received pre-test assistance for design • 16 states received design awards Reaching across Arizona to provide comprehensive quality health care for those in need

5. SIM Round 2 • Round 2 applications due July 21, 2014 – Model Test award period of 48 months • Model Design: Up to $30 million for up to 15 states ($1-$3 million per state) • Model Test: Up to $700 million for up to 12 states ($20-$100 million per state based on state population and scope of proposal) Reaching across Arizona to provide comprehensive quality health care for those in need

6. Proposed Arizona Strategy • Arizona well-positioned to focused on driving innovation by expanding successful public private partnership • Proposal would build on numerous existing initiatives to: • Reduce fragmentation • Integrate the delivery system • Align incentives to reduce costs and improve quality • Align with (without duplicating) other efforts such as Medicare initiatives, where possible Reaching across Arizona to provide comprehensive quality health care for those in need

7. Proposed Arizona Strategy (ctd.) • Environmental scan of numerous value-based purchasing and reform efforts identified a need for support of behavioral health integration and efforts, including efforts to address substance use disorders • Gaps in existing efforts (e.g., ACOs) • Siloed public system • Lack of coordination among payers and providers (and infrastructure needs to enable coordination – data gaps) • Without addressing behavioral health needs, numerous other reform efforts will face continued challenges. For example: • Reducing ED use and readmissions • Public health efforts to curb obesity, smoking, etc. • Value-based purchasing Reaching across Arizona to provide comprehensive quality health care for those in need

8. Proposed Arizona Strategy (ctd.) Reaching across Arizona to provide comprehensive quality health care for those in need

9. Proposed Arizona Strategy (ctd.) Reaching across Arizona to provide comprehensive quality health care for those in need

10. Stakeholder Engagement • Arizona strategy requires broad engagement and support from stakeholders • Kickoff meeting and letters of support for application by July 11 • Structured workgroups on initiative focus areas • Ongoing, collaborative participation in initiative Reaching across Arizona to provide comprehensive quality health care for those in need

11. Next Steps • Stakeholder letters due to Governor’s Office July 11, 2014 • Arizona to submit Model Test application on July 21, 2014 • Presentation to CMS/HHS experts in late summer/early fall • Award in Fall 2014 • Work continues Reaching across Arizona to provide comprehensive quality health care for those in need

12. Questions? Reaching across Arizona to provide comprehensive quality health care for those in need

13. Thank You. Reaching across Arizona to provide comprehensive quality health care for those in need