State Innovation Model Self-Evaluation

In December 2014, Ohio was awarded a federal State Innovation Model (SIM) test grant to implement a comprehensive primary care (CPC) payment model that increases access to patient-centered medical homes (PCMH) statewide. PCMH is a team-based care delivery model led by a primary care provider who comprehensively manages a patient's health needs with an emphasis on health care value and quality. The goal is to give Ohioans the quality of care and information they need to increase their level of health at every stage of life, and to reduce the overall cost of care by improving cost efficiency and care quality.

The SIM Self-Evaluation utilizes qualitative and quantitative data to evaluate the implementation, cost-effectiveness, and impact of both the Comprehensive Primary Care (CPC) delivery and payment model, and the statewide Episode-Based payment model.

The SIM Self-Evaluation will provide the Ohio Department of Medicaid with snapshots of the status of population health, health systems transformation, and cost trend patterns statewide. GRC will analyze the relevant impacts of the SIM model and its implementation by geography and subpopulations, with an emphasis on health disparities. Analytics include:

  • Service utilization
  • Expenditure
  • Cost-effectiveness
  • Descriptive statistics
  • Modeled statistics
  • Meta-data analyses (i.e., process comparisons)
  • Qualitative coding using predominant theme techniques (i.e., theme prioritization)

The comprehensive SIM Self-Evaluation consists of three elements:

  1. Qualitative analyses of the SIM Model Design Process

  2. Episode-based payment evaluation

  3. Ohio CPC evaluation

Read the SIM Self-Evaluation One-Pager for more details.