State Innovation Model (SIM)

What is SIM?
In 2015, Rhode Island was one of 24 states to receive a State Innovation Model (SIM) Test Grant from the federal Centers for Medicare and Medicaid Services (CMS). The state received $20 million with the expectation that the funds would be used to transform the way healthcare is delivered and paid for. SIM funds are supporting several activities that can be broken into three categories: improving the primary care and behavioral health infrastructure, engaging patients in positive health behaviors and self-advocacy, and expanding the ability of providers and policy makers to use and share data. The belief is that by transitioning to a system of value-based care that addresses social and environmental determinants of health, SIM can support Rhode Island in enhancing the physical and behavioral health of the population, improving the experience of care, and reducing the cost of healthcare.

Who is SIM?
Rhode Island SIM is led by a team of staff from several state departments, including the Executive Office of Health and Human Services, the Departments of Health, Human Services, Children Youth and Families, Behavioral Health, Developmental Disabilities, and Hospitals, Medicaid, HealthSourceRI, and the Office of the Health Insurance Commissioner. SIM is also governed by a Steering Committee made up of a diverse range of stakeholders, including providers, insurers, patient advocates, and community organizations. Additional stakeholders and interested individuals are also encouraged to participate in the various working groups that SIM convenes on specific topics related to healthcare transformation.

Vision
The vision of the Rhode Island SIM Test Grant represents the desired future state resulting from a transition to value-based care in the state. Our vision statement, borrowed from the Triple Aim, reads: Continuously improving Rhode Islanders’ experience of care (including quality and satisfaction), enhancing the physical and behavioral health of all Rhode Island’s population, and reducing the per capita cost of healthcare for our residents.

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