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Connecticut State Innovation Model

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Connecticut State Innovation Model 2020 Connecticut State Innovation Model FINAL EVALUATION REPORT Connecticut SIM Evaluation Team UConn Health, Center for Population Health Yale School of Public Health SIM Evaluation Co-Principal Investigator: SIM Evaluation Co-Principal Investigator: Robert H. Aseltine, Jr., Ph.D. Paul D. Cleary, Ph.D. Director, Center for Population Health Anna M.R. Lauder Professor of Public Health Professor and Chair, Division of Department of Health Policy and Management Behavioral Sciences and Community Health Beth A Jones, Ph.D., MPH Sara Wakai, Ph.D. Research Scientist and Lecturer Associate Director, Center for Population Health Department of Chronic Disease Epidemiology Assistant Professor, Department of Medicine Eugenia Buta, Ph.D. Elizabeth Schilling, Ph.D. Associate Research Scientist Research Associate Yale Center for Analytical Sciences Riddhi Doshi, Ph.D., MPH Emily Bordreau, BA Postdoctoral Fellow Doctoral Student Department of Health Policy & Management Laurel Buchanan, MA Research Associate Jun Wang, MS Research Assistant Connie C. Cantor, BS Publicity/Marketing Manager University of Connecticut, Department of Statistics Yale School of Medicine Jun Yan, Ph.D. Sai Ma, MS Martha Staeheli, PhD Professor of Statistics Doctoral student Instructor Department of Psychiatry Hongfei Li, Ph.D. Yaqiong Yao, MS Doctoral student Doctoral student Yuen (Abby) Lau, BS Doctoral student SIM EVALUATION REPORT · i | Page Acknowledgements We would like to acknowledge the contributions and assistance provided by: • The Connecticut Department of Public Health • The Connecticut Office of Health Strategy • Onpoint Health Data • National Committee for Quality Assurance • Connecticut All Payers Claims Database (APCD) Advisory Group • Research Triangle Institute • SIM Work stream leads and team members • Connecticut Federally Qualified Heath Centers and Advanced Networks This project was supported by Grant Number 1G1-CMS-331630-01-05 from the Department of Health and Human Services, Centers for Medicare and Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services, or any of its agencies. The research presented here was conducted by the awardee. Findings might or might not be consistent with or confirmed by the findings of the independent federal evaluation contractor. Recommended citation: UConn Health, Center for Population Health and Yale School of Public Health; 2020. Connecticut State Innovation Model, Final Evaluation Report. Farmington, CT and New Haven, CT © May 2020, UConn Health http://health.uconn.edu/population-health Center for Population Health SIM EVALUATION REPORT · ii | Page Table of Contents Introduction ........................................................................................................................................1 State Innovation Model: Multiple Aligned Initiatives ............................................................................................ 2 Figure 1. State Innovation Model Work Streams ............................................................................................ 2 Work Stream One: Value Based Payment ....................................................................................................... 2 Work Stream Two: Care Delivery..................................................................................................................... 3 Work Stream Three: Consumer Engagement .................................................................................................. 3 Work Stream Four: Health Information Technology ....................................................................................... 3 Section One: Implementation ...............................................................................................................5 Methods ............................................................................................................................................................ 5 Results ............................................................................................................................................................ 5 SIM Accountability Measures: Process and Outcome .................................................................................... 5 Table 1. SIM Accountability Measures by Primary Driver, Status, and Type .................................................. 6 SIM Accountability Measure Targets ............................................................................................................... 6 Figure 2. Cumulative Target Metrics ............................................................................................................... 6 Table 2. SIM Accountability Targets Status ..................................................................................................... 7 Table 3. Active Measure Type and Category ................................................................................................... 7 Discussion ............................................................................................................................................................ 7 Section Two: Statewide Impact ............................................................................................................9 Patient Experience ................................................................................................................................................ 10 Methods ......................................................................................................................................................... 10 Results .......................................................................................................................................................... 10 Figure 3. Care Experiences among CT commercially insured and Medicaid Patients .................................. 11 Figure 4. Care Experiences among CT commercially insured and Medicaid Patients by Race/Ethnicity .... 11 Health Outcomes ................................................................................................................................................. 12 Methods ......................................................................................................................................................... 13 Calculation of SIM Targets. ............................................................................................................................ 14 Featured Results ................................................................................................................................................... 15 Figure 5, Death from Cardiovascular Disease................................................................................................ 15 Figure 6. Cardiovascular Death by Race/Ethnicity ........................................................................................ 16 Figure 7 Hospital Admissions for Chronic Ambulatory Care Sensitive Conditions ....................................... 16 Figure 8. Hospital Admissions for Chronic Ambulatory Care Sensitive Conditions by Race/Ethnicity......... 17 Figure 9. 30-Day Readmissions after Discharge for Chronic Ambulatory Care Sensitive Conditions .......... 17 Figure 10. 30-Day Readmissions after Discharge for Chronic Ambulatory Care Sensitive Conditions (PQI 92) by Insurance Type ........................................................................................................................... 18 Figure 11. HbA1c Testing by Commercial Insurance .................................................................................... 18 Population Health Measure Results ..................................................................................................................... 19 Adult Diabetes ................................................................................................................................................ 19 Adult Obesity .................................................................................................................................................. 19 Adult Smoking ................................................................................................................................................ 19 Child Obesity .................................................................................................................................................. 20 High School Youth Cigarette Smoking ........................................................................................................... 20 SIM EVALUATION REPORT · iii | Page Premature Death due to Cardiovascular Disease.......................................................................................... 20 Healthcare Delivery Measure Results .................................................................................................................. 21 Adults with Regular Source of Care ............................................................................................................... 21 Hospital Admissions for Ambulatory Sensitive Conditions, Rate per 100,000 ............................................. 21 Hospital Admissions for Acute Conditions .................................................................................................... 21 Hospital Admissions for Chronic Conditions ................................................................................................
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