Areas of Expertise
- Financial metric benchmarking
- Program design, implementation, and evaluation
- Patient attribution
- Risk stratification and adjustment
- Quality measurement
- Health information exchange
As regulators, legislators, conveners, and both suppliers and purchasers of health care services, state governments are uniquely positioned to use a wide array of policy levers, engage a broad range of stakeholders, and build on existing efforts to improve health care delivery, cross-sector collaboration to address health determinants, and health outcomes. RTI offers experts in Medicaid, health system financing, mental and behavioral health, public health, child welfare, and education to develop, implement, and evaluate health care strategies and programs in state-specific contexts.
Especially in uncertain economic times, when states face the twin challenges of shrinking budgets and increased demand for services, transforming care delivery and payment models may offer a path toward applying limited resources efficiently and effectively. RTI has been at the center of implementing and evaluating initiatives sponsored by the federal government and foundations to test these models nationwide.
State Health Policy Experience
For example, beginning in 2013, the Center for Medicare and Medicaid Innovation (the Innovation Center) awarded over $870 million in State Innovation Models (SIM) Initiative to 17 states to test the ability of state governments to use their policy and regulatory levers to accelerate health care transformation efforts in their states. Under the SIM Initiative, states use a variety of strategies to encourage health care providers to adopt health care models that promote coordination across provider types, integration of primary care and behavioral health care, and attention to population health. For example, states are changing payment models used by Medicaid and, where possible, aligning those payment models with new or existing efforts across Medicare and commercial payers. States are also offering technical assistance to primary care practices to implement new delivery system models and are developing or enhancing services—such as health information technology (health IT) and data analytic investment—that enable or improve model effectiveness.
As the Innovation Center’s evaluator for the SIM Initiative, RTI offers states evidence-based lessons on leveraging policy and partnerships to accomplish key health goals.