Skip to Main Content

RTI uses cookies to offer you the best experience online. By and clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.

Accept
RTI International
  • About
    • Office Locations
    • Executive Leadership
    • Corporate Governance
    • Partner with Us
      • U.S. Government
      • Clients and Funding Agencies
      • Industry and Commercial Clients
      • Foundations and Associations
      • Bilateral Agencies and Multilateral Banks
      • Universities and Academic Research Institutions
      • Suppliers and Small Businesses
    • Commitment to Quality
      • RTI's Client Listening Program
    • Ethics and Human Research Protection
    • Living Our Mission
    • Veteran Opportunities at RTI

    About

  • Practice Areas
    • Health
      • Public Health and Well-Being
      • Health Care Transformation
      • Behavioral Health
      • Health Behavior Change
      • Precision Medicine
      • RTI Health Solutions (RTI-HS)
      • RTI Center for Community Health Evaluation and Economics Research
      • Health Equity
      • RTI Health Advance
    • Transformative Research Unit for Equity​
      • Equity Capacity Building Hub
      • Social and Economic Justice Research Collaborative
      • Narrative Research and Community Engagement Lab
    • Education and Workforce Development
      • Early Childhood
      • K-12 Education
      • Postsecondary Education
      • Career and Adult Education and Workforce Development
      • Education Policy, Systems, and Governance
      • Education Research Methodologies
      • Education Technologies
    • International Development
      • Energy for Development
      • Environment
      • Global Food Security, Agriculture, and Nutrition
      • Global Health
      • International Education
      • Monitoring, Evaluation, Research, Learning, and Adapting (MERLA)
      • Youth and Economic Opportunity
      • Building Resilience Against COVID-19 in Developing Countries
      • Water, Sanitation, and Hygiene (WASH)
      • RTI Center for Governance
    • Climate Change
      • Clean Energy Technology and Renewables
      • Climate Finance
      • Climate Justice and Equity
      • Climate Planning, Preparedness and Resilience
      • Climate Policy
      • Climate Vulnerability, Adaptation, and Mitigation
      • Economic Impacts of Climate Change
    • Water
      • Food-Energy-Water Nexus
      • Water Quality
      • WASH (Water, Sanitation, Hygiene)
      • Water Resources Management
    • Energy Research
      • Carbon Capture and Utilization
      • Biomass Conversion
      • Natural Gas
      • Energy Efficiency
      • Industrial Water
      • Syngas Processing
    • Environmental Sciences
      • Air Quality
      • RTI Center for Water Resources
      • Urban Sustainability
      • Toxics
      • Building Resiliency in the FEW Nexus
      • Climate Change Sciences and Analysis
      • Environmental Policy
      • Environmental Justice
      • Sustainable Materials & Waste Management Solutions
    • Justice Research and Policy
      • RTI Center for Community Safety and Crime Prevention
      • RTI Center for Policing Research and Investigative Science
      • Child Well-Being and Family Strengthening
      • RTI Center for Forensic Sciences
    • Food Security and Agriculture
      • Market Systems Strengthening
      • Food Safety
      • Food and Nutrition
      • Global Food Security, Agriculture, and Nutrition
      • Climate-Smart Agriculture
      • Agricultural Innovation
      • Obesity Prevention
    • Innovation Ecosystems
      • Innovation Advising
      • Innovation for Economic Growth
      • Innovation for Emerging and Developing Economies
      • Innovation for Organizations
      • Research, Technology, and Innovation Policy
      • Technology Acceleration
    • Military Support
      • Military Behavioral Health
      • Military Health and Human Performance
      • Military Sexual Assault, Harassment, and Domestic Violence Prevention
      • Wearable Sensor Technologies
      • Military Health System Transformation

    Practice Areas

  • Services + Capabilities
    • Surveys and Data Collection
      • Survey Design
      • Instrument Development
      • Survey Methodologies
      • Data Collection
      • Establishment Surveys
      • Health Registries
      • Data Analysis and Reporting
      • Research Operations Center
    • Statistics and Data Science
      • Survey Statistics
      • Environmental Statistics
      • Coordinating Centers for Multisite Studies
      • Analysis and Design of Complex Data
      • Biostatistics
      • RTI Center for Data Science
    • Evaluation, Assessment and Analysis
      • Evaluation Design and Execution
      • Advanced Qualitative, Quantitative, and Mixed Methods
      • Evaluation, Monitoring, and Assessment
      • Economic Analysis
      • Evaluating Communication Interventions and Campaigns
      • Evidence Synthesis for Policy and Practice
      • Risk Assessment and Prediction
    • Program Design and Implementation
      • Systems Strengthening and Scaling
      • Capacity Assessment and Building
      • Policy Reform Support
      • Curriculum and Teacher Professional Development
      • Interventions and Prevention Programs
      • Implementation Science
    • Digital Solutions for Social Impact
      • Human-Centered Design of Digital Solutions
      • Digital Product Development
      • Digital Communication Campaigns
      • Digital Data Analytics
    • Research Technologies
      • Survey Technologies
      • Data Management and Decision Support Systems
      • Geospatial Science, Technology, and Visualization
      • ICT for Limited-Resource Settings
      • Mobile Applications
      • Web Applications
      • Bioinformatics
      • Interactive Computing
    • Drug Discovery and Development
      • Medicinal Chemistry
      • Molecular Design and Cheminformatics
      • Behavioral Pharmacology
      • Drug Metabolism and Pharmacokinetics (DMPK)
      • In Vitro Pharmacology, Bioassay Development, and High-Throughput Screening (HTS)
      • Isotope Labeling
      • Regulatory Consulting and Support for Medical Products
    • Analytical Laboratory Sciences
      • Bioanalytical and Toxicology Research
      • Forensic Sciences
      • Physicochemical Characterizations
      • Metabolomics
      • Proficiency Testing and Reference Materials
      • Microbiology
      • Analytical Chemistry and Pharmaceutics
    • Engineering & Technology R&D
      • Biomedical Technologies
      • Decarbonization Sciences
      • Environmental Exposure & Protection
      • Materials & Environment
      • Sustainable Energy Solutions

    Services + Capabilities

  • Centers
    • RTI Center for Advanced Methods Development
    • RTI Center for Communication Science
      • Communication Research
      • Communication Design
      • Communication Delivery
    • RTI Center for Data Science
    • RTI Center for Education Services
      • Teaching and Learning
      • Education Leadership
      • Peer Learning Networks
      • Strategic Consulting
    • RTI Center for Forensic Sciences
    • RTI Center for Global Noncommunicable Diseases
      • Program Financing & Economics for NCDs
      • Health Systems Strengthening for NCDs
      • Communication Science and Behavior Change for NCDs
      • Implementation Science for NCDs
    • RTI GenOmics, Bioinformatics, and Translational Research Center
      • Disability Studies
      • Ethics
      • Newborn Screening
    • RTI Center for Water Resources
      • Water Resources Sectors
      • Water Resources Services
      • Water Resources Tools
    • RTI Center for Governance
    • RTI Global Gender Center
    • North Carolina Center for Optimizing Military Performance
    • NCCU-RTI Center for Applied Research in Environmental Sciences
    • RTI Center for Climate Solutions

    Centers

  • Impact
    • Newsroom
    • Insights Blog
    • Events
    • Publications
    • RTI Press
      • About the RTI Press
      • Instructions for Authors
      • RTI Press Collections
    • Projects
    • Global Reach
      • Asia
      • Eastern Europe and Central Asia
      • RTI International India
      • Africa
      • Middle East and North Africa (MENA)
      • Latin America and the Caribbean (LAC)

    Impact

  • Experts
    • Our Experts
    • In-Depth With Our Experts
    • Related News
    • Experts In the Media
    • RTI Fellow Program

    Experts

  • Emerging Issues
    • COVID-19 Research
    • Artificial Intelligence
    • Global Health Security
    • Cannabis Research
    • Opioid Research
      • Interventions for Opioid Use Disorders
      • Preventing Opioid Misuse and Overdose
      • Treating Opioid Use Disorders
    • Policing Research and Investigative Science
    • Drone Research and Application
    • E-cigarette Research
    • Zika Virus Research
    • Integrated Governance

    Emerging Issues

  • COVID-19 Research + Response
  • Global Reach
  • Insights Blog
  • Newsroom
  • RTI Press
  • Publications
  • Partner With Us
  • Careers
  • Facebook IconTwitter IconInstagram IconYouTube IconLinkedin Icon
  • Home
  • Impact
  • Newsroom
  • RTI International Report Finds that the SIM2 Initiative Transformed States’ Healthcare Systems and Yielded Favorable Impacts on Spending and Utilization
Newsroom

RTI International Report Finds that the SIM2 Initiative Transformed States’ Healthcare Systems and Yielded Favorable Impacts on Spending and Utilization

October 22, 2021
Share
  • Share on Facebook
  • Share on Twitter
  • Share on Linkedin
  • Email

RESEARCH TRIANGLE PARK, N.C. — The RTI International, a nonprofit research institute, led report to the Centers for Medicare & Medicaid Services (CMS) evaluating the federally-funded Round 2 State Innovation Models (SIM2) Initiative found that states were largely successful changing health care delivery and improving health outcomes.

CMS awarded over 600 million dollars to 11 states—Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington—to test innovative health care models between 2015 and 2020. The focus of these models was to transform states’ health care systems to incentivize better care and lower costs.

The SIM Initiative provided a unique opportunity for states to create and test novel strategies adapted to their state context and population needs.

“The states were essentially test laboratories to try new innovations that best fit their unique contexts – some building on years of prior healthcare transformation work and others with almost no prior work in this area,” according to Anupa Bir, the vice president of Comprehensive Health Innovation, Research and Policy division at RTI who served as project director.

The report evaluated how the states implemented delivery and payment reform activities and rigorously analyzed the impacts of these activities through a synthesis of in-depth interviews and focus groups with stakeholders and analysis of claims data.

The evaluation found that, overall, states increased the use of value-based payment (VBP) models, particularly in Medicaid, often through mandating these arrangements in managed care contracts. Although the initiative was designed as a multi-payer intervention, most states faced challenges with advancing specific models or measuring progress from multiple payers.

States invested in primary care transformation and behavioral health integration to increase access and provide more holistic care for patients. SIM funds supported technical assistance, care coordination payments, health information technology, and expanded clinical staff and community health workers. Stakeholders reported that SIM-funded programs promoted early identification of diseases, greater screening and referral, and improved integration or coordination between providers.

Most states sought to improve primary care through technical assistance to primary care providers, enhanced payment to practices that were patient-centered medical homes, or both. In many states, the evaluation found favorable impacts including reductions in spending and emergency department visits relative to comparison groups.  For example, total spending decreased by $73 per beneficiary per month more for those served by practices in Delaware’s Practice Transformation Initiative relative to the comparison group.

The study also found promising results related to emergency department and primary care use. In the quantitative analyses, 3 of the 6 states that implemented primary care models and 2 of the 3 states that implemented behavioral health integration models showed a decline in emergency department visits relative to comparison groups. Several states also showed an increase in primary care visits relative to comparison groups.

“Overall, the claims analyses reflect lower costs and more efficient utilization of health care services among participants in these models,” according to Dr. Sabina Gandhi, a senior economist at RTI who served as the deputy director of the evaluation.

Capitalizing on the flexibility of the SIM Initiative, some states used funds to build population health infrastructures to address health-related social needs at the community and patient level. In some states, this included systems for identification, screening, and referral of patients with high needs.

Stakeholders made clear that population health initiatives were highly valued, provided a bridge for patients between providers, and helped fill some gaps in care.  

As more states continue to look for effective ways to reduce health care costs and improve population health outcomes, the RTI evaluation team hopes that the report can inform policymakers with key state examples for advancing new payment models and supports for improved care delivery.

The SIM Initiative evaluation team included the Urban Institute, The Henne Group, and the National Academy for State Health Policy. The evaluation was led by Dr. Anupa Bir with Dr. Sabina Gandhi, Stephanie Kissam, and Dr. Joy Piontak serving as deputy directors.

To access the full report, including more information on states’ implementation successes, challenges, stakeholder responses, and impact analyses of specific delivery and payment models: Report and Appendix.

This work builds on prior RTI International-led evaluation findings from Round 1 SIM (SIM1) Initiative. To learn more about RTI’s involvement in CMS’ State Innovation Models Initiative, visit: https://www.rti.org/impact/state-innovation-models-impact

Highlights

  • RTI International led a report for the Centers for Medicare & Medicaid Services evaluating the federally-funded Round 2 State Innovation Models (SIM2).
  • The Initiative found that states were largely successful changing health care delivery and improving health outcomes.
  • The SIM Initiative provided a unique opportunity for states to create and test novel strategies adapted to their state context and population needs.

Meet the Experts

Anupa Bir
Anupa Bir Senior Vice President, Health Practice Area
Sabina Gandhi
Sabina Gandhi Director, Economics
Stephanie M. Kissam
Stephanie M. Kissam Senior Health Services Researcher
Joy Piontak Program Manager

Media Info

To request an interview, contact our Media Relations team.

  • +1 919 708 8205
  • news@rti.org
Subscribe to RTI

RTI Logo
Partner With Us
  • US Government
  • Commercial
  • Foundations & Associations
  • Multilateral Donors
  • Universities
  • Suppliers
Site
  • Privacy Policy
  • Security Policy
  • Site Map
  • Terms of Use
  • Accessibility
  • Contact Us
Contact Us
Facebook Icon Twitter Icon Instagram Icon YouTube Icon Linkedin Icon
delivering the promise of science
for global good
RTI Health Solutions RTI Innovation Advisors RTI Health Advance

© 2023 RTI International. RTI International is a trade name of Research Triangle Institute. RTI and the RTI logo are U.S. registered trademarks of Research Triangle Institute.