25 states receive funds for health system transformation: Ensure community prevention is part of the solution

Late last week, the federal government announced that 25 states have received funding to test and design health system innovation.  This is an exciting new opportunity for prevention champions to directly ensure that community prevention plays an integral role in our health system.  The funding comes through the federal Center for Medicare and Medicaid Innovation (CMMI), which was established as part of the Affordable Care Act to foster improvements in health care quality, health outcomes, and cost containment. The State Innovation Models (SIM) grants provide up to $300 million to support states to test and design “multi-payer models with a broad mission to raise community health status and reduce long term health risks” with a focus on people enrolled in Medicare, Medicaid and the Children’s Health Insurance Program.

CMMI has made clear that funded states will need to engage a broad range of stakeholders in developing innovative, comprehensive, and potentially transformative models that control costs and improve health. We know that the majority of deaths and current health care costs result from preventable illnesses and injuries and that systematically increasing the focus on prevention is integral to a more efficient, effective health system. Recognizing this, CMMI has encouraged SIM grantees to focus on “accountability for population health,” “a community-centered health system,” and “public health and prevention,” and to “include care models and interventions that aim to reduce health disparities and address the social, economic, and behavioral determinants of health.”

Last year Prevention Institute laid out a framework for bridging the gap between clinical services and community prevention in our Community-Centered Health Homes report. The SIM process presents an opportunity to look at the same issues at broader, systems level: How do we incentivize and pay for community prevention? (See the webinar announcement in the sidebar.) How do we set up data and monitoring systems so that we understand how community conditions and environments shape health? What sorts of staffing and capacity building is needed to successfully address health at a population level?

If you are in a state that received a SIM grant, we encourage you to participate in the design or implementation process in your state.  Please contact Jeremy Cantor and see here for support in working with your state.