Health Care Alert: SIM

The State Innovation Model Initiative (SIM) is an initiative of the Center for Medicare and Medicaid Innovation (CMMI). CMMI was created under the Affordable Care Act to address the need for healthcare innovation to improve the quality of care delivered in the U.S. and to contain increasing healthcare costs.

History of SIM

Under the SIM initiative, CMMI awarded model design grants to Governors to align multiple stakeholders, including providers, consumers, employers, payers and state leaders around healthcare reforms that improve access to care, improve population health and reduce or contain healthcare costs. CT’s model design grant requires the state to produce a state healthcare innovation plan (SHIP) and a model of healthcare delivery and payment reforms that will reach 80% of Connecticut’s residents within 3 – 5 years. BIAC met with the Lieutenant Governor, Nancy Wyman, SIM Steering Committee members, and other advocacy groups to address issues that may negatively impact the brain injury community.

To see a copy of the final SIM plan, that incorporated some but not all of recommendations provided, go to the CT Health Reform & Innovation website.

The Consumer Advisory Board formed. The purpose of the Consumer Advisory Board is to ensure significant consumer participation in the planning and implementation process.

Workgroups were created: Equity and Access Council, Practice TransformationTask Force, Health Information Technology Council and Quality Council

The original proposal called for a go slow approach, in particular with the Medicaid enrollees. A DSS document on July 1st, 2014 showed late changes to the SIM plan that threaten to harm Medicaid enrollees:

1) Enrollment of at least 200,000 Medicaid enrollees in a shared savings plan by January 1, 2016, without sufficient planning, data and preparation, which puts vulnerable Medicaid enrollees at high risk.

2) Development of a Sec. 1115 waiver, which will include a "global cap" or "budget neutrality" over a five year period on the federal share of Medicaid expenses returned to CT taxpayers, which puts vulnerable Medicaid enrollees at high risk.

Independent Consumer Advocates wrote a letter in opposition to recent changes to the Final State Innovation Model Plan regarding Medicaid Enrollees. The letter was addressed to Lieutenant Governor Nancy Wyman and Mark Schaefer and copied to Commissioner Roderick Bremby, members of the SIM Steering Committee and the Consumer Advisory Board. BIAC signed on to the letter opposing the recent changes.

Independent Consumer Advocates' Opposition to Recent Changes to Final SIM Plan Regarding Medicaid Enrollees

Independent advocates, including BIAC, signed a Letter sent to Center for Medicare & Medicaid Innovation (CMMI) voicing concerns about the planned shift to shared savings payments in Medicaid.  This was in September 2014.

For the most current updates visit State of CT Healthcare Innovation Central.

If you have questions or would like additional information about SIM call 860.331.2460 or email