PROVIDENCE – Rhode Island may be on the verge of being awarded about $20 million from the Centers for Medicare and Medicaid Services as part of its State Innovation Model proposal, according to a number of sources. The state was asked last week to submit a budget for $20 million.

The intent of the award is to provide model test funding to support Healthy Rhode Island, an innovative transformation of Rhode Island’s health care delivery system, emphasizing investments in public health and population health management.

The award centers around the transition to value-based purchasing, where providers get paid for delivering on population health improvements, instead of fee-for-service.

Jennifer Wood, the chief of staff of Lt. Gov. Roberts, whose office had been coordinating the grant proposal, did not return numerous phone calls and e-mails on Friday, asking for an update on the status of the SIM grant.

Sen. Sheldon Whitehouse's aides did not respond to questions asked in person by ConvergenceRI at the Senator's appearance at the Childhood Lead Action Project event about the status of the grant.

In October, a delegation from Rhode Island went to Washington, D.C., to meet with CMS representatives, including Neil Steinberg, president and CEO of the Rhode Island Foundation, and Dr. G. Alan Kurose, president and CEO of Coastal Medical Group.

Kurose, in a talk before the Rhode Island Business Group on Health the day after the visit, said that the visit had been very well received. Kurose said the proposal was an example of the kinds of collaborative efforts now underway in Rhode Island. 

The initial grant, submitted in July, asked for $58 million in funds. It was submitted by Gov. Lincoln Chafee, with Secretary Steven M. Costantino, head of the R.I. Executive Office of Health and Human Services, as the principal contact. The $20 million award will require some re-jiggering of the initial budget.

Buy-in
The proposal had collaborative support pledged from Rhode Island’s major hospital systems, including Lifespan, Care New England, Charter CARE and South County Hospital, the state’s health insurers, including Blue Cross & Blue Shield of Rhode Island, UnitedHealthcare, Tufts Health Plan, and Neighborhood Health Plan of Rhode Island, community agencies such as YMCA of Greater Providence and Rhode Island Kids Count, organizations such as the R.I. Chronic Care Sustainability Initiative and Healthcentric Advisors, as well as the state’s network of community health centers, including Blackstone Valley Community Health Care and Thundermist.

The state’s application had been coordinated through the offices of Lt. Gov. Roberts. It was the second leg of a process that began with the submission in December of 2013 of a State Health Innovation Plan, or SHIP, prepared by the consultant, the Advisory Board Company.

“The result of a successful Test Model demonstration in Rhode Island will be a transferable model of public-private health care engagement, coupled with a flexible, evidence-based and market-driven options for delivery and payment reform that support overall containment of health care costs while increasing coordination of services and improving population health outcomes,” Chafee wrote in his cover letter.

The funding may be used to support initiatives already underway, including community health teams in South County and Pawtucket and Central Falls, establishment of health equity zones that invest in prevention, expansion of the R.I. Chronic Sustainability Initiative to include R.I. Kids and R.I. Adolescents, expansion of Accountable Care Organization models between hospitals, insurers and providers, new global payment models being pioneered by insurers and hospitals, such as the Maternity Bundle between Blue Cross and Women & Infants, and creation of a neighborhood health station as part of a proposed innovation center.