SIMs are key to improving healthcare
Rittenhouse et al 19 – authors/editors/publishers for the National Library of Medicine (Diane Rittenhouse, Aryn Phillips, Salma Bibi, Hector Rodriguez, “Implementation Variation in Natural Experiments of State Health Policy Initiatives”, NIH, September 17, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6866654/)//TMMS
There is a trend toward more state-level health policy development and implementation in the United States, with less emphasis on homogenous federal reforms. Given the inherent challenges posed by the naturally occurring variation in such natural policy experiments, new methods are needed to take into account differences in policy implementation. We describe a method based on Delphi assessments and analysis of source documents relevant to policy implementation that may be useful for assessing differential impacts of SIM across states. Importantly, the SIM implementation factors prioritized by the expert panel process included the extent of behavioral health integration and the depth and breadth value-based payments, which were recently found to be important differentiators of SIM implementation in national evaluations of round 1 SIM states.13,14 As our natural experiment research moves forward, we will directly examine the impact of implementation variation on healthcare utilization and outcomes. We hypothesize that SIM states with high implementation intensity for the prioritized areas and greater resources will achieve relatively greater reductions in preventable utilization and improved patient outcomes.