Through the State Innovation Models (SIM) initiative, 38 states (including territories and the District of Columbia) have received financial and technical support from the federal government to design or test innovative payment and service delivery models with the goal of improving health, improving services and lowering costs for Medicare, Medicaid, and Children’s Health Insurance Program consumers. Using SIM funds, states are designing or testing reforms that transform how health care services are purchased, and are aligning payments to reward quality care and improve patient outcomes in new and creative ways. States also are integrating programs aimed at improving health in the community and working outside of clinical settings on a population-wide level, with initiatives taking place in hospitals and doctors’ offices.

The National Governors Association Center for Best Practices (NGA Center) is working with states that have received SIM grants on a range of initiatives to support, catalyze, and sustain proposed state-led transformations. For example, the NGA Center is providing technical assistance to SIM states including work focused on how to bolster population-level programs that address social determinants of health such as diet and exercise. The NGA Center also is helping states to establish patient-centered medical homes to coordinate care, including the development of financial incentives to drive change in care delivery, such as enhancing community services and home visits that can reduce emergency department use. The NGA Center also has worked with the federal government to convene SIM states to learn and share experiences about transformative health reform initiatives from across the country.