(Updated October 22nd, 2018)
Michigan received a State Innovation Model grant from Centers for Medicaid and Medicare Services (CMS) to test delivery and payment system changes.
The State Innovation Model SIM) focuses on the development and testing of multi-payer health care payment and service delivery models in order to achieve better care coordination, lower costs, and improved health outcomes for Michiganders. The Michigan Department of Health and Human Services (MDHHS) is implementing this initiative. The State Innovation Model (SIM) in Michigan implements the strategies that were outlined in the Blueprint for Health Innovation and facilitate the development and testing of new multi-payer health care payment and services delivery models in Michigan.
- Strategies focus on moving towards cost-effective use of healthcare dollars overall in terms of patient experience and quality outcomes.
- System that coordinates care within the medical system to improve disease management and utilization; and out into the community to address social determinants of health.
State Innovation Model (SIM) funding and activities will support all accepted previous MiPCT practices across the State, and expand the number of PCMH practices participating in the five SIM regions.
- Washtenaw & Livingston
- Northern Michigan (Northwest Prosperity Region)
Embedded Care Management and Coordination staff members function as integral, fully-involved members of every participating Care Team.
- The following types of professionals are eligible to serve as a Care Manager:
- Registered Nurse
- Licensed Practical Nurse
- Nurse Practitioner
- Licensed Master’s Social Worker
- Licensed Professional Counselor
- Licensed Pharmacist
- Registered Dietician
- Physician Assistant
- The following types of professionals are eligible to serve as a Care Coordinator:
To access the SIM PCMH web page Click Here.
To access the SIM PCMH Initiative Participation Guide Click Here.
To access the SIM PCMH Care Management and Care Coordination Tracking Codes Click Here.
SIM PCMH Initial Training Requirements
SIM Care Coordinators and Care Managers are required to complete the following initial training:
A. Each Care Manager and Care Coordinator must complete a Self-Management Support Program approved by the PCMH Initiative/MiCMRC within six months of hire.
- The MiCMRC-Approved Self-Management Support Program Summary provides a list and description of these programs.
- The SIM PCMH Initiative has partnered with three organizations to offer Self-management Support training. If the SIM Care Coordinator and Care Manager complete a Self Management Support course through one of the approved vendors, Michigan Center for Clinical Systems Improvement (MiCCSI), Practice Transformation Institute (PTI), or Integrated Health Partners (IHP), then the PCMH Initiative will cover the cost of the course. Note the cost of the course will be covered only for SIM CC and CM participants who have not previously completed a self-management support course. (See SIM PCMH Initiative Participation Guide)
B. Each Care Manager (in addition to the Self-Management Support Program as stated above) must complete the following Complex Care Management Course:
- Complex Care Management Course offered by MiCMRC. For course details and registration visit http://micmrc.org/training/micmrc-complex-care-management-course
C. In addition to the above, both Care Managers and Coordinators, newly hired or existing must complete on line training via webinar(s) & eLearning modules as indicated in the table below. Access to the on line training is located at the bottom of this page.
Note: Exisitng Care Coordiantors and Care Managers that have completed the MiCMRC approved self-management course and/or the MiCMRC Complex Care Management course are not required to attend the courses again.
Longitudinal Learning Activity Requirements per Year
The PCMH Initiative maintains the expectation that all Care Managers and Coordinators will maintain their current licensure/certification, including the requirements to seek continuing education approved by the appropriate professional organization/association. To support this expectation, the Initiative requires each Care Manager and Care Coordinator must complete a total of twelve (12) hours of education per year. The requirement of training throughout the year is termed “longitudinal learning activity.” This can be satisfied by either:
Twelve (12) hours of MiCMRC webinars/sessions (e.g., topic based live webinars and recorded webinars that offer CE certificates, web based interactive self-study eLearning modules – Basic Care Management, in person Summit attendance, etc.), OR Six (6) hours of MiCMRC webinars/sessions PLUS six (6) hours of PO-led, or other related learning activity events. No preapproval is necessary for PO-led or other CE granting care manager, care coordinator training sessions. However, a certificate of completion should be maintained for audit purposes. For details see 2018 Participation Guide
SIM PCMH Required Self-Study Modules
PCMH Initiative Care Manager and Care Coordinator intial training requirements: