The HPC is seeking to invest in evidence-based health care payment or service delivery innovations that achieve cost savings within an 18-month implementation period and target the most complex health care cost challenges in Massachusetts.

These challenges, which are fully described in HCII - Round 1 RFP - Attachment A, Exhibit 1 - Challenge Descriptions  pdf format of RFP Attachment A.1
, each represent innovation opportunities – areas where limited existing market progress has been made, despite their strategic importance and the presence of promising, emerging solutions.

The following tables offer resources to learn more about the example models for each challenge area highlighted in Attachment A, Exhibit 1.

These models are provided as examples to support and guide applicants in developing highly effective, previously tested initiatives, but adapting or citing the models described in Attachment A, Exhibit 1 does not confer an advantage.
 

Social Determinants of Health (SDH)
Meet the social needs that impact the health of high-risk / high-cost patients

Behavioral Health Integration (BHI)
Integrate behavioral and physical health care (including substance use disorders) for high-risk / high-cost patients

Value-Informed Choices – Purchasers
Increase value-informed choices by purchasers (including both employers and consumers) that optimize patient preferences.

Value-Informed Choices – Providers
Increase value-informed choices by providers that address high-cost tests, drugs, devices, and referrals.

Practice Pattern Variation (PV)
Reduce practice pattern and cost variability in hip / knee replacements, deliveries, and other high-variability episodes of care.

Post-Acute Care (PAC)
Improve hospital discharge planning to reduce over-utilization of high-intensity post-acute care (PAC) settings as well as improve efficiency and transitions of care within and between PAC providers.

Serious Advancing Illness (SAI) & Care at the End of Life (EOL)
Support patients in receiving care that is consistent with their goals at the end of life and provide comprehensive community- and home-based services.

Site & Scope Of Care (SOC)
Expand scope of care of medical and paramedical providers who can most efficiently care for high-risk / high-cost patients in community settings (e.g., through care models, partnerships, or technologies).

 

Social Determinants of Health (SDH)
Meet the social needs that impact the health of high-risk / high-cost patients

EXAMPLE MODELS

Integrated Health Care and Housing Services (10th Decile Project)

Health Connections (KentuckyOneHealth)

Medical Legal Partnership (Lancaster General Health System)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Behavioral Health Integration (BHI)
Integrate behavioral and physical health care (including substance use disorders) for high-risk / high-cost patients

EXAMPLE MODELS

Tele-Mental Health (Veterans Health Administration)

Primary Care and Behavioral Health Integration (Colorado Access)

ED-initiated Buprenorphine / NalaxoneTreatment (Yale-New Haven Hospital / Yale School of Medicine

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Value-Informed Choices – Purchasers
Increase value-informed choices by purchasers (including both employers and consumers) that optimize patient preferences.

EXAMPLE MODELS

Remote Second Opinion and Referral Services (Costco Wholesale Corp, Vanderbilt Medical Center)

Price Transparency and Reference Pricing (CalPERS)

Employer-Driven Care Delivery and Benefit Innovations (Boeing, Dartmouth College, Expedia)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Value-Informed Choices – Providers
Increase value-informed choices by providers that address high-cost tests, drugs, devices, and referrals.

EXAMPLE MODELS

E-Consult / E-Referral (Los Angeles County Dept. of Health)

Surgical Bundled Payments (Cleveland Clinic)

Shared Decision Making (Choosing Wisely)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Practice Pattern Variation (PV)
Reduce practice pattern and cost variability in hip / knee replacements, deliveries, and other high-variability episodes of care.

EXAMPLE MODELS

Care Coordination & Decision Support (UPennHealth System, Houston Methodist Hospital)

Reduction of Inappropriate Practice Pattern Variation (Choosing Wisely)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Post-Acute Care (PAC)
Improve hospital discharge planning to reduce over-utilization of high-intensity post-acute care (PAC) settings as well as improve efficiency and transitions of care within and between PAC providers.

EXAMPLE MODELS

Care Coordination & Decision Support (UPennHealth System, Houston Methodist Hospital)

Home-Based Remote Management (CHRISTUS Health System, Intermountain Health System

Nursing Home After-Hours Telemedicine Service (Harvard Medical School)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Serious Advancing Illness (SAI) & Care at the End of Life (EOL)
Support patients in receiving care that is consistent with their goals at the end of life and provide comprehensive community- and home-based services.

EXAMPLE MODELS

In-Home Palliative Care (Kaiser Permanente)

Advanced Illness Management (AIM) Program (Sutter Health) and Home-Based Palliative Care Program (Home Connections)

Oncology Medical Home (Consultants in Medical Oncology and Hematology)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.
 

Site & Scope Of Care (SOC)
Expand scope of care of medical and paramedical providers who can most efficiently care for high-risk / high-cost patients in community settings (e.g., through care models, partnerships, or technologies).

EXAMPLE MODELS

Mobile Integrated Health Care (MedStarEMS; MN Community Paramedicine)

Community Health Worker Program (UVA Medical Center)

Model III: Hospital at Home (Johns Hopkins)

For more information on these models, please see the HCII RFP Attachment A, Exhibit 1: Challenge Descriptions.