Vermont State-led State Innovation Model Evaluation

Dates: 2016-2017

State: Vermont

Client(s): Vermont Green Mountain Care Board

Services: Health Care & Public Health Planning, Health Systems Transformation

Technical Expertise: Health Care Reform


There is a pressing need for sweeping transformation across every aspect of our health system to accelerate progress toward the Triple Aim of lower costs, better care and improved population health. The systems transformation being undertaken through Vermont Health Care Innovation Project Vermont's State Innovation Model (SIM), is an extraordinarily complex, dynamic, and multi-faceted process that evolves over time. Having timely information on status and progress is essential for stakeholders to identify both successes that can be spread and emerging barriers that need to be addressed. Equally important to the identification of successful strategies and challenges is the dissemination of these findings to establish stakeholder ownership of the findings and invite stakeholder input and involvement to inform the path forward.

JSI has been contracted by the Green Mountain Care Board to conduct an evaluation of their SIM project utilizing an implementation science framework as an overall evaluation approach. Implementation science recognizes that for any innovation or intervention it is essential to know not just whether it worked or did not work but also how, why, and under what circumstances did it work or not. Implementation science is about translating research to the field.

The three topical areas that are the focus of this evaluation—care integration, use of data to inform practice improvement, and value-based payment reform—are all research driven and evidence-based strategies. However, implementing evidence-based strategies is always context dependent. How strategies are implemented and their ultimate success within the three topical areas may vary depending on provider type or characteristics, organization type or setting, consumer perception and acceptance, community characteristics, and/or policy or regulatory factors. Getting at questions of how, why, and under what circumstances also informs how interventions and best practices spread, an important consideration post-SIM testing grant. The implementation science frame will be used in working with VCHIP leaders and the Evaluation Steering Committee to design and implement the data collection activities required through this scope of work.

Using an implementation science frame, JSI will incorporate a “sequential” and an “embedded” mixed methods approach to the evaluation. “Sequential” mixed methods means that qualitative data is conducted first to inform quantitative data collection or vice versa. For this evaluation, the environmental scan will be largely qualitative (although will also include a review of secondary data sources) and findings from the scan will inform the development of the site visit protocol. Both the scan and the site visits will inform the development of the provider and care integration surveys. “Embedded” mixed methods mean that quantitative and qualitative data are reported together with qualitative data is used to provide context and richness to quantitative data.