Notes: SIM funding began on Apr 1, 2013, which included an initial 6-month test period, resulting in the test implementation phase beginning Oct 1, 2013. Because the diagnosed diabetes prevalence data is annual, we modeled the implementation period as beginning Jan 1, 2014. Hospital rate differences were calculated each year by subtracting the mean of the county-level hospitalization rate in the 240 SIM counties from the mean of the county-level hospitalization rate in the 343 comparison counties. The error bars are 95% confidence intervals of the difference in the mean hospitalization rate by year. Apr indicates April; Dec, December; Jan, January; Oct, October; SIM, State Innovation Model
Sources: Authors’ analysis of Centers for Disease Control and Prevention’s county-level estimates and Healthcare Cost and Utilization Project’s State Inpatient Databases