California

in 2010, California was approved for a Section 1115 Medicaid Waiver launching the Bridge to Reform which resulted in several changes including expanding Medicaid coverage, reforming safety-net hospitals, and promoting coordinated systems of care for dual eligibles and persons with disabilities. The Delivery System Reform Incentive Pool (DSRIP) is a program offering safety-net hospitals in California funds to make investments in infrastructure, system design and improvements in population health. More than half of participating hospitals expanded medical homes which included expanding primary care capacity, chronic care management, and integration of physical and behavioral health care. Under the Bridge to Reform, the California Children's Services Program Demonstration included pilot programs to improve coordination of care through medical homes, improve satisfaction with care, and develop family-centered care.  In 2012, a waiver amendment provided for the California Duals Demonstration program - Cal MediConnect - that will be implemented in eight California counties in 2014. The program aims to improve care coordination for dual eligible beneficiaries and drive high quality care through medical homes.

California encourages issuers selling Qualified Health Plans (QHPs) in the Marketplace, Covered California, to assist enrollees in selecting a primary care provider, Federally Qualified Health Center (FQHC) or a patient-centered medical home (PCMH) within 60 days of enrollment.

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
Yes
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
Yes
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
38,114,300
Uninsured Population:
15%
Total Medicaid Spending FY 2013: 
$61.9 Billion 
Overweight/Obese Adults:
60.1%
Poor Mental Health among Adults: 
36.8%
Medicaid Expansion: 
Yes

Measures and Results from an Ambulatory, Interprofessional Team OSCE Project

2014-09-30 14:00 to 15:00

Measures and ResultsAs part of a five-year project with the California Geriatric Education Center at UCLA, and funded by the Health Resources and Services Administration (HRSA), Western University of Health Sciences developed the Ambulatory Team Observed Structured Clinical Evaluation (ATOSCE). 

Announcement Type: 

Advancing Innovation To Eliminate Health Disparities

Health Equity and the Patient-Centered Medical Home

The Institute of Medicine (IOM) set forth goals for care coordination in their report “Crossing the Quality Chasm: A New Health System For The 21st Century,” and established guidelines to address measuring disparities in access to and the quality of health care, and developing adequate data sources in the National Healthcare Disparities Report (NHDR).

News Author: 
Joseph West

Sharp HealthCare ACO drops out of Medicare's Pioneer program

Another Medicare Pioneer accountable care organization has exited the program, renewing questions about its long-term sustainability.

Sharp HealthCare, a five-hospital system in San Diego, said in its third-quarter financial statement (PDF) that it dropped out of the Pioneer ACO program. Sharp notified the CMS and itsCenter for Medicare and Medicaid Innovation on June 20. Twenty-two Pioneer ACOs remain from the original 32. Last summer, nine other Pioneers said they were leaving. Several of them switched to Medicare's less financially risky Shared Savings Program.

News Author: 
Bob Herman

A Team-Based Approach to Primary Care

Since the passage of the Affordable Care Act, primary care has been receiving a lot more scrutiny. In many cases across the nation, the health care system hasn’t been providing the most effective or efficient care.  “We’ve had to do a bit of soul-searching in primary care because we weren’t delivering the goods very well,” said Kevin Grumbach, MD, chair of UCSF’s Department of Family and Community Medicine.

News Author: 
Kathleen Masterson

Reform Update: Many dual-eligibles opt out of care coordination

People who are eligible for both Medicare and Medicaid are opting out at high rates from voluntary state initiatives aimed at better coordinating their care. 

News Author: 
Virgil Dickson

California Academy of Family Physicians Fresno PCMH Initiative

Launched in July 2012, the Fresno PCMH Pilot project was a collaboration of California Academy of Family Physicians (CAFP), the self-insured Fresno Unified School District (FUSD) and a primary care physician group, Community Medical Providers. The pilot included 2,500 patients (10 percent of FUSD’s beneficiaries).

Anthem Blue Cross and HealthCare Partners Saves $4.7 Million in Six Months

While Improving Quality of Care Provided First Commercial PPO Accountable Care Organization in California to Document Savings from Coordinated Care 

The Accountable Care Organization (ACO) formed by Anthem Blue Cross (Anthem) and HealthCare Partners in California produced $4.7 million in savings for the first six months of 2013 compared to a comparison group, Anthem and HealthCare Partners announced today. 
 

Pilot Program at Oakland Hospital Cuts HIV/AIDS Readmissions Almost in Half

University of California researchers yesterday released initial results of a pilot project to launch a patient-centered medical home model of care for HIV/AIDS patients at a hospital and four community clinics in Alameda County. The early results were pretty striking, according to George Lemp, director of the California HIV/AIDS Research Program for the UC system. "It's very encouraging," Lemp said. "If we can reduce hospital readmission rates, we might be able to bring down some of the cost of medical care and improve outcomes."

News Author: 
David Gorn

Pagine

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