Publication LHPC WorksJune 2018 Issue

CEO Message

Welcome to the first issue of LHPC Works, a publication dedicated to providing information and insights about the issues confronting California’s local health plans and the priorities they are working on to provide high quality, accessible health care coverage for millions of Californians enrolled in Medi-Cal (California’s Medicaid program). The local plans’ story began nearly 50 years ago with one county’s vision of creating a health plan directly connected and accountable to its community. Other communities followed suit, bringing California’s Medi-Cal managed care delivery system to the distinguished place it is today – served by the largest community of not-for-profit, public health plans in the nation.

In 1973, Contra Costa Health Plan began enrolling Medi-Cal patients, making it the first county-sponsored health plan in California and the first federally qualified county sponsored health plan in the nation. In the years that followed, 35 counties created 15 more local health plans to ensure Medi-Cal beneficiaries have access to health care through mission-driven, publicly accountable health plans. Today, California’s 16 local health plans serve 70 percent of Medi-Cal patients enrolled in a health plan and continue to lead the way in providing quality health care to millions of Californians.

Local plans have a strong history of service and aspiration …

Contra Costa    First LI/county plan in California
CenCal             First COHS plan in nation
LA Care            Largest public plan in nation
CalOptima        Highest NCQA-rated Medicaid plan in California

Recognizing that a collaborative effort would yield even stronger results, a group of visionary local plan leaders formed LHPC more than 25 years ago. LHPC now represents all local health plans – local initiatives and county organized health systems alike – and touts a strong track record of managed care advocacy and policy expertise in Sacramento.

Publicly available reports show that local health plans have low administrative costs and among the highest quality scores in the state, outperforming their commercial counterparts 85% of the time. When Medi-Cal beneficiaries select a health plan, on average 80% choose the local health plan. This type of success is possible because local plans are aligned with their community, member, and non-profit oriented missions creating better health outcomes throughout California.

Our most recent initiative, the LHPC Institute, is a forward-thinking series of classes and forums for LHPC members to learn from experts, share best practices and work together to solve problems. The LHPC Institute is a beacon of the local plan community’s commitment to excellence, innovation and collaboration.

I am proud of local plans’ history of service and success and honored to lead an organization representing health plans with an uncompromising commitment to improving the health of Californians.

 


Brianna Lierman, Esq.
Chief Executive Officer

Publication LHPC WorksJune 2018 Issue

Connecting Health Care and Housing

The conditions in which people are born, grow, live, work, and age have such significant influence on an individual’s health that the World Health Organization calls them “social determinants of health” (SDOH). Local plans, with a depth of understanding about and connections to their communities, are finding creative solutions to better bridge the divide between health care delivery and SDOHs – with particular focus on housing, which is among the most pressing and complex of SDOHs to address within regulatory restrictions.

Publication LHPC WorksJune 2018 Issue

Local Health Plans Work to Improve Access to Care

California’s successful implementation of the ACA gave millions of people access to health insurance. The rapid expansion of the Medi-Cal program – over 4 million since 2013 – meant health plans had to focus on creative solutions to account for longstanding provider shortages and meet regulatory and contractual access requirements. Access challenges exist across California, but are felt most acutely in rural areas, where obstacles faced by both health care providers and patients are vastly different from those in urban areas.  

Publication LHPC WorksJune 2018 Issue

Managed Care 101: Quality Requirements in Medi-Cal Managed Care

The Medi-Cal managed care program currently covers approximately 10.6 million Californians, an increase of more than four million since 2013. This dramatic growth in a relatively short period of time – combined with provider shortages, diverse member demographics and vast geographic and market variations across California – makes quality improvement a complicated and significant undertaking. Nevertheless, care quality is a top priority for policy makers, health plans, and consumers. As it should be.

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