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

Analysis: Can States Fix The Disaster Of American Health Care?

Last week, California’s new governor, Gavin Newsom, promised to pursue a smörgåsbord of changes to his state’s health care system: state negotiation of drug prices, a requirement that every Californian have health insurance, more assistance to help middle-class Californians afford it and health care for undocumented immigrants up to age 26.

News Author: 
Elisabeth Rosenthal

As billions in tax dollars flow to private Medicaid plans, who's minding the store?

With no insurance through his job, Jose Nuñez relied on Medicaid, the nation’s public insurance program that assists 75 million low-income Americans.

Like most people on Medicaid, the Los Angeles trucker was assigned to a private insurance company that coordinated his medical visits and treatment in exchange for receiving a set fee per month — an arrangement known as managed care.

News Author: 
Chad Terhune Heide de Marco

2.7 million Californians still don't have health insurance. Can that number go lower?

After a streak of steady declines, California's uninsured rate bottomed out last year with some 2.7 million people still without health insurance.

The last estimates from the U.S. Census offer a fragmented portrait of the remaining people who are uninsured while posing an even bigger question for the state: How much lower can the uninsured rate go?

According to the Census Bureau, 7.2 percent of Californians were without health insurance in 2017. That's lower than the national average of 8.7%

News Author: 
Michael Finch II

California - AB-2895 Primary Care Spending Transparency Act

This bill, the Primary Care Spending Transparency Act, would require a health care service plan or health insurer that reports rate information, as specified, to annually report the percentage of expenses the health care service plan or health insurer allocated to primary care, among other things.
 

APA2018

2018-08-09 09:00 to 2018-08-12 14:00

WHY ATTEND APA 2018?

 
APA is transforming and bringing you a new and improved way to learn and be inspired! 
 
Announcement Type: 

Children’s Hospitals Look To Voters For Financial Aid

California’s children’s hospitals say they’re struggling to keep up with advances in medical care and a growing demand for their services, and they’re asking taxpayers to help — again.

News Author: 
Ana B. Ibarra

Primary care is a home run for both sides of the aisle

In 2008, Billy Beane, former Speaker Newt Gingrich (R-Ga.), and former Sen. John Kerry (D-Mass.) argued in the New York Times that health care in the United States was overpriced and underperforming. A bipartisan policy has emerged to address this problem — focus on paying for value not volume, with the Medicare Access and CHIP Reauthorization Act as the latest manifestation of this strategy.

News Author: 
Evan Saulino

Advanced PCMH 2017: Mastering the Medical Home Transformation

2018-05-10 08:30

May 10 | Marina Del Rey, CA

Early Bird Registration Ends: March 29, 2018

Duration: 1 day

Credits: 4.75

About the Seminar

Announcement Type: 

Introduction to PCMH: Foundational Concepts of the Medical Home

2018-05-08 08:30 to 2018-05-09 12:30

Early Bird Registration Ends: March 27, 2018

Duration: 1.5 days

Credits: 7.75

About the Seminar

Announcement Type: 

A Health Plan ‘Down Payment’ Is One Way States Try Retooling Individual Mandate

As President Donald Trump and congressional Republicans tirelessly try to dismantle the Affordable Care Act, a number of states are scrambling to enact laws that safeguard its central provisions.

The GOP tax plan approved by Congress in the last days of 2017 repealed the ACA penalty for people who fail to carry health insurance, a provision called the “individual mandate.” On Jan. 30, in Trump’s first State of the Union address, he claimed victory in killing off this part of the health law, saying Obamacare was effectively dead without it.

News Author: 
Rachel Bluth

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