Event

Participant Information: California’s Local Health Plans — A Panoramic View

Webinar recorded live on Sept. 27, 2018

Overview

Learn about the history and development of local health plans in California’s Medi-Cal managed care program. Expert faculty discuss:

  • How and why the local plan model took shape
  • Types and characteristics of local plans
  • Role and importance of safety net providers in the development and operation of local health plans
  • Current and future challenges for local health plans
  • And more.

Recording

Access Program Recording
Passcode: localplans
 

Materials

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Agenda

Overview

  • California’s Medi-Cal program and the statewide significance of local health plans
  • Roadmap for the webinar

The Story Behind the Local Health Plan Model 

  • How and why local health plans came to be
  • Types of local plan models, and the similarities and differences across plans
  • Statutory authorities for local plans and implications for accountability, structure and operations
  • Importance of safety net providers in development and operation of local plans
  • Key accomplishments to date

How California’s Local Plans are Unique 

  • How local plans fit in today’s Medi-Cal landscape
  • Local plans vs. commercial and other non-safety net counterparts
  • How local plans contribute to their communities

Current and Future Challenges for Local Health Plans

  • Issues and challenges facing local plans
    • IPA interest in Knox-Keene licensure and delegation
    • Private plan mergers and implications for local plans
    • Looking ahead — California’s impending commercial plan procurement
    • Pursuing innovation while staying true to the mission
  • Q&A

Faculty

Brianna Lierman
Chief Executive Officer
Local Health Plans of California

Brianna Lierman is chief executive officer of Local Health Plans of California and has more than a decade and a tremendous breadth of experience in health care. Previously, she was vice president of government affairs and compliance for California Health & Wellness Plan, where she was responsible for county and state government affairs and advocacy with the executive and legislative branch, served as legal counsel in health plan operations and new business initiatives, and was the health plan’s compliance officer. Ms. Lierman was also a founding executive and the lead licensing counsel in the start-up of California Heath & Wellness Plan.

Bobbie Wunsch 
Partner
Pacific Health Consulting Group

Bobbie Wunsch has more than 30 years of experience in the health care industry and specializes in the restructuring and financing of health care delivery organizations, primarily safety net providers. She provides strategic planning services to community clinics, county health and local Medicaid managed care organizations, public hospitals, ambulatory care centers and health care financing organizations. She focuses on a variety of issues, including restructuring through mergers or affiliations, program development, redesigns for improved effectiveness and efficiency, and cooperative business ventures. A leading resource in financing and operating health services for low-income uninsured individuals, Bobbie conducts seminars and has published numerous reports and articles on related topics.

Christopher Perrone
Director, Improving Access
California Healthcare Foundation

Christopher Perrone is director of CHCF’s Improving Access team, which works to improve access to coverage and care for low-income Californians. He was previously director of the foundation’s Health Reform and Public Programs initiative, where he led efforts to improve the policies and practices that shape Medi-Cal and other publicly funded health care programs, and to promote greater transparency and accountability within these programs.

Q&A

To support your learning, below are answers to a few viewer questions submitted during the webinar:

  1. How close are we to the max number of county organized health systems (COHS) allowed in the state? 

    We are at the max under current federal legislation for the number of COHS allowed in California. In order to establish new federal COHS, the limit will have to be expanded under federal law.
     
  2. Can you elaborate on the differences between local initiatives and COHS?

    The major differences include:
  • COHS require only one plan per county; local initiatives (LIs) are part of the two-plan model with a commercial plan counterpart.
     
  • COHS are authorized in federal law and established by local ordinances in each county; LIs are authorized in state W&I codes and are established by local ordinance.
     
  • COHS are not required to have a Knox Keene license for Medi-Cal business only, although some do; LIs are required to have a Knox Keene license.
     
  • COHS were not required to protect the safety net; LIs were required to do so.

3.  Please define safety net provider.
     Counties, public hospital systems, community clinics and FQHCs,  
     and Indian clinics.