Article HealthPayer IntelligenceThomas Beaton

Health Plan Variety Does Not Boost Managed Medicaid Performance
Expanding health plan variety in state Medicaid programs may not lead to improved Managed Medicaid performance.

Managed Medicaid performance does not increase as state Medicaid programs introduce more health plan variety, but a single health plan with value-based characteristics may be more effective in improving performance, a new JAMA commentary argued.

Article John Baackes The Hill

From Confusion to Solution in Health Care — The Public Option in Los Angeles

The health-care battlefield is burning brighter than ever. Eight years after the passage of the Affordable Care Act (ACA), conservatives think that the ACA is an overreach of government authority and should be repealed. Progressives, on the other hand, believe that the ACA should be replaced by a single-payer system operated with public funds, guaranteeing universal coverage for all citizens.

The truth may lie somewhere in the middle.

Article John Baackes

The Health Care Industry Must Lead the Way on Medicaid Reform

More than 70 attempts to repeal the Affordable Care Act failed, but the groundbreaking legislation is still facing death by a thousand cuts, and it’s clear we cannot depend on Washington to fix what ails the health care system. The health care industry must step up and develop reforms that will ensure the most vulnerable continue to have access to quality care.

Press release

Alameda Alliance for Health Commits $102,000 to Help Prevent and Reduce Influenza in the Community
Shoo the Flu program serves thousands of students and teachers in the Oakland area

OAKLAND, CA – Alameda Alliance for Health (Alliance) made a $102,000 contribution to the Alameda County Public Health Department’s Shoo the Flu program, which will allow them to continue to offer free flu vaccinations at local schools. The Shoo the Flu program reduces influenza in the community by providing free flu vaccinations, regardless of insurance to students and teachers, at elementary schools throughout the Oakland area.

Article Santa Barbara IndependentNick Welsh

CenCal Health Ranks Fourth Statewide
Health Plan Covers 20 Percent of S.B., S.L.O. Counties

Sixty-six percent of all Medi-Cal patients in Santa Barbara and San Luis Obispo counties get appointments for urgent calls within 48 hours, according to the California Department of Managed Health Care, and 83 percent of Medi-Cal patients seeking non-urgent treatment get seen within two weeks.

These patients — totaling about 180,000 — are part of a managed care system known as CenCal Health. These response times earned CenCal a fourth-place ranking of 36 full-service health plans. CenCal provides coverage to 20 percent of the two counties’ population.

Article Greenfield NewsRyan Cronk

Greenfield Clinic Expansion Set for Spring
Mee Memorial Hospital Awarded $2.5m Grant

Mee Memorial Hospital CEO Susan Childers and Manager of Plant Operations Jim Johnson hold up renderings of the new Greenfield Clinic expansion.

GREENFIELD — Mee Memorial Hospital has received a $2.5 million grant from the Central California Alliance for Health that will go toward the expansion of the hospital’s outpatient clinic in Greenfield.

“We are honored to have been awarded this grant from Central California Alliance for Health,” said Susan Childers, CEO of Mee Memorial Hospital, in a news release. “With the new grant, Mee Memorial will be better able to support local efforts to coordinate care and provide better outcomes for patients throughout our community.”

Press release

San Joaquin Board of Supervisors Appoints New Commissioners for Health Plan of San Joaquin (HPSJ) Governing Board
Also, Two Returning Commissioners

(French Camp, CA) – San Joaquin County Director of Health Care Services Greg Diederich – chair of the San Joaquin Health Commission – has announced that the San Joaquin County Board of Supervisors has formally appointed a new member of the Health Commission, the governing board of Health Plan of San Joaquin (HPSJ).  He is San Joaquin County Board of Supervisors member Chuck Winn, representing District 4.

Press release

Local Health Care Leader Alan McKay, Founder and Chief Executive Officer of Central California Alliance for Health to Retire; New CEO Assumes Role

Scotts Valley, Calif., Feb. 21, 2018 — Central California Alliance for Health (the Alliance), an award winning, regional non-profit Medi-Cal managed health care plan serving Santa Cruz, Monterey and Merced counties, today announced that Alan McKay, founder and Chief Executive Officer (CEO), is retiring on Feb. 28, 2018, after 22 years of service.

Press release

Caloptima Program for Seniors to Expand
Participants to gain greater access to adult day health care through community partnerships

ORANGE, Calif. (February 8, 2018) — Dedicated to serving frail seniors, CalOptima’s Program of All-Inclusive Care for the Elderly (PACE) is expanding through new partnerships with selected Community-Based Adult Services (CBAS) centers. With access to these centers, more seniors may join PACE and existing PACE participants will gain more options to receive adult day health care that suits their culture, location or medical condition.

Press release

Caloptima Conducts Most Extensive Member Health Needs Assessment in its 22-year History
More than 6,000 CalOptima members, providers and community representatives participated

ORANGE, Calif. (February 2, 2018) — CalOptima’s Member Health Needs Assessment (MHNA) is the agency’s most comprehensive study to date quantifying for the first time significant health care and social challenges. The MHNA provides data critical to ensuring that health care providers and the community can continue to address issues faced by CalOptima members.

Article Central Coast Physicians Magazine

Commitment to Excellence
Stakeholder network helps CenCal Health achieve milestone performance

In a time when the future of healthcare coverage may seem uncertain, what is certain is that our community can be proud of the quality of healthcare experienced by CenCal Health’s nearly 180,000 members.

Press release

Alameda Alliance for Health Improves Quality Scores for the Second Year in a Row and Now Ranks Among the Higher Performing Health Plans in the State

(Alameda, CA, January 4, 2018) -  The California Department of Health Care Services (DHCS) recently published the Medi-Cal Managed Care Dashboard, which showed that Alameda Alliance for Health (Alliance) continued to expand on quality gains.

Press release

Gold Coast Health Plan Introduces New Palliative Care Program
MyGoldCare Provides Coping Mechanisms for Severely Ill Members

CAMARILLO, Calif., Dec. 29, 2017 – Gold Coast Health Plan’s (GCHP) new palliative care program, MyGoldCare, launches January 1 for qualified enrollees. MyGoldCare helps relieve the pain and suffering of those who are seriously ill.

Press release

Local Medi-Cal Recipients and Providers Get Important Updates During Thomas Fire

Santa Barbara and San Luis Obispo counties, Calif., Dec. 12, 2017 – CenCal Health is reaching out to keep its nearly 180,000 members and over 1,500 providers and the community informed with important information and resources as the region faces unprecedented impacts from the Thomas Fire.

Updates include critical information about medication prescriptions and refills for members, providers and pharmacies.

Press release

Gold Coast Health Plan Member Alert
Ventura County's Medi-Cal Plan is Making it Easy for Members to Access Prescriptions and Transportation During the Thomas Fire

CAMARILLO, Calif., December 5, 2017 – Gold Coast Health Plan (GCHP) is alerting its members that during the Thomas Fire, members can get their prescriptions filled, receive necessary oxygen and have their transportation needs met.

The Plan, which has more than 200,000 Medi-Cal members throughout Ventura County, has lifted any restrictions on refills so that those who evacuated their homes without their medications can have their prescriptions filled. More information is available by calling the Plan’s pharmacy benefit manager, OptumRx, at 1-855-297-2870 / TTY 711.

Press release

Santa Clara Family Health Plan Receives NCQA Interim Accreditation

Campbell, CA – November 27, 2017 – Santa Clara Family Health Plan (SCFHP) announced today that it has been awarded an Accreditation status of “Interim” by the National Committee for Quality Assurance (NCQA), a private, not-for-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations.

Press release

IEHP is First Health Plan in the Nation to Reach 25,000 Medicare-Medicaid Members

RANCHO CUCAMONGA, Calif., Nov. 20, 2017 — Inland Empire Health Plan (IEHP) is the first of 65 Medicare-Medicaid Plans (MMP) in the nation to reach 25,000 members. MMPs serve people who have low income and are over 65 or have a disability.

“This milestone is the result of our commitment to serving our members, and working with our providers and the community to help them fully understand the benefits of our program,” said IEHP Chief Executive Officer Bradley P. Gilbert, MD.

Press release

Santa Clara Family Health Plan Recognized by the State for Strategic Focus on Quality

Campbell, CA – November 20, 2017 – Santa Clara Family Health Plan (SCFHP), a local, public, not-for-profit health plan serving over 270,000 Santa Clara County residents, announced today that it received the 2017 award for Greatest Improvement in Quality Strategy Focus Areas from the California Department of Health Care Services (DHCS). The annual DHCS quality awards recognize Medi-Cal managed care plans that have excelled in improving health care quality for beneficiaries.

Article Community Contributor

CenCal Health Earns Excellent Rating and Recognition among California’s Medicaid Plans

SANTA BARBARA — CenCal Health rated in the top 5 percent of Medicaid plans nationally for 2 important areas of care, and in the top 10 percent for an additional 12 areas of care according to the most recent state quality measurement ratings. For CenCal Health’s Santa Barbara County managed care product, these exceptional results rated fourth statewide among Medi-Cal health plans.

Press release

San Francisco Health Plan is Recognized for Outstanding Performance in Quality Care From The California Department of Health Care Services
This is the 12th time San Francisco Health Plan and its provider network have received the statewide quality award.

SAN FRANCISCO, Oct. 17, 2017 – San Francisco Health Plan (SFHP), a community health plan serving over 145,000 San Francisco residents, announced today that it is the recipient of the 2017 Outstanding Performance in Quality Care from the California Department of Health Care Services (DHCS) for the Medi-Cal program.