DOCSLIB.ORG

BOARD of GOVERNORS MEETING # 207 April 5, 2012 2:00 PM

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
BOARD of GOVERNORS MEETING # 207 April 5, 2012 2:00 PM L.A. CARE HEALTH PLAN BOARD OF GOVERNORS MEETING # 207 April 5, 2012 ● 2:00 PM – 5:00 PM Vision A healthy community in which all have access to the health care they need. Mission To provide access to quality health care for Los Angeles County’s vulnerable and low income communities and residents and to support the safety net required to achieve that purpose. Values We are committed to the promotion of accessible, high quality health care that: • Is accountable and responsive to the communities we serve and focuses on making a difference; • Fosters and honors strong relationships with our health care providers and the safety net; • Is driven by continuous improvement and innovation and aims for excellence and integrity; • Reflects a commitment to cultural diversity and the knowledge necessary to serve our members with respect and competence; • Empowers our members, by providing health care choices and education and by encouraging their input as partners in improving their health; • Demonstrates L.A. Care’s leadership by active engagement in community, statewide and national collaborations and initiatives aimed at improving the lives of vulnerable low income individuals and families; and • Puts people first, recognizing the centrality of our members and the staff who serve them. BOARD OF GOVERNORS Thursday, April 5, 2012 (Meeting No. 207) 2:00 - 5:00 PM, L.A. Care Health Plan 1055 W Seventh Street, 10th Floor, Los Angeles, CA 90017 All votes in a teleconferenced meeting shall be by roll call. Teleconference Information Call (866) 528-2256 Access Code 7485299 Teleconference Sites Honorable Gloria Molina G. Michael Roybal, MD, MPH Los Angeles County Board of Supervisors 5240 Mimosa Lane 500 W. Temple Street #856 Las Cruces, NM 88001 Los Angeles, CA 90012 AGENDA I. Welcome Walter A. Zelman, PhD Chair II. Approval of today’s meeting agenda Chair III. Approval of March 1, 2012 Meeting Minutes Chair IV. Chairperson’s Report Chair • Board and Committee Meeting Processes V. Chief Executive Officer’s Report Howard A. Kahn • Board of Governors Retreat Chief Executive Officer • Changing Marketplace • Operations Report • Second Quarter Organizational Performance Report VI. Chief Medical Officer’s Report Elaine Batchlor, MD, MPH Chief Medical Officer VII. Standing Committee Reports A. Executive Committee Walter A. Zelman, PhD Chair * - Proposed Consent Agenda items Last saved 4/2/2012, 9:10:52 AM Agenda - Board of Governors Meeting April 5, 2012 Page 2 of 4 1. Legislative Update/Actions Cherie Fields • State Issues Director of Government Affairs • Federal Issues • Local Health Plans of California Sponsored Legislation Concerning Quorum for Teleconferenced Meetings 2. Tranquada IV Grant Recommendations Elaine Batchlor, MD Motion EXE 100.0412 To increase the budget for the Robert E. Tranquada, M.D. Safety Net Infrastructure Initiative IV by $100,000 and approve seven grants for a total of $1,100,000 as outlined in the enclosed memo and Attachment A. 3. Community Health Councils – South LA Diabetes Initiative Elaine Batchlor, MD Motion EXE 101.0412 To approve a $100,000 grant to the Community Health Councils to implement and evaluate the “Enhanced Diabetes Care Management Initiative” in South Los Angeles. 4. Community Health Investment Fund (CHIF) Annual Report Elaine Batchlor, MD B. Finance & Budget Committee Philip L. Browning Chair 1. Annual Sponsorship Report Elena Stern Director, Communications & Marketing 2. Financial Report Tim Reilly Chief Financial Officer Motion FIN 100.0412 To accept the Financial Report for the five months ended February 29, 2012, as submitted. 3. Cornerstone Consulting Contract Amendment Gene Fernandez Chief Information Officer Motion FIN 101.0412 To authorize Howard A. Kahn, Chief Executive Officer, to execute a contract amendment with Cornerstone Data Strategies, Inc. to complete the new core system vendor negotiations process and provide project management resources in an amount not to exceed $1,585,000. 4. Language Select Contract Amendment Elaine Batchlor, MD Motion FIN 102.0412 To authorize staff to amend the Language Select contract to add $410,000, extend the contract term to December 31, 2012 for a total amount not to exceed $685,000, and execute a contract for up to three years with equal or better terms for a total amount not to exceed $2,400,000. * - Proposed Consent Agenda items Agenda - Board of Governors Meeting April 5, 2012 Page 3 of 4 VIII. Periodic Committee Reports A. Governance Committee Mark Gamble, Chair B. Services Agreement Committee Elected Chair IX. Advisory Committee Reports A. Executive Community Advisory Committee Mario Ramos/Maria Guerrero X. Public Comments Chair XI. ADJOURN TO CLOSED SESSION (Estimated time: 45 mins) Chair A. CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) • DHCS Medi-Cal Rate • Provider Rates • Plan Partner Medi-Cal Rates B. REPORT INVOLVING TRADE SECRET Pursuant to Welfare & Institutions Code Section 14087.38(n) • Discussion concerning New Product Lines • Discussion concerning Core System Modernization Estimated date of public disclosure: March 2014 • Consideration of options to minimize managed care organization tax (AB 1422) Estimated date of public disclosure: April 2014 • Discussion concerning issues related to LA County Board of Supervisors’ motion on HMA Recommendations Estimated date of public disclosure: October 2013 C. CONFERENCE WITH REAL PROPERTY NEGOTIATORS Pursuant to Section 54956.8 of the Ralph M. Brown Act Property: 1055 West 7th Street, Los Angeles Agency Negotiator: Howard A. Kahn Negotiating Parties: Jamison Properties, 1055 West Seventh, LLC Under Negotiation: Price and Terms of Payment D. PUBLIC EMPLOYEE APPOINTMENT Pursuant to Section 54957 of the Ralph M. Brown Act Title: Compliance Officer E. CONFERENCE WITH LEGAL COUNSEL--ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9 (b) of Ralph M. Brown Act: Three (3) Potential Cases F. PUBLIC EMPLOYEE PERFORMANCE EVALUATION Pursuant to Section 54957 of the Ralph M. Brown Act Title: Chief Executive Officer * - Proposed Consent Agenda items Agenda - Board of Governors Meeting April 5, 2012 Page 4 of 4 G. CONFERENCE WITH LEGAL COUNSEL – EXISTING LITIGATION Pursuant to subdivision (a) of Section 54956.9 of the Ralph M. Brown Act. Cedars-Sinai Health Systems v. L.A. Care Health Plan (Anthem Blue Cross) California Department of Health Services Office of Administrative Hearings and Appeals; Emergency Services Claim Dispute Nos. 859-06-RW, et seq. and 1599-06-RW, et seq. XII. RECONVENE IN OPEN SESSION Chair XIII. Adjournment Chair The order of items appearing on the agenda may change during the meeting. Please keep your comments to three minutes or less. THE PUBLIC MAY ADDRESS THE BOARD OF GOVERNORS ON ALL MATTERS LISTED ON THE AGENDA BY FILLING OUT A “REQUEST TO ADDRESS” FORM AND SUBMITTING THE FORM TO L.A. CARE STAFF PRESENT AT THE MEETING BEFORE THE AGENDA ITEM IS ANNOUNCED. YOUR NAME WILL BE CALLED WHEN THE ITEM YOU ARE ADDRESSING IS DISCUSSED. THE PUBLIC MAY ALSO ADDRESS THE BOARD ON L.A. CARE MATTERS DURING PUBLIC COMMENT. NOTE: THE BOARD OF GOVERNORS CURRENTLY MEETS ON THE FIRST THURSDAY OF MOST MONTHS AT 2:00 P.M. POSTED AGENDA and PRINTED MEETING MATERIALS ARE AVAILABLE FOR INSPECTION AT Board Services, 1055 W. 7th Street – 10th Floor, Los Angeles, California 90017 Any documents distributed to a majority of the Board Members regarding any agenda item for an open session after the agenda has been posted will be available for public inspection at Board Services, L.A. Care Health Plan, 1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017, during regular business hours, 8:00 a.m. to 5:00 p.m., Monday – Friday. Meetings are accessible to people with disabilities. Individuals who may require any accommodations (alternative formats – i.e., large print, audio, translation of meeting materials, interpretation, etc.) to participate in this meeting and wish to request an alternative format for the agenda, meeting notice, and meeting packet may contact L.A. Care’s Board Services Department at (213) 694-1250. Notification at least one (1) week before the meeting will enable us to try and make reasonable arrangements to ensure accessibility to the meetings and to the related materials. * - Proposed Consent Agenda items Board of Governors General Meeting #206 Meeting Minutes – March 1, 2012 L.A. Care Health Plan Conference Room 29ABCD 555 W. Fifth Street, Los Angeles, CA 90013 All votes during a teleconferenced portion of the meeting were by roll call. Members Management/Staff Walter A. Zelman, PhD, Chairperson* Jim Mangia, MPH* Howard A. Kahn, Chief Executive Officer Thomas Horowitz, DO, Vice Chairperson Louise McCarthy, MPP** Elaine Batchlor, MD, MPH, Chief Medical Officer Philip L. Browning Treasurer* Supervisor Gloria Molina** Barbara Cook, Chief, Human and Community Resources Mario A. Ramos, Secretary* Michael A. Rembis, FACHE Gene Fernandez, Chief Information Officer Mark Gamble G. Michael Roybal, MD, MPH Augustavia J. Haydel, Esq., General Counsel Maria Guerrero John F. Schunhoff, PhD Tim Reilly, Chief Financial Officer Thomas S. Klitzner, MD, PhD* John Wallace, Chief of Staff *absent; ** via telephone AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN CALL TO ORDER Thomas Horowitz, D.O. Vice Chairperson, called the meeting to order at 2:03 p.m. Thomas Horowitz, D.O. Vice-Chairperson APPROVAL OF Vice-Chairperson Horowitz indicated that Item IX. C.4, consideration of Motion COM 103, Approved unanimously MEETING AGENDA was postponed to a future meeting at the request of the hospital association. Today’s agenda by roll call. 7 AYES was approved as amended. (Gamble, Guerrero, Thomas Horowitz, D.O. Horowitz, McCarthy, Rembis, Roybal, Schunhoff). Member Molina did not vote. APPROVAL OF The Executive Committee approved six motions to be considered under the consent agenda. Motion to Approve the CONSENT AGENDA FIN 100 Increase in Expenditures to Black Box Consent Agenda and FIN 101 Amendment to AppleCare Insurance Services contract Motion to approve the Thomas Horowitz, D.O.
Load more

Recommended publications
  • 2016 Community Health Needs Assessment
    2016 Community Health Needs Assessment A Triennial Report Summary Northridge Hospital Medical Center: 2016 Community Health Needs Assessment TABLE OF CONTENTS Executive Summary……………….……………………………………………………………………………………………………... 3 Assessment Purpose and Organizational Commitment…..……….………………. ……………………………………………………. 9 Community Definition …………….……………………………..…………………………………………………………………….. 10 Demographic Profile ……….………….………………………………………………………………………………………. 12 Community Needs Index (CNI) ……………………………………………………………………………………………….. 24 Assessment Process and Methods……………………..…………………………………………………………………………….….. 29 Assessment Data and Finding………………………..……………………………………………………………………… ………… 32 Prioritized Descriptions of Significant Community Health Needs……………………………………………………………………. 35 Community Resources………………………………………………………………………………………………………………….. 50 Impact: Actions Taken…………………………………………………………………………………………………………………. 51 Appendix A: Acknowledgements………………………………………………………………………………………………………. 53 Appendix B: Demographic Tables…………………………………………………………………………………………………….. 55 Appendix C: Summary of Community Engagement……………………………………………………………………………….….. 67 CHNA Community Public Health and Community Health Expert Participants……….......................................................... 76 Appendix D: Community Engagement Survey Tools ………………………………………………………..……………………….. 81 Appendix E: List of Secondary Data Sources………. …………………………...…………………………………………….……. 95 Northridge Hospital Community Health Needs Assessment, May 2016 2 EXECUTIVE SUMMARY____________________________________________________________________________________
    [Show full text]
  • Health Policy Research Brief
    Health Policy Research Brief December 2009 Creation of Safety-Net-Based Provider Networks Under The California Health Care Coverage Initiative: Interim Findings Dylan H. Roby, Cori Reifman, Anna Davis, Allison L. Diamant, Ying-Ying Meng, Gerald F. Kominski, Zina Kally and Nadereh Pourat rganized provider networks have been developed as a method of achieving efficiencies in the delivery of health care, and to reduce problems such as limited access to specialty and tertiary care, fragmentation and duplication of services, low- Oquality care and poor patient outcomes. Provider networks are based on collaborative agreements between an array of providers offering a comprehensive range of services, bolstered with extensive administrative, structural and financial supports.1, 2 Standard components of networks include private practice and clinic-based physicians, hospitals, and ancillary service providers such as laboratory and diagnostic services. Service providers are organized and supported by an organization that administers important aspects of the network, including provider reimbursement, utilization management, quality assurance and health information technology (HIT).3, 4 Organized provider networks have been used efforts to develop effective networks based by commercial insurers as part of managed on safety-net providers. care, and are being adopted increasingly by Medicaid and Medicare as an important Inherent Challenges in the Safety Net aspect of an effective health care delivery In contrast to the private sector, networks system.5
    [Show full text]
  • April 23, 2014 ILLINOIS' UPDATED MEDICAID CARE COORDINATION
    April 23, 2014 THIS WEEK IN FOCUS: ILLINOIS’ UPDATED MEDICAID CARE COORDINATION ROLLOUT CALIFORNIA PUBLISHES EXCHANGE ENROLLMENT REPORT INDIANA PROVIDES UPDATES ON UPCOMING MEDICAID MANAGED ABD RFP NEW YORK UPDATES ON MANAGED LTC AND DUALS DEMONSTRATION COLORADO REPORTS ON EXCHANGE ENROLLMENT UTAH AGREEMENT ON MEDICAID EXPANSION WITH CMS REPORTEDLY CLOSE UNITED, CENTENE REPORT FIRST QUARTER 2014 EARNINGS HMA UPCOMING APPEARANCE BY LYNN DIERKER, JUAN MONTANEZ, AND ALICIA SMITH IN FOCUS ILLINOIS’ UPDATED MEDICAID CARE COORDINATION ROLLOUT RFP CALENDAR This week, our In Focus section reviews an updated rollout plan for Illinois Medicaid’s care coordination initiatives. Under a 2011 Medicaid reform law (P.A. 96-1501) passed DUAL ELIGIBLES by the state’s legislature and signed by Governor Pat Quinn, the state’s Medicaid CALENDAR agency – The Department of Healthcare and Family Services (HFS) – is mandated to transition a minimum of 50 percent of all Medicaid beneficiaries into “care HMA NEWS coordination” by January 1, 2015. Shortly after the law was enacted, HFS determined that the state’s Medicaid Primary Care Case Management (PCCM) program, one of the Edited by: largest in the nation at more than 1.6 million enrollees, would not meet the definition of Greg Nersessian, CFA care coordination. Illinois’ care coordination transition is notable for both its scope and Email structure: Andrew Fairgrieve Email Rather than transitioning fully to a traditional Medicaid managed care program, HFS has, through a series of procurements, engaged provider-led care coordination entities (CCEs) and accountable care entities (ACEs) to operate alongside traditional Medicaid managed care organizations (MCOs). Illinois has moved first to transition the most complex recipients – aged, blind, and disabled and dual eligibles – into commercial managed care plans.
    [Show full text]
  • Mental Health Committee White Paper
    LOS ANGELES COUNTY MENTAL HEALTH SERVICES 2014 WHITE PAPER Presented by the Second Supervisorial District Empowerment Congress Mental Health Committee July 2, 2012 Background The Second Supervisorial District Empowerment Congress Mental Health Committee endorses this white paper which envisions the Los Angeles County public mental health service system of 2014. This is intended to be a “talking paper” – to create a dialogue which envisions a system of care that meets the lofty aspirations of the Affordable Care Act.1 While not a definitive document, it does create a working framework by which existing mental health services can be integrated with health care services in a way which best utilizes funding and workforce assets in support of those beneficiaries of public services who have mental health-related needs. With the landscape of health, mental health, and drug and alcohol services being transformed across the nation by federal health care reform legislation, the mental health community welcomes the opportunity to support the integration of the three services domains. In California, as counties assume full responsibility for the provision of public mental health services by way of realignment legislation, Los Angeles County has the opportunity to forge a model program which integrates the three domains in support of significant improvements in the physical and emotional well-being of its public beneficiaries. For purposes of this white paper integration of health, mental health, and drug and alcohol services is envisioned as horizontal integration – which reflects the value of each domain – working in concert with one another – in improving outcomes and achieving cost savings. This construct supports a continuum of care which, from the beneficiaries’ perspective, should be experienced as seamless.
    [Show full text]
  • South Los Angeles Health Equity Scorecard
    South Los Angeles Health Equity Scorecard Annie Park, MSW Nancy Watson, MSW Lark Galloway-Gilliam, MPA December 2008 Community Health Councils, 2008 Community Health Councils (CHC) is a non-profit, community-based health advocacy, policy and educational organization. Established in 1992, our mission is to improve health and increase access to quality healthcare for uninsured, under-resourced and underserved populations. Coalition for Health & Justice (CHJ), founded in 2004 to address the growing healthcare crisis in South Los Angeles, is a coalition of diverse leadership throughout South Los Angeles working to ensure access to quality healthcare for underserved residents of South Los Angeles. This project was made possible with generous funding from The California Endowment • Robert Wood Johnson Foundation • UCLA Center for Community Partnerships South Los Angeles Health Equity Scorecard South Los Executive Summary 3 Introduction 8 Study Design 10 Community Profile 14 Table of Health Status 17 Contents Scorecard Domain 1: Healthcare Environment Resources 21 . Healthcare Facilities . Healthcare Workforce . Healthcare Financing . Healthcare Coverage . Primary & Preventive Care Access . Primary & Preventive Care Utilization Scorecard Domain 2: Physical Environment Resources 51 . Nutrition . Physical Activity . Public Safety . Housing . Schools . Air & Land Quality Next Steps/Conclusion 75 Acknowledgments 77 Appendices 78 Appendix 1: Data Sources, Notes and Limitations Appendix 2: Scoring Methodology Appendix 3: Maps and Zip Codes of Study Areas Appendix 4: Table of Community Profile Measures Appendix 5: Table of Health Status Outcomes Appendix 6: Bibliography 1 South Los Angeles Health Equity Scorecard 2 South Los Angeles Health Equity Scorecard South Los EXECUTIVE SUMMARY The South Los Angeles Health Equity Scorecard is the culmination of a year-long study conducted by CommunityThe area known Health as SouthCouncils Los inAngeles collaboration has become with thean iconCoalition for the for plight Health and and struggle Justice.
    [Show full text]
  • State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform
    STATE STRATEGIES TO IMPROVE QUALITY AND EFFICIENCY: MAKING THE MOST OF OPPORTUNITIES IN NATIONAL HEALTH REFORM Jill Rosenthal, Anne Gauthier, and Abigail Arons December 2010 ABSTRACT: There is an acknowledged need for extensive reform to the health care delivery system in the United States. The Patient Protection and Affordable Care Act offers unprecedented opportunities to transform care delivery, with numerous provisions that support systemic improvements. States have an imperative to greatly improve system efficiency if they are to effectively and sustainably implement the law’s changes, particularly mandatory coverage expansion. This report examines specific Affordable Care Act provisions that support state system improvement goals and profiles efforts in 10 states: Colorado, Kansas, Maine, Massachusetts, Minnesota, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington. The report highlights the opportunities and challenges that federal health care reform will bring and offers suggestions for how state and national leaders can streamline implementation. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. To learn more about new Commonwealth Fund publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1464. CONTENTS List of Exhibits..................................................................................................................
    [Show full text]
  • Providing Health Care to Undocumented Residents: Program Details and Lessons Learned from Three California County Health Programs
    Providing Health Care to Undocumented Residents: Program details and lessons learned from three California county health programs By Denisse Rojas and Miranda Dietz University of California, Berkeley Center for Labor Research and Education October 4, 2016 1 INTRODUCTION While the number of people without health insurance has declined dramatically since the Affordable Care Act went into effect, undocumented immigrants continue to be exclud- ed from many health coverage options under this law. In California, approximately 1.8 million individuals are projected to remain uninsured due to their immigration status.1 Without resources to pay for costly health care, w undocumented immigrants may delay care and eventually seek treatment in the emergency room In California, 1.8 million 2 or go untreated entirely. individuals are projected to Undocumented adults in California are generally remain uninsured due to their eligible for only emergency and pregnancy-related services through Medi-Cal, the state’s Medicaid immigration status. program, though undocumented children and those granted deferred action may be eligible for full-scope Medi-Cal. Many of California’s counties provide primary and preventive health care services to low-income undocumented residents through safety-net programs.3 These programs are of interest to advocates and policymakers in other states who are looking for local solutions to offer non-emergency health services to undocumented immigrants. This report profiles three county programs that offer health care services to undocumented res- idents and aims to serve as a resource for designing and implementing similar programs elsewhere across the nation. It is based on interviews with county program staff, statewide informants, provider organizations, consumer advocacy groups, and published reports and documents gathered in June and July of 2016.
    [Show full text]
  • Taxi Operators' Dispatch Centers
    I doN’t Have health coverage. I alReady Have health coverage. Health Care Reform How can I get healthcare NoW? How will Health Reform impact me? and YOU... ✦ Healthy Way LA (HWLA)—This is a free program ✦ I have Medi-Cal! You can keep your Medi-Cal you can apply for right now. Learn more at health insurance. Find out more at: www.ladhs.org/hwla or call 1-877-333-4952. dpss.lacounty.gov/dpss/health or ✦ Medi-Cal—Right now, this is a program for low- call 1-877-597-4777. income children and parents, pregnant women, ✦ I have Medicare! You can keep your Medicare. seniors and disabled people. If you fit in one of The health reform law may lower the cost of your these categories you may be able to apply for medicine. You won’t have to pay for preventive Medi-Cal now. Call 1-877-597-4777 or visit dpss.lacounty.gov/dpss/health care like cancer screenings, vaccines, flu shots, and wellness visits. Find out more at: ✦ L.A. Care’s Healthy Kids Program—This is www.medicare.gov or call 1-800-633-4227. low-cost health insurance for children up to age 5 who do not qualify for other programs because ✦ I have insurance through my job! You of citizenship, residency or their family income is can keep your health insurance. The health too high. Visit www.lacare.org/potentialmembers/ law doesn’t make employers change your healthprograms/healthy-kids or call: insurance. Find out more by contacting your 1-888-452-2273.
    [Show full text]
  • Los Angeles: Fragmented Health Care Market Shows Signs of Coalescing
    california Health Care Almanac regional markets issue brief January 2013 Los Angeles: Fragmented Health Care Market Shows Signs of Coalescing Summary of Findings or even merging with each other, in part to help adjust Illustrating the fragmented nature of the Los Angeles capacity, expand referral bases, organize service-line (LA) health care market, scores of hospitals and numerous strategies, and improve care coordination. The more physician practices are scattered across a vast and congested prestigious and financially healthier hospitals (including area that is home to 10 million people. With the exception UCLA) have been at the forefront of these activities. of Kaiser Permanente, hospital systems and physician ▶▶ Physician organizations leading integration efforts. organizations tend to operate in isolated silos without an Given their experience in accepting financial risk for extensive footprint across the county. Emerging market patient care, LA physician organizations are spearheading trends and expected changes under national health reform are efforts to develop accountable care organizations (ACOs). prompting many providers to pursue new strategies to ensure For example, HealthCare Partners and Heritage Provider their viability. Network are participating in Medicare ACOs, while Key developments since the last study was conducted in HealthCare Partners is also working with Anthem Blue 2008 include: Cross in a commercial ACO. ▶▶ Intense competition for physicians. Physician ▶▶ Fresh leadership for the county’s safety net. New organizations, hospitals, and others are seeking new, health department leadership is redesigning the extensive tighter affiliations with physicians to gain patients, county-operated delivery system, which includes compete with Kaiser Permanente, and prepare for hospitals, outpatient centers, and primary care clinics, health reform.
    [Show full text]
  • Act 128 Health System Reform Design
    Act 128 Health System Reform Design Achieving Affordable Universal Health Care in Vermont Submitted by WILLIAM C. HSIAO, PhD, FSA K.T. Li Professor of Economics Harvard University STEVEN KAPPEL, MPA Principal Policy Integrity, LLC JONATHAN GRUBER, PhD Professor of Economics Massachusetts Institute of Technology And a team of health policy analysts February 17, 2011 ACKNOWLEDGEMENTS We would like to thank the more than 100 individuals who met or talked with us over the course of this study, sharing their views, ideas and insights on health reform in Vermont. Without their contributions, our work would not have been possible. _________ We would also like to thank the numerous Vermonters and Vermont organizations who provided thoughtful comments and insight during the public comment period. Their efforts helped make this report better, clearer and hopefully more useful to the State of Vermont. The comments pointed out some gaps, lack of clarity and inadequate analysis in our draft report. We are deeply grateful for these comments and have revised our draft report to improve the completeness and clarity of our analysis. The comments painted a clear picture of the diversity of views, of experiences with the health care system, of the deep feelings and beliefs about what a health care system should be, and the desire to do better for Vermonters. The comments also showed a sense of trepidation at the prospect of major systemic change, despite a general agreement over the unacceptability of the status quo. Health care touches us all, in personal, professional and economic ways. Major change brings uncertainties. We strongly believe, however, that Vermont can achieve its goals and set a model for the nation for an equitable, affordable, high-performing health system.
    [Show full text]
  • Counties Have Been Busy Building More Inclusive and Smarter Safety-Net Programs
    Profiles of Progress: California Coun es Taking Steps to a More Inclusive and Smarter Safety-Net HEALTH ACCESS May 2016 Introduction Beyond the recent well-publicized expansions of coverage at the federal and state level, from the significant reductions in the number of uninsured under the Affordable Care Act to California-specific efforts to cover all children, there has also been a revolution at the local level as California counties have been busy building more inclusive and smarter safety-net programs. In just the last year, the counties of Sacramento, Contra Costa, and Monterey as well as a consortium of 35 rural counties created limited- benefit pilot programs that cover the remaining uninsured without regard to immigration status. Efforts in other counties are pending, joining counties like Los Angeles and Santa Clara that are improving existing indigent care programs to better provide primary and preventive care and a medical home. Each of these counties are profiled in this paper, which highlights these historic changes, helps provide context and analysis for the rationale for these reforms, and predicts additional advances in the near future. Ultimately, more counties can and should extend indigent care to the remaining uninsured, including undocumented immigrants, and provide more primary and preventive care that not only directly helps these families but is also more effective and efficient for our health system. For decades, California counties have been the last resort to care for low-income uninsured residents who have no other options and who would otherwise live sicker, die younger, and are one emergency from financial ruin.
    [Show full text]
  • Evaluation of the Office of Managed Care of the Los Angeles County Department of Health Services
    Evaluation of the Office of Managed Care of the Los Angeles County Department of Health Services Evaluation of the Office of Managed Care of the Los Angeles County Department of Health Services MARCH 2010 Health Management Associates March 2010 Evaluation of the Office of Managed Care of the Los Angeles County Department of Health Services Table of Contents Introduction ................................................................................................................ 1 Executive Summary ................................................................................................... 3 Findings ...................................................................................................................... 6 General Context ...................................................................................................... 6 OMC and DHS ....................................................................................................... 8 DHS, Los Angeles County and Managed Care .................................................... 11 LA Care Potential Collaboration .......................................................................... 15 Recommendations .................................................................................................... 17 Conclusion ............................................................................................................... 22 Health Management Associates March 2010 Evaluation of the Office of Managed Care of the Los Angeles County Department of Health Services
    [Show full text]