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September 13, 2011
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September 13, 2011

HCR Delivery System Reform

Overview

Delivery System Reform

October 11, 2011

Delivery System Reform works to improve value relating to changes in care and payment models that reward increased quality, reduced costs, improved health of patients, and enhanced coordination of care.  Reforming how care is delivered and paid for is at the heart of health care reform for all patients with a focus on complex populations.

CHA News Article

Covered California to Host Plan Management and Delivery System Reform Webinar

April 10, 2013 Anne McLeod

Tomorrow, Covered California will host its third Plan Management and Delivery System Reform Advisory Group (health plan advisory group) webinar from 10 a.m. to 1:30 p.m. (PT). The meeting will provide input to the Covered California board and staff on qualified health plan contracting strategies and ongoing benefit design issues, as well as strategies to promote health care value and drive delivery system reform. Discussion items include standard and alternate benefit plan designs, a quality rating system, model contracts and a public comment period. To review the complete agenda, visit www.healthexchange.ca.gov/StakeHolders/Documents/Agenda_April%2011_Advisory%20Group.pdf.To register for the webinar, visit https://attendee.gotowebinar.com/register/481217006368810496.

CHA News Article

New Report Establishes Performance Baseline for Health Plans and Insurers
California Healthcare Foundation studies marketplace before ACA takes effect

March 29, 2013 Anne McLeod

A report released yesterday by the California Healthcare Foundation provides a reference point for health plans and insurers in the state before changes from the Affordable Care Act (ACA) take effect. The report uses data primarily from the California Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI) to examine market share, enrollment, financial performance, share of premiums devoted to medical care and consumer satisfaction.

CHA News Article

HHS Announces State Innovation Models Initiative Awards

February 22, 2013 Anne McLeod

The U.S. Department of Health and Human Services (HHS) today announced awards to 26 states – including California – as part of the State Innovation Models Initiative. The program provides financial support to states that design and test multi-payer payment and delivery models that improve quality and performance while lowering costs. Over the next six months, California will receive up to $2,667,693 to develop a state health care innovation plan, with funding subject to successful completion of the terms and conditions for the State Innovation Models Initiative. Information on the state awardees can be found in the attached fact sheet. For more information on the State Innovation Models initiative, visit http://innovation.cms.gov/initiatives/State-Innovations/.

Additionally, HHS released its Medicaid Moving Forward report, detailing improvements to and advancements in Medicaid and the Children’s Health Insurance Program. The report, attached below, shares examples of how states are using these tools to advance their own state initiatives.

CHA News Article

Moody’s to Request New Supplemental Data From Providers

February 8, 2013 Anne McLeod

Moody’s Investors Service has announced that it will request new supplemental data from providers for fiscal years 2011 and 2012 to better understand how they are performing under the Affordable Care Act. According to Moody’s, the request will include data on new payment arrangements and patient demand, as well as new physician data. Moody’s also will be collecting data on how hospitals are reimbursed, which will provide an indication of risk and strategy. For more information, see attached article.

CHA News Article

State Holds Online Meeting on Payment Reform

February 4, 2013 Anne McLeod

The California Health and Human Services Agency (CHHS) held its first multi-stakeholder workgroup meeting Jan. 31 on the state’s application for funding to test multi-payer payment and delivery models through a State Innovation Model (SIM) funding initiative. The SIM initiative is offered through the Center for Medicare and Medicaid Innovation (CMMI) and is intended to support states in driving large-scale reform that can transfer care into models that reward value and have potential to reduce costs and improve quality. CHHS is assuming receipt of an award under the CMMI SIM initiative, which could provide between $20 million and $60 million in federal support over a three-year period. CHA participated in this first meeting, which included a discussion of the attached “framing report” and slide presentation. The task of the multi-stakeholder workgroup is to recommend a comprehensive payment reform strategy that moves the state toward value-based care.

General information

DHCS Announces 22 Applications for Dual Eligible Demonstration

March 8, 2012 Anne McLeod

California is one of 15 states awarded a federal contract to develop new models of coordinated care for people eligible for both Medicare and Medicaid, also known as “dual eligibles.” The state has about 1.15 million dual eligibles, who tend to have many chronic health conditions and rely on services from numerous providers. Currently, only a small portion of California’s dual eligibles are enrolled in organized health care systems.

General information

CMS to Host Call on Applying for Medicare Shared Savings Program and Advance Payment Model

February 22, 2012 Anne McLeod

On March 1, the Centers for Medicare & Medicaid Services will host a national provider call on the application process for the Medicare Shared Savings Program and the Advance Payment Model. These two initiatives are intended to help providers participate in Accountable Care Organizations to improve the quality of care for Medicare patients. The call will conclude with a question and answer session.

General information

Coverage Expansion Map Tool Estimates Medicaid Eligibility

February 22, 2012 Anne McLeod

The Kaiser Family Foundation released an online tool using 2010 American Community Survey data to help individuals estimate how much, if any, they will benefit from the new Medicaid eligibility rules and the new health insurance tax credit under the Affordable Care Act. Starting in 2014, most people who are uninsured or buying individual insurance with incomes up to four times the poverty level ($92,200 for a family of four and $44,680 for a single person in 2012) will be eligible for expanded coverage through Medicaid or tax credits to subsidize the cost of private insurance.

General information

CHA Board Approves Statewide Transform for Tomorrow Task Force

February 15, 2012 Anne McLeod

On Feb 9, the CHA Board authorized creating a multidisciplinary statewide taskforce charged with developing policies, services, programs and information that will help hospitals transform for the future and guide CHA’s health care reform policy development. “We are at a critical point in time, and an intensive effort by a broad, high-level taskforce creates the best forum to assist hospitals with new and innovative ideas as they transform to meet future challenges,” said CHA Board Chair Steve Packer, MD, who has appointed the taskforce members.

General information

CBO Estimates ACA to Cost $54 Billion More Than Expected Between 2012 and 2021

February 8, 2012 Anne McLeod

The Congressional Budget Office (CBO) has released its budget forecast for fiscal year (FY) 2012 through FY 2022 in a report that projects a $1.079 trillion deficit for FY 2012. Key assumptions in the CBO projections include an increased cost of $54 billion for the Affordable Care Act (ACA) due to 1) the repeal of the CLASS Act (reducing $76 billion in premiums) and 2) correction of the modified adjusted gross income formula used to calculate Medicaid eligibility (the Medicaid “glitch”) netting revenue increases of $22 billion.

General information

CMMI Releases Year-in-Review Report

February 8, 2012 Anne McLeod

The Center for Medicare & Medicaid Innovation (CMMI) has released One Year of Innovation –  a report summarizing the initiatives it has introduced involving providers of Medicare and Medicaid beneficiaries in all 50 states. Since its launch, CMMI has focused on improving patient safety, promoting care that is coordinated across health care settings, investing in primary care transformation, creating new bundled payments for care episodes, and meeting the complex needs of the dual-eligible population.

General information

Patient-Centered Outcomes Research Institute Issues Draft Priorities

January 24, 2012 Anne McLeod

The Patient-Centered Outcomes Research Institute (PCORI) has released its first draft of national research priorities that includes five research areas: 1) comparative assessments of prevention, diagnosis and treatment options; 2) improving health care systems; 3) communication and dissemination; 4) addressing disparities; and 5) accelerating patient-centered and methodological research. PCORI was created to fund research that will offer clinicians and patients more information to support health care decisions.

General information

Innovation Summit to Be Broadcast Live Online

January 24, 2012 Anne McLeod

The Center for Medicare & Medicaid Innovation is co-hosting a Care Innovations Summit on Jan. 26 in Washington, D.C., that will bring together representatives from health professions, the insurance industry, patient advocacy, finance and government to discuss ways they can collaborate to improve patient care and health at a lower cost. Registration is closed for in-person attendance; however, the summit will be broadcast live online from 5:30 a.m. to 3 p.m. (PT).

General information

CMS Selects 6 California Organizations for Pioneer ACO Initiative
32 health care organizations selected nationwide

December 20, 2011 Anne McLeod

Out of 32 health care organizations selected nationwide to participate in the Pioneer Accountable Care Organization (ACO) initiative, six are located in California.

General information

CMS Issues Report on Health Spending by State

Image of CMS Issues Report on Health Spending by State
December 13, 2011 Anne McLeod

The Centers for Medicare & Medicaid Services (CMS) Office of the Actuary has released a report on state health expenditures for 1991-2009. The findings reflect that in 2009, the 10 states with the highest per-capita spending spent 13 percent to 36 percent more than the national average, and the 10 states with the lowest per-capital spending spent  8 percent to 26 percent less than the national average.

General information

CHCF Report Describes Implications of ACA and Impact on California

November 15, 2011 Anne McLeod

The California HealthCare Foundation has issued the third report in a series that describes implications of the Affordable Care Act (ACA) and its expected impact on California’s health care delivery system. The report, Implementing National Health Reform in California: Payment and Delivery System Changes, focuses on reimbursement changes, ACA pilot programs, grants and other provisions designed to demonstrate alternative health care delivery and payment models. The report was prepared with information provided by federal and state officials, stakeholders and thought leaders.

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