CHA News Article

California Announces Continued State Health Care Innovation Plan Efforts
Receives CMMI Round Two Design Award funding

The California Health and Human Services Agency has announced continued advancement of its State Health Care Innovation Plan. According to the agency, it has received a second grant of $3 million from the Center for Medicare and Medicaid Innovation (CMMI). Including its partnership with leading California health foundations, the investment in the effort to move the Innovation Plan forward is estimated to exceed $12 million.

“Our key foundation partners are  Blue Shield of California Foundation, the California HealthCare Foundation and The California Endowment,” said Secretary Diana Dooley. “Furthermore, CMMI has agreed to allow the Pacific Business Group on Health (PBGH) to use funds from a prior grant to provide technical assistance for delivery system transformation for the Medi-Cal health homes initiative. This technical assistance complements work PBGH has been doing on behalf of California Medicare beneficiaries for the past three years.”

California’s $3 million CMMI Round Two Design Award funding will be used for:

  1. Maternity Care Toolkit — $250,000
  2. Health Homes Provider Technical Assistance — $1.5 million
  3. Accountable Communities for Health: Develop an Evaluation Framework and Identify Data Analytics and Sharing Capacities — $500,000
  4. All Payer Database — Identify Optimal Solutions that Leverage Current California Databases—$400,000
  5. 2016 Innovation Conference — $100,000
  6. Project Management — $250,000

Additionally, some aspects of the Innovation Plan have been included in the state’s Medi-Cal 1115 waiver concepts; other aspects are being advanced through various policies and initiatives. For example, a recent state statute provides for palliative care for Medi-Cal beneficiaries.

California’s Innovation Plan sets forth three overarching goals: 1) Demonstrate significant progress toward reducing health care expenditures regionally and statewide so that the annual growth rate is in line with that of the Gross State Product by 2022; 2) Increase value-based provider payments that reward performance and reduce pure fee-for-service reimbursement to 50 percent by 2022; and 3) Demonstrate significant progress on the Let’s Get Healthy California Dashboard.

California’s Innovation Plan is organized into two main strategic components: 1) initiatives, which include four targeted health system and payment reforms; and 2) building blocks, which directly support the four initiatives and are designed to enhance overall data, transparency and accountability efforts intended to accelerate transformation throughout the state.

The core organizing principle underlying all of the initiatives is care coordination, including team-based care and linking with community-based programs. The initiatives are:

Maternity Care. Promote safe, evidence-based deliveries to improve birth outcomes, promote maternal and infant health, and reduce unnecessary costs.

Health Homes for Complex Patients. Implement and spread care models, which include coordinated, team-based care, to improve the quality of care and outcomes for medically complex patients and reduce costs associated with unnecessary emergency department visits and hospitalizations.

Palliative Care. Promote the use of palliative care, when appropriate and in line with patient preferences, by educating patients, training providers and removing any structural or informational barriers to receiving care.

Accountable Care Communities. Support development of two or three Accountable Care Community pilots, which will model how population health can be advanced through collaborative, multi-institutional efforts that promote a shared responsibility for the health of the community. Pilots will include a Wellness Trust designed to serve as a vehicle to pool and leverage funding from a variety of sources for long-term sustainability.

The building blocks are intended to address the capacities and supports necessary for success with health and health care transformation, as well as payment reforms. Designed to sustain the transformation process over the long term, the building blocks address data, transparency and accountability issues on a system-wide basis. The building blocks’ goal is to enable California to track costs and quality across diverse systems of care, promote transparency and competition, and drive continuous improvement. The building blocks are:

Workforce. Leverage and advance existing efforts to deliver team-based, culturally engaged health care services, focusing on support for training and technical assistance of key health personnel, including enhancing the ability of community-based health and other lower-cost workers to play an enhanced role, where appropriate.

Health Information Technology and Exchange. Target assistance to high-need entities and geographies developing health homes for complex patients, and support research analysis, including business case analyses, related to the take-up and spread of health technologies and data collection.

Enabling Authorities. Identify and secure policy changes that either remove barriers or create incentives to achieve the goals of the Innovation Plan. Because the initiatives proposed in the Innovation Plan build off of existing innovations and activities in California, most can be implemented without significant legislative and regulatory changes. Two requests for Medicare waivers are included.

Cost and Quality Reporting System. Build on current efforts to create a robust reporting system that promotes transparency and monitors trends in health care costs and performance.

Public Reporting. Enhance state efforts to make data on health care quality, costs and population health – especially focusing on the Let’s Get Healthy California goals and indicators – readily available and accessible to stakeholders and the general public.

Payment Reform Innovation Incubator. Support an expanded private-public forum to facilitate payers, providers and purchasers to build consensus on methods for developing and implementing new payment reform methods, and for calculating costs and impacts of payment reforms.

California’s Innovation Plan is projected to yield savings of $1.4 to $1.8 billion over three years – a more than 20-fold projected return on the potential $60 million investment. For more information, see the following resources: