Below, please find a message from our Executive Director, Lucien Wulsin.
ITUP’s goals for 2014-15 were to build on and accelerate the first year’s successes in Affordable Care Act (ACA) enrollment and to begin building consensus on the necessary next steps in the health reform process to improve health status and lower the costs of care. These included: integrating behavioral and physical health (whole person care), developing the health workforce in medically underserved communities, refining the performance of Medi-Cal managed care, improving the affordability of Covered California and delivery system reforms, and exploring the opportunities of e-medicine.
We were deeply engaged over the past year in the care and financing of the remaining uninsured in Southern California counties, the development of the §1115 waiver renewal concepts, and the transformation of local safety net systems. Many of the concepts developed, discussed, and recommended in our interviews and convenings with Southern California stakeholders were incorporated in the state’s concepts for the waiver renewal.
We updated our ObamaCare educational materials and trained Southern California clinics and community groups through webinars, convenings, and presentations to help consumers enroll in the newly available coverage. We monitor, analyze, and report annually on the trends and impacts of the ACA on usage of hospital inpatient, outpatient, and emergency room services, as well as community clinics. Covered California continued to grow to 1.3 million newly enrolled; Medi-Cal managed care enrollment grew by over 55% and reached over 12 million beneficiaries in July of 2015. Meanwhile, clinics have reported an increase in visits by patients with Medi-Cal and private coverage, accompanied by a 28% decrease in uninsured. In fact, California’s uninsured rate is about half of what it was prior to the ACA, and California is among the top five states most successful in reducing the numbers of uninsured.
There is an emerging need to better explain the new coverage to those newly eligible, and to educate the newly enrolled on the importance of prevention and primary care, rather than waiting for their health to deteriorate to the point of requiring emergency services. We worked with clinics, plans, and community-based organizations through our regional workgroups to identify and to begin addressing these educational needs.
In some communities, the supply of health care professionals is simply insufficient to meet the community’s needs. We prepared a report and convened a workgroup to discuss how to improve participation by solo and small group practices in Medi-Cal managed care. We discussed the potential of e-medicine to help alleviate shortages and highlighted its potential at our annual conference. We also emphasized these workforce needs as an issue to be addressed in the state’s §1115 waiver renewal.
Those with mental illness and substance use disorders receive treatment in three separated programs, with patient confidentiality protections that prohibit information sharing by their providers. Better-integrated and coordinated care has enormous potential and demonstrated capacity to improve their patient outcomes and reduce health costs. We prepared reports, held an issue workgroup, convened Los Angeles stakeholders, and discussed these challenges in our regional workgroups as well as at the annual conference. California has expanded mental health, and recently sought and secured federal approval to expand substance use disorder treatments over the past year. Our workgroups and reports have helped to educate our networks on these developments.
At this year’s annual conference, we featured two well-attended and much appreciated sessions on payment and delivery system reforms in the public and private sectors. In addition, we prepared a report and organized an issue workgroup on payment reforms in Medi-Cal managed care programs.
We also prepared a report and held an issue workgroup on local and state opportunities to improve affordability of Covered California premiums through augmented premium assistance. Healthy San Francisco is the first community to embrace this opportunity.
Our staff has been unstinting in their efforts to support our networks in their efforts to increase care and coverage for California’s remaining uninsured and newly insured. California could not be a leader without the efforts of all of you.
We deeply appreciate and are enormously grateful for the generous support of our funders: Blue Shield of California Foundation, The California Endowment, Kaiser Permanente, The California Wellness Foundation, California Community Foundation, California HealthCare Foundation, and L.A. Care Health Plan.
Best wishes for the New Year and thank you all for the extraordinary opportunity to work with each of you.
Lucien Wulsin Jr.