Author: Sara Watson


2015 Workgroups

ITUP conducted a series of regional and statewide issue workgroups in 2015.  Regional workgroups are hosted throughout the state and focus on the health needs of local communities. The statewide issue workgroups focus on key health reform implementation issues facing California.  Executive summaries are available here to provide an overview of the main topics of discussion, ranging from local enrollment success and challenges, local reform initiatives, and developing issues.  Below,  please find all 2015 workgroup materials.

 

ITUP Los Angeles Health Collaborative

December 16th at The California Endowment, Los Angeles, CA.

Materials:  AgendaPanelist BiographiesLos Angeles County Enrollment SuccessesCalifornia §1115 Waiver Renewal Highlights ,  CA Quick FACTs,  Open Enrollment: Feedback from the Field,  CA County Behavioral Health ProfilesMedi-Cal Managed Care SummarySolo & Small Group Practices Summary, & Care, Coverage and Financing for Southern California’s Remaining Uninsured.

 

Small Business Issue Workgroup

November 24th from 11:30am-2:30pm at The California Endowments, Sacramento & Los Angeles

Materials:  Small Business Workgroup AgendaLessons from the Small Business Health Options Program: The SHOP Experience in California and Colorado.

 

Inland Empire Regional Workgroup

November 10th at Inland Empire Health Plan

Inland Empire Workgroup Materials:  Inland Empire Enrollment Successes,  CA Quick FACTs,  Statewide ITUP Workgroups Executive SummaryOpen Enrollment: Feedback from the Field,  CA County Behavioral Health ProfilesMedi-Cal Managed Care SummarySolo & Small Group Practices SummaryCare, Coverage and Financing for Southern California’s Remaining Uninsured2015 Health Care Financing Report California’s Drug Medi-Cal Waiver Is a Big Deal: Here’s Why, & ACA Section 1332 Opportunities.

 

North Rural Regional Workgroup (October 27-29, 2015) 

Mendocino County Regional Workgroup: October 27, 2015 from 12:30pm-3:30pm at The County Executive Office

Humboldt County Regional Workgroup: October 28, 2015 from 11:30am-2:30pm at Humboldt Bay Aquatic Center: 921 Waterfront Drive, Room 211, Eureka, CA 95501

Shasta County Regional Workgroup: October 29, 2015 from 11:00am-1:30pm at Health Alliance of Northern California: 2280 Benton Drive, Building C, Suite C, Redding, CA 96003

North Rural Workgroup Materials: CA Quick FACTsStatewide ITUP Workgroups Executive SummaryNorthern Rural Executive Summary 2014, Open Enrollment: Feedback from the Field,  CA County Behavioral Health ProfilesMedi-Cal Managed Care SummarySolo & Small Group Practices SummaryCare, Coverage and Financing for Southern California’s Remaining Uninsured2015 Health Care Financing Report California’s Drug Medi-Cal Waiver Is a Big Deal: Here’s Why, & ACA Section 1332 Opportunities.

Additional:  Fine Print: Exchanging Behavioral Health Information in California

 

Central Coast Regional Workgroup

September 25th from 11:30am-2:30pm at Sierra Vista Regional Medical Center, San Luis Obispo, CA

Materials: CA Quick FACTsStatewide ITUP Workgroups Executive SummaryCA County Behavioral Health ProfilesMedi-Cal Managed Care SummarySolo & Small Group Practices SummaryCare, Coverage and Financing for Southern California’s Remaining Uninsured2015 Health Care Financing Report California’s Drug Medi-Cal Waiver Is a Big Deal: Here’s Why, & ACA Section 1332 Opportunities.

 

Behavioral Health Issue Workgroup

September 24th in Los Angeles (Community Clinic Association of Los Angeles County) & Sacramento (The California Endowment)

Materials: AgendaCA County Behavioral Health Profiles,  California’s Drug Medi-Cal Waiver Is a Big Deal: Here’s Why, & Fine Print: Exchanging Behavioral Health Information in California.

 

Webinar on §1332 Waiver  

Please click here to be directed to the webinar recording.

 

Los Angeles Health Collaborative

August 19th from 1:00pm-3:00pm at The California Community Foundation

Materials:  AgendaBOS Preliminary TranscriptHealth Agency Integration Amendment by Supervisor Hilda L. Solis

 

San Diego Regional Workgroup

August 14th from 11:30am-2:30pm at The Council of Community Clinics- San Diego

Materials: CA Quick FACTsStatewide ITUP Workgroups Executive SummaryCA County Behavioral Health ProfilesMedi-Cal Managed Care SummarySolo & Small Group Practices SummaryCare, Coverage and Financing for Southern California’s Remaining Uninsured2015 Health Care Financing Report

 

California Legislative Briefing in D.C.

July 31, 2015  1416 Longworth House Office Building

Materials: CA Quick FACTsStatewide ITUP Workgroups Executive SummaryCA County Behavioral Health ProfilesMedi-Cal Managed Care SummarySolo & Small Group Practices Summary,  California’s Remaining Uninsured EXERPT

 

Orange County Regional Workgroup

July 8th from 11:30am-2:30pm at Coalition of Orange County Community Health Centers

Materials: Care, Coverage and Financing for Southern California’s Remaining UninsuredBehavioral Health: Profile of Six California CountiesDrug Medi-Cal Waiver SummarySummary of DHCS Waiver RenewalSolo and Small Group Practices

Grand Jury reports recently released regarding Orange County’s behavioral health system from workgroup participants: Orange County – Grand Jury Mental Health ReportOrange County Grand Jury Report on Mental Illness

 

Bay Area Regional Workgroup

May 6, 2015 from 11:30am – 2:30pm

Materials: Summary of DHCS Waiver RenewalWhere Are We GoingSolo and Small Group PracticesMedi-Cal Managed Care: Raising the Bar for Quality & Outcomes

 

Medi-Cal Managed Care Issue Workgroup 

May 7, 2015 from 11:30am – 2:30pm, video conference between Sacramento and Los Angeles

Materials: Medi-Cal Managed Care: Raising the Bar for Quality & Outcomes

 

Sacramento Legislative Briefing

April 10, 2015 at The Capitol in Sacramento

Materials below: Sacramento Briefing AgendaSouthern California Waiver ThoughtsWhere Are We GoingSolo and Small Group PracticesMedi-Cal Managed Care: Raising the Bar for Quality & OutcomesWorkgroup Summaries

North Central Regional Workgroup

April 9, 2015 at Partnership Health Plan of California

Materials: AgendaNorth Central Executive Summary 2014Summary of DHCS Waiver RenewalWhere Are We GoingSolo and Small Group PracticesMedi-Cal Managed Care: Raising the Bar for Quality & Outcomes

 

For the 2015 Executive Summaries, please click here.

For 2014 and 2013 Workgroup information and materials, please click here.  

 

Summary of WalletHub article, “2015’s Rates of Uninsured by State Before & After Obamacare”

Using data from the US Census Bureau, WalletHub measured the uninsured rates, after the implementation of the Affordable Care act, in all 50 states and the District of Columbia.  Rates have been broken down to state levels. Commentary and methodology can be found here.

In addition to overall insurance rates, states were compared based on age, race/ethnicity, income and type of insurer.  An overall rank of No. 1 was awarded to the state with the lowest uninsured rate, Oregon.  California was ranked # 4 nationally in reducing its numbers of uninsured, following Oregon, Nevada, and Kentucky.  California ranked 36th out of all the states with an average uninsurance rate of 12.5% in 2014, after the implementation of the ACA.  Also, all but 10 states saw an increase in employer-based insurance from 2010 to 2014. States that did see a decrease saw only small declines in the rates of employer-based insurance.

The data shows the implementation of the ACA continues to be successful in reducing the number of uninsured and increasing health insurance throughout the country — even more pronounced in states that expanded their Medicaid programs as indicated in the map below.

WalletHubMap

 

 

 

 

 

 

20th Annual ITUP Conference

20th Annual Insure the Uninsured Project
Celebration Dinner and Conference

[Conference 2016] Email HeaderFebruary 8th and 9th at the Sacramento Convention Center

Registration is now open!

This year’s ITUP conference will focus on steps to close the coverage gaps and move Californians into a culture of health and wellness. Conference sessions will present a vision for the future of health reform, look at how to lay the foundations for a better integrated system, examine the implementation of California’s reforms today, and look closely at how we are improving our current systems and patient outcomes.

For more information, please see the conference webpage.

We’ve gone mobile this year. Download our app now to view the agenda, access materials and connect with attendees and more: https://guidebook.com/g/ITUP2016/

ITUP Launches Search for New Executive Director

ITUP launches its search for a new Executive Director. For more information, please download the position specifications here: ITUP ED Position Specifications

You may also contact Carlson Beck for further details at:

Sally Carlson, Managing Partner,  sally@carlsonbeck.com, 415.433.2299

Heidi Holzhauer, Senior Principal,  heidi@carlsonbeck.com, 707.963.1250

 

Congratulations Congress!

The over 20% in Medicare rate reductions for physicians called for by the Sustainable Growth Rate (SGR) is repealed in legislation passing the House and Senate with overwhelming majorities.

SGR sought to link the growth in Medicare provider reimbursement to the growth in the economy. What that meant in very crude terms is that if physician payments per Medicare beneficiary increased by 10% and the growth in the economy was flat, then Medicare payments to doctors would be cut by 10%. No significant changes were made to the ways in which providers were reimbursed by Medicare that would have allowed the program to live within the SGR cap. Congress was never willing to pull the trigger and cut physician reimbursements and kicked the issue down the road from year to year until the anticipated cut in 2015 now equaled more than a 20% cut in physician reimbursement rates.

Replacing the SGR are small increases in physician reimbursement and a shift from volume to value based reimbursements – i.e. reimbursements will be tied to improved quality and better outcomes. The reimbursement increases are 0.5% for 5 years, then flat for 5 years, then 0.25% increases thereafter. Value based means “alternative payment models,” patient centered medical homes, transparency of outcomes and quality improvements. A technical advisory committee would set these changes in place.

Also included is a two-year extension of the CHIP program for uninsured children, two years and $7.2 billion for community health centers, and a one-year delay to 2018 in federal Medicaid DSH cuts.

The bill’s costs are partially offset by cuts of 1% in reimbursement rates to long term care institutions and an increase in the amounts that seniors with higher incomes pay towards their Medicare coverage.

 

Posted by Lucien Wulsin

References:

Mary Ann Carey, Congress Passes a Bill to Fix Medicare’s Doctor Payments, What’s in It? (Kaiser Health News , April 15, 2015)

Kathleen Hunter, Congress Votes Raise for Doctors in US Medicare Payments (Bloomberg news, April 14, 2015)

ITUP Summary of DHCS Waiver Renewal Concepts

The concept paper includes the following: Delivery System Transformation and Global Safety Net Payments for the Remaining Uninsured. Within the Delivery System Transformation are the following six sub-elements: managed care transformation, fee for service transformation, public safety net transformation, workforce development, housing and supportive services, and regional whole person care pilots.

DHCS is seeking $15 to $20 billion over the next 5 years or $3-4 billion a year. It projects that without the waiver it would spend $269 billion over the five years and with the waiver it would reduce spending to $253 billion, thereby saving $16 billion with the waiver.

Download the full summary here: Summary of DHCS Waiver Renewal Concepts

Thank You for Attending the ITUP Conference!

February 24, 2014

Dear Colleagues,

It was great to see all of you for this year’s 19th Annual Insure the Uninsured Project Conference. The power point slides, photos and session summaries are being posted for your use at http://itup.org/conference.

I wanted to particularly commend a few of the most recent ITUP staff papers for your consideration:

John Connolly and Carolina Coleman, “Medi-Cal Managed Care: Raising the Bar”;
John Connolly, Improving the Health of Re-Entry Populations”;
Chauntrece Washington and Marina Acosta, “Solo and Small Group Practices in California”;
Kiwon Yoo, “Improving the Health of the Homeless”;
Kiwon Yoo, “2013 OSHPD Hospital and Clinic Data”;
Lucien Wulsin, “Where are We Going, Where Should We be Going?”, and
Lucien Wulsin, “Southern California Waiver Thoughts”.

These and many other ITUP staff papers prepared for this year’s conference can be downloaded at http://itup.org/conference or you can find them on the conference flash drive with the other relevant and timely research papers compiled by the ITUP staff for you.

Congratulations and so many thanks to all of you, to the staff and leadership of Covered California and of the California Department of Health Care Services for 4.5 million Californians enrolled under the ACA.

All my very best,

 

Lucien

PS: For those of you who love to plan ahead, next year’s conference is scheduled for February 8 and 9, 2016 and for those wishing to suggest particular sessions for next year’s conference, the deadline is June 1, 2015 so that they can be considered by our staff and Board.

2014 ITUP Regional Workgroups

Each year ITUP hosts a series of Regional Workgroups throughout California’s eight regions, including the Bay Area, Central Valley, Central Coast, North Central, Northern Rural, Inland Empire, San Diego and Orange County. ITUP’s workgroups serve as an opportunity for regional stakeholders to discuss local, state, and federal issues related to the implementation of health reform. ITUP hosted seven regional workgroups in 2014. To find more information about these workgroups, you may contact Sara Watson at: sara@itup.org.

In 2014, the Regional Workgroups discussed the following:

  • Covered California to inform participants about local outreach and enrollment plans while exploring issues related to counselors, affordability, QHP’s and network adequacy, etc.
  • Medi-Cal Expansion to explore the best solutions for implementation while considering issues related to provider access and behavioral health.
  • Remaining Uninsured to assess the impact of reallocated realignment funds and its effect on county’s commitment to the population.

Materials and the Executive Summaries from the 2014 workgroups can be found below:

2014 Workgroup Materials

Executive Summaries

Issue Workgroups

Bay Area Regional Workgroup

North Central Regional Workgroup

Central Coast Regional Workgroup

Central Valley Regional Workgroup

Northern Rural Regional Workgroups

General Materials

CHCF In Their Own Words Report CHCF In Their Own Words Report.pdf
Covered California Enrollment Data Covered California Enrollment Data.pdf
Covered California Enrollment Forecast 2015 Covered California Enrollment Forecast 2015.pdf
ITUP DRAFT Premium Assistance Report ITUP DRAFT Premium Assistance Report.pdf
Health Coverage for California Farm Workers Health Coverage for California Farm Workers .pdf
ITUP Remaining Uninsured Reports

What Can Californians Expect in 2014?: Analyzing our Future with the Affordable Care Act

Today, the UCLA Center for Health Policy Research conducted an informative seminar for Californians, titled ” What Can Californians Expect in 2014?: Analyzing our Future with the Affordable Care Act”

Dylan Roby, Director of The Health Economics and Evaluation Research Program at the UCLA Center for Health Policy Research discussed California’s progress on the Medi-Cal expansion and the development of the California Health Benefit Exchange as the state prepares for full implementation of the ACA.

Use the link below to access the presentation:

What Can Californians Expect in 2014?: Analyzing our Future with the Affordable Care Act (855)

 

 

The California Endowment Releases Undocumented California Youth Video and Launches #Health4All Campaign

The California Endowment releases “Dreaming of Health Care”, a video made in partnership with a group of Californian undocumented youth who are residents of Southern California and the Central Valley.

The video kicks off The Endowment’s #Health4All campaign, an effort to drive a dialog about providing a health care solution for the remaining uninsured. Estimates by the UC Berkeley Labor Center and UCLA Center for Health Policy Research say that even after full implementation of health care reform, more than three million Californians will remain uninsured with a quarter of this population being undocumented. The California Endowment proposes that Low-Income Health Programs (LIHP)—county-run, Medicaid expansion programs set to expire in 2014—be transitioned to provide health care for the remaining uninsured, including undocumented Californians.

Click here to watch the video.