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Secretary Belshé at CPCA’s Annual Conference

Yesterday, our friends at the California Primary Care Association (CPCA) held their 2010 annual conference, entitled “Community Clinics and Health Centers: Response, Reform, Resiliency.

Secretary of California Health and Human Services Agency Kim Belshé gave the opening speech at CPCA’s very impressive gathering.

Here are some of the major take-aways from Secretary Belshé’s remarks.

• Health reform is one of the most sweeping changes to social policy in well over a generation.
• The federal reform law is very similar in approach to California’s efforts to pass statewide health reform in 2007. At root, both reforms were based on the principle of shared responsibility, the idea that everyone will have to take responsibility and contribute for our health care system to improve.
• If we do, there is the potential to move forward in some big ways. Yet we must keep in mind to not let the desire to have a perfect system get in the way of making the system much better that it is today.

The Governor’s Implementation Task Force
• The Secretary once again outlined the Task Force’s goals and priorities.
• Ultimately, the Task Force will be creating a road map of implementation plans for the transition to the next Gubernatorial administration.
• The transition document will outline important dates and milestones, as well as all of the federal financial grants and support available under reform (of which the state is tracking closely, having received more than $25 million in federal grant money to date).

The California Health Benefit Exchange
• The Exchange is health reform’s most complex and novel component
• While most states are still contemplating the Exchange and deciding whether to move forward, we are the first in the nation to get started on it.
3 Principle Exchange Goals: (1) lower cost coverage options for individuals and small business so they have the advantage of a big pool; (2) single entry point to the system, allowing for easy use of tax credits and cost sharing subsidies; (3) having the Exchange partner well with Medi-Cal, agents/brokers, navigators, clinics, etc.
• There were lots of questions answered in the Exchange bills that passed this year, but lots of other important questions left for the Exchange and lawmakers to answer next year and beyond. Major questions left to be answered include: (1) what will be the standards and obligations for participating plans; (2) how will the single point of entry look, and (3) will the benefits in the Exchange be above those required by the federal law, and if so, in what areas and by how much.

How California Can Achieve Successful Implementation
• Recognize that implementation is both a sprint and a marathon. This will be a long effort, but “2014 is basically tomorrow.” State needs to take action now in order to lay the foundation successfully.
• Recognize that “coverage isn’t enough.” We need to focus on coverage, but also on value — to think about what we’re buying, improved outcome and performance. There are powerful tools in federal reform to drive toward improved outcomes and lower costs.
• Commitment to a Culture of Prevention & Wellness. Reform is all about Care Coordination and Integration / Patient focus, community based attention and collaborative networks, with other providers.
• Be flexible. Everyone will need to be able to change the way they do business to adjust to new incentives in new system,
• Recognize that there isn’t yet a social consensus on the need for reform… everyone, particularly those that work in communities, has this responsibility to share information on reform and how it will be helpful.