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UCLA releases report on safety net integration resulting from CA’s coverage initiatives

The UCLA Center for Health Policy Research recently released a report discussing safety net integration resulting from coverage initiatives in California’s (2005 and 2010) §1115 Waivers. The new study is an extension of an earlier UCLA assessment that summarized the development of provider networks and medical homes from the 2005 Health Care Coverage Initiative (HCCI). Surveys and interviews were conducted in the 10 legacy counties: Alameda, Contra Costa, Kern, Los Angeles, Orange, San Diego, San Francisco, San Mateo, Santa Clara and Ventura.

The study focused on which components of an integrated delivery system model each county implemented and which supportive services were provided to strengthen the HCCI/LIHP networks. An integrated delivery system model includes six key characteristics:

  1. A single integrated entity which is responsible for providing all services and has financial and clinical accountability for the health of a defined population,
  2. Patients have easy access to appropriate care which includes same-day, after hours and culturally competent care,
  3. Care is coordinated into a continuum of services in which administrative supports enhance quality,
  4. Patient information is available to all providers across the continuum at the point of care,
  5. Quality improvement activities and performance measures are used to improve health outcomes and enhance patient experience; and
  6. Financial incentives are aligned to create accountability and efficiency and improve quality.


Notable findings from the report provide strategies for building provider networks and incorporating these providers into an integrated delivery system. The findings include:

  • Highlighting the benefit of utilizing a third party administrator and pharmacy benefit manager for support services,
  • Encouraging establishing and operating referral management systems to improve access to specialty care; and
  • Promoting investing in information technology to enhance quality improvement and system integration.

Each of the 10 counties surveyed made significant progress toward system integration as a result of the HCCI/LIHP programs.  Despite rising health care costs, lower government budgets and a greater number of uninsured, county safety nets have proven to be an effective source of care.


To access the full report, click here.

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