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Delivery Systems

Payment and Delivery Systems Across California

As California’s health care landscape continues to evolve, one of the most significant areas where change can and is starting to occur is within the local health care delivery systems. There is a shift towards providing more integrated, better-coordinated care that emphasizes value, managed care, and better integrated health care […] more

California’s §1115 Waiver Renewal

California’s §1115 waiver recently expired on October 31, 2015, and HHS granted a temporary extension of the waiver until December 31, 2015.  On October 31, 2015, DHCS and CMS announced a conceptual agreement that outlines the major components of the waiver renewal. There are several improvements in the renewed waiver, while also room to continue […] more

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, […] more

Behavioral and Physical Health Service Integration in California’s Safety Net: Six County Profiles

In the wake of the Affordable Care Act’s implementation, counties throughout the State continue to strive to meet the expectations set by the new law to better serve Medi-Cal beneficiaries. This includes providing more coordinated and integrated care that leads to improved service access and quality, better health outcomes, and […] more

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 […] more

Solo and Small Group Physician Practices in California (UPDATED)

Solo and small group (fewer than 10) physician practices are an important piece in California’s healthcare landscape. They serve as access points for consumers to receive healthcare services, emphasize relationship-based continuity of care and serve the geographically and socio-economically underserved. More specifically, solo and small group physicians commonly serve ethnically […] more

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

To realize better health outcomes, Medi-Cal Managed Care (MMC) plans have many challenges to confront. Plans must tackle the tasks of ensuring that provider networks are of sufficient size, coordinated, high performing in service quality, and engaging patients to be critical partners in improving their health. These achievements require a […] more

Open Letter on the Next Section 1115 Waiver

California’s next §1115 waiver provides an important opportunity to improve health outcomes for over 10 million Californians. We wanted to share our thinking on possible directions. We have completed our nine regional workgroups throughout the state and our stakeholder convenings in Southern California counties. So these comments are informed by […] more

Upcoming Waiver – Thoughts From Southern California (UPDATED)

This four part series examines the upcoming Medicaid Waiver. Section 1 is background on waivers; Section 2 reviews California’s implementation of the Affordable Care Act; Section 3 provides 2012 data on Southern California’s safety nets on the eve of ACA implementation, and Section 4 discusses the 11 key issues brought […] more

New York’s New DSRIP Waiver & What It Could Mean in California UPDATED

New York state and CMS signed a new DSRIP waiver in April 2014. The goals are transforming the state’s health care system, bending the Medicaid cost curve and assuring quality care for all Medicaid members. The waiver puts an emphasis on transformation of the safety net, cost reduction and improved […] more