Creation of Safety-Net-Based Provider Networks Under the California Health Care Coverage Initiative: Interim Findings

Roby, Dylan H.; Reifman, Cori; Davis, Al; Diamant, Allison; Meng, Ying‐Ying; Kominski, Gerald F.; Kally, Zina; Pourat, Nadereh

doi:10.2139/ssrn.1568971

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…28 However, in order to really 26 For example, a vast array of public and private providers participate in the safety-net provider networks organized under the 10-county Health Care Coverage Initiative in California. See Roby et al 2009. 27 LSUHCSD 2008 A study by Jiang and Blake, 2008, and unpublished data make the comparison, we need more years' worth of data on a broader set of medical services as well as other aspects of the experience of receiving health care such as patients' comfort level in community clinics versus private physicians' offices and their ease of access to specialists.…”

Section: Discussionmentioning

confidence: 99%

Access to Care versus Access to Coverage: What Can We Learn from the Louisiana State Hospital Model?

Clark

2010

World Med & Health Policy

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Publicly-funded direct access-to-care models are so clearly inadequate in most of the United States that little attention has been devoted to them as alternatives to insurance expansions for low-income populations. Louisiana's state hospital system is an unusually comprehensive access-to-care model in a particularly poor state. This paper describes a series of improvements made in the Louisiana State University (LSU) hospital system under the rubric of a healthcare effectiveness campaign begun in 1997. They have made Louisiana's access-to-care model a workable avenue for providing healthcare services for its low-income population. But financial instability and shortfalls threaten the sustainability of the LSU hospital system both in terms of annual operating budgets and money for capital improvements.

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Section: Discussionmentioning

confidence: 99%

Access to Care versus Access to Coverage: What Can We Learn from the Louisiana State Hospital Model?

Clark

2010

World Med & Health Policy

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“…These assessments revealed that some counties had implemented organized networks before the start of the program, while others used the program as a vehicle for developing or expanding their networks. 20,21 These assessments captured the use of thirdparty administrators and pharmacy benefit managers, which are organizations that deliver network administrative support such as member services or pharmaceutical support services, including drug utilization review and pharmacy network management. In addition, the assessments tracked the availability of disease and case management services, specialty referral guidelines and tracking, educational materials and resources, and clinical practice guidelines, as well as the use of telemedicine to increase access to enrollees.…”

Section: Interim Assessments Of California's Local Safety-net Initiatmentioning

confidence: 99%

In Ten California Counties, Notable Progress In System Integration Within The Safety Net, Although Challenges Remain

et al. 2012

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When fully implemented, the Affordable Care Act will expand insurance coverage to the currently uninsured, and experiments in delivery and payment under the law's auspices could produce greater efficiencies in how care is delivered. Both factors may accelerate the development of one viable model to streamline care, integrated delivery systems--coordinated care networks that deliver all needed health services to a defined population. Through interviews and surveys, we examined ten California counties that participated in two federally and locally funded initiatives to redesign how care is delivered to predominantly poor and uninsured populations. We found substantial progress in assessing and managing access to specialists, monitoring and promoting quality, and offering disease management and care coordination training in a majority of counties. However, efforts to coordinate care, electronically disseminate patient information, and align financial incentives were less successful or more difficult to assess. We posit that integrated delivery systems could improve care efficiency and quality and make countywide safety-net systems a desirable source of care for newly insured patients under health reform.

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Impact of Patient-Centered Medical Home Assignment on Emergency Room Visits Among Uninsured Patients in a County Health System

et al. 2010

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The Medical Services Initiative program--a safety net-based system of care--in Orange County included assignment of uninsured, low-income residents to a patient-centered medical home. The medical home provided case management, a team-based approach for treating disease, and increased access to primary and specialty care among other elements of a patient-centered medical home. Providers were paid an enhanced fee and pay-for-performance incentives to ensure delivery of comprehensive treatment. Medical Services Initiative enrollees who were assigned to a medical home for longer time periods were less likely to have any emergency room (ER) visits or multiple ER visits. Switching medical homes three or more times was associated with enrollees being more likely to have any ER visits or multiple ER visits. The findings provide evidence that successful implementation of the patient-centered medical home model in a county-based safety net system is possible and can reduce unnecessary ER use.

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Creation of Safety-Net-Based Provider Networks Under the California Health Care Coverage Initiative: Interim Findings

Cited by 4 publications

References 21 publications

Access to Care versus Access to Coverage: What Can We Learn from the Louisiana State Hospital Model?

Access to Care versus Access to Coverage: What Can We Learn from the Louisiana State Hospital Model?

In Ten California Counties, Notable Progress In System Integration Within The Safety Net, Although Challenges Remain

Impact of Patient-Centered Medical Home Assignment on Emergency Room Visits Among Uninsured Patients in a County Health System

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