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UPDATED: Covered California Votes on Disparities Reduction Efforts

UPDATED: Covered California Votes on Disparities Reduction Efforts

Covered California’s Board of Directors voted on April 7th to require Qualified Health Plans (QHPs) selling insurance in the Exchange to reduce health disparities for their enrollees starting in 2017. Under this new initiative health plans will be provided with incentives for showing year-over-year improvement in key target areas where disparities are well-documented: diabetes, hypertension, asthma, and mental health. To achieve these goals, health plans will also be required to increase the percentage of self-reported demographic data of their membership annually with an 80% goal by the end of 2019.

“We are raising the bar not just for California but for the nation,” declared Peter Lee, Executive Director of Covered California. Covered California’s new contract requirements included as part of Attachment 7 to the QHP contract, includes 45 separate and distinct new requirements on plans focused on improving the quality of care for Covered California enrollees. These new requirements which were the culmination of six months of stakeholder discussions led by Covered California’s Chief Medical Officer, Dr. Lance Lang also include important new requirements to improve hospital safety and promote primary prevention and wellness, amongst other initiatives.

“Communities of color are disproportionately impacted by chronic diseases, the leading cause of death in the United States and the largest contributor to health care costs,” noted Cary Sanders, CPEHN’s Director of Policy Analysis. For example, Latinos and African Americans in California are twice as likely to be diagnosed with and to die from type 2 diabetes.[i] Despite significant health disparities, not all health plans or systems are effectively measuring health outcomes for California’s most vulnerable populations, or targeting groups for improvement, noted Anne Price, Covered California’s Director of Plan Management. Covered California’s landmark initiative will change all that by requiring health plans to track, trend and improve disparities in diabetes, hypertension, asthma and mental health care over time.

“I want to echo how delighted I am in terms of the ambitious steps being outlined, it is exactly these types of bold and ambitious steps that we need in California to really make an impact on reducing the health disparities that are burdening many in our communities,” said Covered California Board Member Genoveva Islas.

The Board discussion was followed by public testimony from CPEHN and other stakeholder groups including Asian Americans Advancing Justice-Los Angeles, the California Immigrant Policy Center, Consumers Union, Health Access, the LGBT Health and Human Services Network, the National Health Law Program, SEIU State Council, Western Center on Law & Poverty, and others.

“These contract requirements will save lives and result in better health outcomes for all,” added CPEHN’s Sanders. Michelle Cabrera, Healthcare and Research Director at SEIU State Council, acknowledged that this new initiative which has set a national precedent “will ensure health disparities are not overlooked or worsened as part of broader quality improvement initiatives in state exchanges.” While this is a significant step forward, advocates urged the Exchange to focus on reducing disparities for other vulnerable populations including LGBTQ, disabled, and Limited English Proficient populations moving forward. For more information on these initiatives and to view the Board meeting discussion, click here.

[i]  “Californians with the Top Chronic Conditions: 11 Million and Counting,” California Health Care Almanac 2015. California Health Care Foundation, April 2015.

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