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.
February is National Children’s Dental Health Month, and we have a reason for you to smile. More kids than ever before have dental coverage in California. Pediatric dental coverage is included in all Covered California health plans thanks to policy changes implemented last year, and all children enrolled in Medi-Cal also have dental coverage. This coverage opens the door to preventive dental services, such as exams, fluoride treatments, and more. There is also coverage for treatment of problems, such as fillings and other needed care.
Expanded coverage is especially significant for low-income children and communities of color facing stark inequities in oral health. According to a report by the California Pan-Ethnic Health Network, the disparity in oral health between poor and affluent children in California is the worst in the nation. African American and Latino children are less likely to have seen a dental provider and often wait longer between visits. When children don’t have good oral health and get the care they deserve, they are at risk for missing school and performing poorly in class, and they often end up in the emergency room for preventable dental problems that become costly when left untreated.
Dental coverage and learning how to use that coverage to get preventive services is the foundation for kids to have healthy teeth. Many families, however, may not know their kids have coverage or how to get dental care. That’s why The Children’s Partnership developed brand new flyers to help families learn how to navigate their children’s dental coverage.
“The Community-Centered Health Homes model has spurred a phenomenal transformation in our community and our clinic. CCHH is a way to make the connection to what we’re doing in the community to the services & treatment that we provide in the exam room.”
A new Prevention Institute (PI) brief outlines what we’ve learned in advancing the Community-Centered Health Homes (CCHH) model across the country since it was first released five years ago. PI originally developed the CCHH model to provide a framework for healthcare organizations to systematically address the community conditions that impact their patients. By implementing activities based on community needs rather than medical treatment needs alone, we can improve health, safety, and equity outcomes.
In the five years since the first report release, the CCHH model has catalyzed action and activity in communities across the country - including California, the Gulf Coast Region, North Carolina, and Texas. The brief reviews and analyzes what we’ve heard from healthcare organizations actively involved in community change – particularly clinics doing early testing of the CCHH model – and summarizes lessons learned, recommendations for success, and common themes that have emerged for healthcare organizations and funders looking to implement the model. The brief was funded by The Kresge Foundation.
It was really exciting to see California front and center this year at Families USA’s 2016 Health Action Conference. Sometimes when we are entrenched in the work, we often forget to reflect on our successes and the tremendous grit, collaboration, and leadership that go into it all. We were humbled as Dr. Bob Ross, President and CEO of The California Endowment, and Marielena Hicapie, Executive Director of the National Immigration Law Center, reminded us just how far California has come but also how much more work there still is to do. Later, we were absolutely thrilled to see our colleague and friend, Reshma Shamasunder, former Executive Director of the California Immigrant Policy Center, honored as the Health Equity Advocate of the Year.
Since 1992, CPEHN has been working to improve the health of communities of color in California, and in 2015 we embarked on an exciting new project around oral health equity. Since last year, we have been preparing to conduct a multicultural community needs assessment throughout the state.
We partnered with nine community organizations representing diverse constituencies and health needs. These core partners are Asian Health Services and Roots Community Clinic in Oakland, Sacramento Native American Health Center, Centro Binacional para el Dessarrollo Indigena Oaxaqueno in Fresno, Korean Resource Center and Black Women for Wellness in Los Angeles, Latino Health Access in Orange County, Nile Sisters in San Diego, and the Inland Empire Immigrant Youth Coalition.
Our core partners have started hosting community discussions to identify oral health needs, barriers, possible solutions, and perspectives. In the past couple weeks, I had the opportunity to attend community discussion sessions in Los Angeles coordinated by Black Women for Wellness and in San Diego coordinated by Nile Sisters.
As Covered California’s third open enrollment period fast approaches, a new report sheds some light on the state’s remaining uninsured and finds that roughly half are eligible for either Medi-Cal or subsidized coverage through Covered California. Earlier this week, the Kaiser Family Foundation released New Estimates of Eligibility for ACA Coverage among the Uninsured, which looks at the over 32 million remaining uninsured across the country after the first two years of the Affordable Care Act (ACA) coverage expansions.
Nationally, the report shows the devastating impact of many states’ refusals to expand Medicaid. Roughly one-tenth of the remaining uninsured in the U.S. – over 3 million individuals – would fall into the coverage gap and could have been covered had their states decided to expand Medicaid as stipulated in the ACA.
But the report also looks at the remaining uninsured at a state-by-state level, and with this analysis we see that over half (53%) of California’s more than 3.8 million uninsured are eligible for either Medi-Cal (37%) or for subsidized coverage in Covered California (16%). These numbers show that while we have cut our state’s uninsured population nearly in half over the past three years, we still have an opportunity to continue this dramatic improvement. With another open enrollment period on the horizon, it is imperative that there are sufficient outreach and enrollment efforts, particularly in low-income areas, communities of color, and Limited English Proficient populations to maximize participation by the eligible population.
As we discussed earlier this month, the American Public Health Association (APHA) is currently in the middle of a four-part series of webinars, The Impact of Racism on the Health and Well-Being of the Nation. Today, APHA’s third webinar, Unequal Treatment: Disparities in Access, Quality and Care, covered a variety of topics, including inequities in access to care for low-income communities and communities of color, the role of implicit biases in health disparities, and the impact of historical trauma on health.
The event featured an impressive lineup of speakers, including Brian Smedley from the National Collaborative for Health Equity, Michelle van Ryn from the Mayo Clinic College of Medicine, and Linda Rae Murray from the University of Illinois School of Public Health. The presentations showed that while we have come a long way in regards to expanding coverage, access issues prevent many in low-income areas and communities of color from getting the best possible care. Also, racism and other biases result in additional barriers to care for these populations.
At CPEHN, we see racism as one of the leading social determinants of health and in order to achieve health equity it will be necessary to eliminate the barriers racism poses as communities of color strive to live healthy lives. We appreciate APHA’s efforts to further this important discussion with events like today’s webinar.
Here are some highlights from the event, which was recorded and will be available to stream on APHA’s website.
Smedley pointed to the disparities that remain despite the coverage expansions of the Affordable Care Act, particularly in low-income communities.
Over 100 advocates from across the state gathered at the Sierra Health Foundation in Sacramento earlier today for CPEHN’s sixth Focus on Equity: Communities of Color in a Post-ACA California convening. The event, co-hosted by OnTrack Program Resources, highlighted a number of topics that impact health in California’s communities of color, including health care quality, behavioral health integration, and access to health care for the remaining uninsured, particularly undocumented immigrants.
After the popularity of our events in Oakland, Fresno, Los Angeles, San Diego, and Riverside, we were invited by OnTrack to continue the discussion in the state capital. The event began with a presentation by CPEHN Executive Director Sarah de Guia that touched on each of the event’s topics.
She focused on how communities of color, who represent a majority of the state’s population, have the most to gain from successful implementation of the Affordable Care Act (ACA). She also pointed to the increased enrollment of Latinos and African Americans during Covered California’s second open enrollment period as a sign that the law’s programs are starting to have their intended impact.
With last month’s Supreme Court ruling affirming that the Affordable Care Act (ACA) is here to stay, advocates and decisionmakers can turn to building on the law’s success, such as closing the Medicaid gap, improving the value of care, and eliminating the “family glitch.” Another top priority in this next phase of health reform is making good on the promise of health care for all, regardless of immigration status. This includes the approximately 11.2 million undocumented immigrants who live and work in our country.