California’s Office of the Patient Advocate just released new 2016-17 health plan report cards to help guide and inform consumers as they shop for coverage during the open enrollment season which is set to begin: November 1, 2016.
The report cards rate California’s 10 largest HMOs, five largest PPOs and over 200 commercial medical groups on quality and patient experience. In addition, county-level ratings of medical groups with newly added cost ratings are also included. This on-line tool makes it easier for employers and consumers to make side-by side comparisons for choosing the right plan.
What do the Report Cards Measure?
OPA uses data from the National Committee for Quality Assurance (NCQA), a non-profit that that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. To arrive at these ratings NCQA analyzes scores on clinical performance and patient satisfaction data.
One of the ways CPEHN participated in National Minority Health Month in April was by co-hosting a panel of experts with the Asian Pacific Islander Capital Association to discuss the status of health equity among the Asian Pacific Islander (API) community. The experts highlighted various approaches we can all take to eliminate health disparities disproportionally affecting certain API communities.
What are the barriers keeping communities from achieving a healthy community?
“You can’t fix what you don’t know,” proclaimed Jonathan Tran from The California Endowment. He was referring to the lack of information and data available regarding South East Asian communities. Before funding and resources can be streamlined into building a healthier community, access to comprehensive data must exist. Since data regarding Asian Americans is characterized for as a whole, research studies are limited in their ability to accurately identify information about the issues affecting specific Asian American subgroups. When all communities are counted for and validated, the numbers can be used to implement change. The AHEAD Act — AB 1726 — addresses this necessary concern by requiring higher education institutions and public health agencies to disaggregate data for additional API groups.
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.
To effectively identify racial and ethnic disparities in health and health care, it is essential that key elements such as patient race, ethnicity, and language proficiency be collected routinely and then utilized to measure performance. There is now also great attention being given to the impact of social determinants on health disparities--including environmental factors, food insecurity, transportation, and safe housing--among others. Hospitals in Pursuit of Excellence of the American Hospital Association and the Disparities Solutions Center at Massachusetts General Hospital are hosting a webinar, “Going Beyond REaL Data Collection: Collecting Social Determinants of Health” on Tuesday, February 23rd, from 9:00 AM – 10:00 AM PT.
This webinar will discuss strategies and approaches implemented by hospitals and health care systems to collect the social determinants of health, with the understanding that this information will be critical for population health efforts of health plans, hospitals and health centers nationwide. Speakers include:
Kirsten Bibbins-Domingo, PhD, MD, MAS, Director, UCSF Center for Vulnerable Populations at San Francisco General Hospital
Lenny López, MD, MDiv, MPH, Chief of Hospital Medicine, University of California San Francisco - SFVA and Senior Faculty, the Disparities Solutions Center at Massachusetts General Hospital
Aswita Tan-McGrory, MBA, MSPH, Deputy Director, Disparities Solutions Center at Massachusetts General Hospital
California’s Office of the Patient Advocate (OPA) released its 2015-16 Health Care Quality Report Cards last week. The new report cards shed light on the quality of care under a variety of health care providers and plans, including California’s 10 largest HMOs, the six biggest PPOs, and more than 200 large medical groups covering 16 million consumers in California. The data is drawn from claims data and patient surveys.
The report cards are timely as consumers gear up for 2016 open enrollment, which begins Nov. 1, 2015, and continues through Jan. 31, 2016. With the release of the report cards, consumers should have an easier time shopping for coverage. Each HMO and PPO is evaluated on their overall medical care and for how it treats certain conditions like asthma and cancer as well as its behavior and mental health care. Further, the report card provides a deeper evaluation on how a health plan treats certain conditions through specific clinical indicators of good care. This helps consumers understand what they should expect from their coverage.
This past week was National Mental Illness Awareness Week, and on October 10, health advocates around the globe observed World Mental Health Day. These events draw attention to the prevalence of behavioral health conditions and seek to combat the stigma that surrounds them. Communities of color in the United States face significant mental health disparities and greater barriers in getting the treatment they need. Fortunately, one way the Affordable Care Act (ACA) is improving the health care system is by requiring most health plans to offer free depression screenings as a preventive health service.
This month, the Centers for Medicare & Medicaid Services (CMS) released a comprehensive report to promote equity in the Medicare program, which is relied upon by millions of older adults across the country. The report, The CMS Equity Plan for Improving Quality in Medicare, offers a four-year strategy to reduce disparities in communities of color, rural communities, and the LGBTQ population.
In today’s California Healthline, CPEHN’s Executive Director, Sarah de Guia, applauded CMS’s effort and noted the imperative of improving Medicare for communities of color and the LGBTQ population:
"We are heartened to see CMS focus on the persistent disparities impacting communities of color, the LGBT community, rural communities and persons with disabilities," said Sarah de Guia, CPEHN executive director.
"This information will provide us a path forward to understanding the impacts of health disparities and identify ways to reverse the inequities that result from them," de Guia said.
For many health advocates across California, today has been highlighted on the calendar for months. That’s because it’s the day that the UCLA Center for Health Policy Research released the results of the California Health Interview Survey (CHIS) for 2013 and 2014. As the most detailed source of health data for California’s diverse population, CHIS is instrumental to our advocacy efforts here at CPEHN as we work to eliminate the inequities faced by communities of color.
During a seminar earlier today, Dr. Ninez Ponce (a former CPEHN board member) and Dr. David Grant discussed the survey and some of the results. One exciting new feature of CHIS is that you can now access individual year data from 2011 to 2014. Before, the data was released every two years, but now the plan is to release new data each year:
"This is a significant development that will provide policymakers and others with much more timely data on the health of Californians," said David Grant, director of CHIS.
The 2013 and 2014 CHIS data is particularly interesting because it shows the impact of the Affordable Care Act’s coverage expansions. We are in the midst of the largest reduction in uninsurance rates in a generation and prior to today we were still looking for solid information on the scope of the ACA’s impact. In a new fact sheet also released today, the UCLA Center showed how the uninsured rate in California dropped significantly in 2014, thanks in large part to a large increase in Medi-Cal recipients.
The Summit will inspire physicians and healthcare providers to participate in community health efforts and to be challenged to improve health care and the quality of life in their communities. You will have the opportunity to hear from nationally acclaimed thought leaders and network with colleagues. Our keynote speakers include California Secretary of State Alex Padilla and George Halvorson, the chair of the First 5 Commission of California. We are also pleased to offer CME credits.
The BHC Summit will also be hosting a poster presentation session for current medical students. We would like to extend to any medical student an opportunity to participate in a poster presentation displaying their health care research. This is a wonderful opportunity for students to display their work and network with other health care providers. For additional information, including guidelines and application, click here.
At CPEHN, we’re always working to promote health equity on a number of fronts. Earlier this year, we joined with the DentaQuest Foundation in a nationwide effort to improve oral health equity for California’s low-income communities and communities of color. Part of the foundation’s Oral Health 2020 initiative, we are partnering with several other grantees in the state, including Latino Coalition for a Health California (LCHC), Asian Americans Advancing Justice – LA, SCOPE LA, Central Valley Health Policy Institute, and Vision y Compromiso, to build a grassroots movement for oral health.
Earlier today, DentaQuest Foundation hosted a Twitter storm with the Children’s Dental Health Project and Northeastern University’s Innovations in Oral Health to promote health equity and raise awareness of oral health disparities across the country. The discussion, using the hashtag #iamhealthequity, resulted in a lot of great information and resources for improving oral health in underserved communities. CPEHN’s founding ethnic partner and partner in the DentaQuest project, LCHC, also participated in the Twitter action today. Here are some highlights, but be sure to check out the full discussion on Twitter here: