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Davis, California

Thursday, April 18, 2024

State health care leaders, UC Davis to evaluate Medi-Cal

On Feb. 9, the California Department of Health Care Services (DHCS) announced their collaboration with the UC Davis Health System’s Institute of Population Health Improvement (IPHI) in improving the state’s Medi-Cal program.

IPHI is currently hiring employees to participate in the project.

The director of IPHI, Kenneth W. Kizer, leads the five-year, $4.25 million effort. Kizer is also a distinguished professor at the UC Davis School of Medicine and School of Nursing.

“This project is one that we signed last December to work with the state’s Medi-Cal program to establish a quality improvement strategy for Medi-Cal, and to work with a particular aspect of the health care reform law that is part of the Medicaid Section 1115 waiver which allows the state to do some things under a special provision of the law,” Kizer said.

The Medicaid Section 1115 waiver is a five-year, $10 billion “Bridge to Reform” proposal. According to the DHCS, the reforms to the Medi-Cal program will take effect in January 2014.

“The Bridge to Reform waiver is basically the main vehicle we are utilizing to prepare for 2014 when the Affordable Care Act becomes law and is implemented in the state of California,” said a DHCS spokesperson.

The Affordable Care Act is a piece of legislation that will fundamentally change American health care. The Medi-Cal program improvement project is one of the goals under the act.

According to the California Association of Public Hospitals and Health Systems Director of Government Affairs and Communication Sarah Muller, there are 19 public health systems throughout California that are involved in a large-scale transformation of preparing for implementation of health reform.

Two of the larger components of the waiver are coverage expansion and the Delivery System Reform Incentive Pool (DSRIP) program.

“Public hospitals see themselves as having a dual role in health reform,” Muller said. “They will continue to serve as the major safety net provider in the community and in addition, they are preparing for the expanded role as a provider of choice.”

Muller said the state is preparing for about two million people throughout California who will be eligible by 2014 by expanding coverage to low-income individuals in advance.

“Right now, there are over 250,000 low-income adults enrolled in the program, which is called the low-income health program,” Muller said. “And the goal is to develop a smooth transition, so they can keep coverage today and enroll in whatever they’re eligible for when health reform is implemented.”

The DSRIP program allows for public hospitals to make improvements in their delivery systems. Muller said many of the delivery system efforts that public hospitals are doing are efforts they’ve been doing for the last few years at a pilot level.

“They’re dramatically expanding work they’ve been engaged in and replicating it throughout the entire hospital system,” Muller said.

Kizer said 17 counties are participating in this waiver program.

“They get additional money; an aggregate amount for the state is about $3.3 billion, and they have milestones and certain things that each hospital has to do in order to get payments,” Kizer said.

To develop a quality improvement strategy, Kizer said they need to look at what is currently being done, what the needs are, where the opportunities for improvement are, what things are being monitored and what isn’t being monitored.

“We’re hiring new staff — there is no existing staff except for me,” Kizer said. “The people who will be hired will be UCD employees who may or may not have faculty positions.”

Three service contracts were signed with the state, with numerous others still underway. Kizer said he signed one earlier this year called the Every Woman Counts program: a three-year, $1.8 million contract that works with the state to reach out to under-served women for breast and cervical cancer services. Another contract is still in state review and will focus on the adverse events that occur in surgery.

“These are primarily service contracts and there are substantial opportunities for research,” Kizer said. “We can use the data and other things that come with this for research and opportunities for education.”

Kizer anticipates that as they continue, there will be graduate students and others working on the effort to improve the Medi-Cal program.

“It’s part of what the university does,” Kizer said. “Their three-legged purpose is to teach, to educate and to do public service.”

CLAIRE TAN can be reached at city@theaggie.org.

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