Archive for June, 2019

Highlights from the 2019 Northern California State of Reform Health Policy Conference

Highlights from the 2019 Northern California State of Reform Health Policy Conference

The 2019 Northern California State of Reform Health Policy Conference provided valuable insights into the state’s current administration and possible future healthcare policy changes.

Expert panelists, including keynote speaker Assemblyman Jim Wood, discussed Governor Gavin Newsom’s plans to focus on improvements to the public insurance option (eg: Medi-Cal), mental health treatment, planning for aging populations, and lowering generic prescription costs. Other discussions at the gathering included use of technology, increased focus on social determinants of health, and collaboration with community care workers for better overall health outcomes.

Common challenges for health systems include billing complexities, providing sufficient resources and personnel, and member engagement and compliance across various health measures. 

  • The social determinants of health are essential for whole-person care, and have spurred the creation of managed care programs by all stakeholders. These programs address non-clinical risks including screening challenges, the inability to bill through standard claims processes, lack of community resources to refer patients to, and disjointed care between clinical and social service systems.  Sacramento Covered and Blue Shield’s Promise Health Plan discussed the new work they were doing in both screening and addressing Social Determinants of Health (SDoH).  
  • Telehealth has been a solution proposed by numerous plans to achieve network adequacy for both mental health and primary care services. However, the ability to measure quality in telehealth poses an obstacle, but could be achieved through real-time quality measurement technology.   
  • Governor Newsom’s plan for the aging population includes increased resources to meet demands for: 
  • As discussed by panelists, the difficulties in mental health integration remain omnipresent. Patients may never receive follow-up treatment after an event, mental health settings are continually stigmatized, and mental health and substance abuse screenings are underutilized. One bright spot is for organizations who provide all services under one roof – focusing on whole-person care, and providing a de-stigmatized environment that is effective in combating these issues.

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Pharmacy Quality Alliance Annual Meeting

Pharmacy Quality Alliance Annual Meeting

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John O’Brien (DHHS) with Siddhartha Sinha (Cozeva) at the PQA Annual Meeting

This year’s Pharmacy Quality Alliance (PQA) Annual Meeting focused on embracing innovation. The keynote speaker – John O’Brien, a senior advisor at the U.S. Department of Health and Human Services discussed utilizing tools like Cozeva to deliver data in real time to providers in an accessible and user-friendly manner. We spoke to Mr. O’Brien after his speech and he actually said “I don’t know why more people don’t use Cozeva – it’s so intuitive!”

In addition to Cozeva’s intuitiveness, we are working on more ways to broaden the scope of our data around the whole person by thinking about health beyond the clinical data and incorporating social determinants of health . Our aim is to give our clients control of the resources so they can leverage our technology to engage patients outside of the healthcare system.

Another session we attended addressed the influence of risk adjustment on quality improvement programs. When comparing outcomes, what would your quality performance be if your population was on the same playing field irrespective of risk? Well, risk adjustment can help level the playing field. At Cozeva, our risk package helps you  understand and improve the care and coding specificity of your members. Our workbooks help you target the risky population based on average Cozeva risk scores or geography (geo map tool) which can affect risk adjustment.

PQA recommended ways to engage patients outside the traditional healthcare system, identify barriers for the patients and measure outcomes. Learn more about how Cozeva can help connect, measure, and act on real time data in order to transform your organization. Contact Eni Aligbe to learn more….

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