California healthcare foundation

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					California HealthCare
California State Rural Health Association

December 4, 2007
 California HealthCare Foundation

  Expand access to affordable, quality health care
  for underserved individuals and communities
  and to promote fundamental improvements in
  the health status of the people of California

   History:     Founded in 1996 as result of conversion of Blue Cross
   of California to for-profit status

   Size:   Total assets of $900 million, annual payout approximately
   $40 million, located in Oakland
         California HealthCare Foundation 5-Year Goals and Objectives
                   1. Goal: Reduce barriers to efficient, affordable health care for the underserved
 Innovations for         1.1 Encourage, test and promote lower-cost models of care
the Underserved          1.2 Improve the availability of specialty and dental care for low-income, uninsured, non-
                             English speaking, and rural Californians
                         1.3 Promote policy and operational improvements to increase enrollment and retention in
                             publicly-sponsored insurance programs
                         1.4 Increase the efficiency of safety-net institutions

                   2. Goal: Improve clinical outcomes & quality of life for Californians with chronic
 Better Chronic      Objectives:
 Disease Care
                         2.1 Expand the number of providers who effectively care for patients with chronic
                         2.2 Increase the participation of patients and families in all aspects of care
                         2.3 Promote appropriate care toward the end of life

                   3. Goal: To promote greater transparency and accountability in California’s health
                            care system
M arket & Policy
    M onitor
                         3.1 Analyze policy developments and market trends to inform or guide decision-makers
                         3.2 Advance reporting on health care provider and insurer performance
                         3.3 Increase the availability and usefulness of information and tools for consumer decision-
                         3.4 Inform statewide efforts to expand access to affordable care and coverage
Problem: Managing Patient Health

 Safety net clinics provide care to over 6.5 million
  Californians, 38% of whom have at least one
  chronic condition

 Only 25% of clinics have electronic tools capable
  of helping providers manage their entire patient

 EHRs remain prohibitively expensive, and do not
  yet have the functionality required to effectively
  manage population health

 Improve clinic outcomes for all patients served by
  safety net clinics

 Increase quality improvement (QI) capacity in
  safety-net clinics

 Help safety net clinics purchase and use tools to
  effectively manage their entire patient population
Registry Tools Program

 Subsidize the purchase of automated disease
  management systems

 Support learning sessions to help clinics optimize
  their use of registries and improve QI capacity

 Provide incentives for clinics reporting
  standardized measures for their entire patient

 Develop tools to automate data entry with free
  registries (e.g., PECS) for smaller clinics and
Problem: Diabetic Retinopathy

 Diabetic retinopathy (DR) is leading cause of
  blindness in working age adults
 Patients are not returning for separate visit for
 Shortage of providers to screen patients for
  diabetic related eye disease
 Clinical trials have demonstrated that early
  detection and treatment of DR can reduce vision
  loss by 90%
   Provide timely access to diabetic eye screening to
    prevent blindness (reach 100,000 patients)
   Broadly disseminate effective telemedicine (store
    and forward) approach
   Create environment to support further adoption of
    practice beyond initiative
CHCF Diabetic Retinopathy Initiative
 UC Berkeley Optometric Eye Center provide
  technical assistance and support
   o Cameras for 50 clinics
   o Training, installation, EyePACS, links to provider for up
     to 100 clinics

 Safety Net Clinics (including rural) selected via
  RFP in December 2007 and September 2008
 Evaluator selected via targeted RFP
Problem: Specialty Access
 Rural providers and patients lack timely access to
  needed specialty care services:
   o Transportation and geographic barriers
   o Provider scarcity
   o Lack of volume (in-person and telehealth)

 Individual efforts to improve specialty care access are
  often hampered by isolation and poor economies of
 Limited understanding of the need and which
  interventions are effective, sustainable and scalable
   Improve timely access to appropriate specialty
    care services in participating regions of rural
   Reduce costs of specialty care and reduce patient
    and family travel for specialty care
   Stimulate innovation in the approaches to
    providing access to specialty care services
   Identify the essential elements of sustainable,
    successful specialty care access programs that
    can be spread to other rural regions
Improving Appropriate Access to Specialty
Care in Rural California
 Planning and implementation grants for coalitions
  of rural health care providers
 Coordinates with Kaiser Permanente Community
  Benefit Programs planning grants

 Coalitions from eligible counties selected via RFP
  in December 2007
 Targeted technical assistance for needs
  assessment, evaluation and other grantee needs
  as identified
For more information:

Veenu Aulakh:

Jonah Frohlich:

Rafael Gomez:

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