California Chronicles: Navigating Healthcare Innovation and Equity
Health Tech 4 Medicaid
We're on a mission to radically change the pace of innovation in Medicaid, improving quality, equity and access to care.
In this edition of our newsletter, we're thrilled to shine the spotlight on the Golden State: California. As one of the largest and most diverse states in the nation, California plays a pivotal role in shaping the future of healthcare, particularly for Medicaid recipients and underserved communities.
Join us as HT4M?explores the latest developments, innovative initiatives, and key challenges facing healthcare access and equity in California. From groundbreaking policy reforms to grassroots advocacy efforts, California continues to lead the charge in driving positive change in the healthcare landscape.
We'll also highlight the remarkable work of local organizations, leaders, and changemakers who are making a difference in the lives of Californians every day. This is deeply personal for me—I began my journey in Medicaid in California over two decades ago as an epidemiologist. I was a leader in the historic 2005 1115 waiver and built my hospital leadership career in this state.
Additionally, we're excited to announce our support and co-leadership in upcoming conferences such as the California Medical Association (CMA) Health IT Summit?in May and panel at the Longevity Venture Summit in June, where we'll be discussing cutting-edge solutions for improving healthcare access and outcomes. We'll delve into our many health equity initiatives including those?focused on older adults across California, addressing their unique healthcare needs and challenges, in addition to?birth equity, tech equity, venture for Medicaid, other critical topics of interest throughout California.??
So, grab your virtual passport and join us on this journey as we dive into the dynamic world of healthcare in California! We are also committed to other State highlights, so please let us know what geographic locations interest you.?Drop us a line at [email protected]. With warmest regards,
Adimika Arthur
CEO & Executive Director
HealthTech 4 Medicaid (HT4M)
HT4M Making Waves in California
HT4M Member Companies Transforming California
HT4M's Member organizations are revolutionizing healthcare across the nation, with transformative impacts reaching into the heart of California. From pioneering digital health solutions to groundbreaking policy advocacy, our members are at the forefront of driving positive change in healthcare delivery and accessibility. We are thrilled to spotlight?recent achievements of a few?member companies working in California, to showcase?their innovative approaches and tangible contributions to improving healthcare outcomes in the state:
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By joining HT4M, healthcare organizations unlock invaluable insights into the Medicaid ecosystem, wield influence over the future of Medicaid innovation, and join forces with a community dedicated to tackling healthcare's most pressing challenges. Our membership offerings for 2024 are bigger and better than ever before – become a member today!
Join?HT4M's California Health Plan Community
HealthTech 4 Medicaid (HT4M) is committed to driving innovation within Medicaid, with the overarching aim of enhancing the quality, equity, and accessibility of care for its 90+ million recipients. Serving as a mission-driven market facilitator and expert ecosystem builder, convener, and policy advocate, we specialize?in fostering collaborative partnerships in health technology on a national scale. As we stride into Q2 2024, we eagerly seek to forge collaborative alliances with California health plans. Together, we can harness our collective expertise to play a pivotal role in reshaping the Medicaid landscape within the state, ushering in a new era of healthcare innovation and accessibility. HT4M Member, Blue Shield of California, stands at the forefront of this movement, exemplifying dedication as a nonprofit health plan committed to providing Californians with access to high-quality healthcare at affordable rates. With a legacy spanning over two decades, Blue Shield of California continues its unwavering commitment to expanding its range of offerings, ensuring that its members receive access to premier healthcare solutions across a wide?array of counties statewide. Join HT4M today, and let's collaborate to transform healthcare for California and beyond!
Contact [email protected] to partner with us!
Join HT4M & CMA in San Francisco May 7-8!
Save the date and?join HT4M & CMA in San Francisco for The?2nd Annual Health IT Summit, "Health IT in the Safety Net."
As California works to expand coverage to underserved populations, health IT can play a pivotal role in ensuring equitable access to care. The 2nd Annual?Health IT Summit will bring together thought leaders from across California and the nation to explore how to make that vision a reality.
Building off the huge success of last year’s sold-out summit,?a diverse and engaged set of attendees is expected,? including?physicians, medical groups and IPAs, health plans, health information organizations (HIOs) and others who will take the learnings from this conference to change how care is delivered in this state.
Details:
Date: May 7-8, 2024
Location: Grand Hyatt at SFO in San Francisco
Find speakers and additional event details here.
Register to attend below! Use the code?"HT4M" for $50 off?registration. ?
Interested?in volunteering ??Or want to be a sponsor??Check out the forms here:
Join HT4M in San Francisco?June 11-12
Now in its 21st year, the What’s Next Longevity Venture Summit continues its mission to bring together top industry entrepreneurs, investors, thought leaders, analysts, media, and innovators, all to help you advance your business and expand your network of experts in the longevity economy.The theme for the 2024 Longevity Venture Summit is Net New: Investment, AI, & Innovation in the Longevity Marketplace. This year we are developing sessions and selecting speakers that will ensure our continued commitment to the collaboration of forward-looking entrepreneurs and investors.It’s more than an event—it’s an opportunity to shape the future of innovation in aging and healthcare!?
领英推荐
Details:
Date: June 11-12, 2024
Location:?The Fairmont San Francisco
Find speakers and additional event details here.
Register to attend below! Use the code?HT4M20 for a 20% discount. ?
Improving Care for?Older Adults on Medicaid through Innovation
In California, and across the nation, there's a pressing need for coordinated, comprehensive care for high-risk populations served by Medicaid, especially for older adults. However, innovation in care delivery for these individuals, particularly dual eligible beneficiaries, remains largely untapped. The prevalent distrust and limited collaboration among stakeholders, including healthcare providers, policymakers, and private sector players, pose significant barriers to effective care. Given the role the private sector plays in driving innovation in many aspects of American health care, Health Tech for Medicaid (HT4M) and the Duke-Margolis Institute for Health Policy ?(Duke-Margolis), funded by The SCAN Foundation , recognize the potential of harnessing private sector innovation to enhance Medicaid care, drawing lessons from other healthcare sectors.? Our initiative promises exciting outcomes for older adult communities in California and beyond by:
Interested in joining this initiative to innovate care for older adults? Let us know below!
Contact us at [email protected] to get involved.
State of the State: Medicaid in California
The Californian?Medicaid program, or Medi-Cal, serves as the predominant health insurance provider for over 15 million individuals in California, constituting 1/3 of the state's population. It?extends health coverage to low-income children and their parents, pregnant people, older adults, and people with disabilities. For seniors with limited financial means, Medi-Cal offers coverage for services not covered by Medicare, such as nursing home care. Receiving substantial funding from both federal and state sources and serving as a crucial healthcare lifeline for millions of Californians, this program holds a significant position in state budget and policy dialogues, consistently showcasing leadership and innovation among state Medicaid initiatives.
Medicaid Redetermination
Amid the COVID-19 Public Health Emergency (PHE), all states temporarily halted Medicaid disenrollment or member "churn" in exchange for increased federal funding. Nevertheless, the Consolidated Appropriations Act, signed into law on December 29, 2022, mandated the conclusion of continuous coverage by March 31, 2023. Disenrollments in California began in June 2023. Since then, enrollment has declined by 977,532 from March to December 2023, according to KFF.? California's implementation of federal flexibilities, however, have allowed more individuals to undergo eligibility determinations via ex parte, along with other beneficial policies and practices introduced during the unwinding process.? Find more key takeaways from Medi-Cal redetermiantion data from the California Health Care Foundation here. ?
We want to hear about your efforts in ensuring uninterrupted healthcare for the Medicaid population! What innovative solutions are you testing, developing or utilizing? Are there any outreach initiatives, education programs, or beneficiary assistance work that we can highlight and support? Let us know below! Interested in talking with Adimika Arthur, HT4M's CEO & Executive Director, to discuss your innovative solution? ?Schedule a meeting here. ?
Statewide Data Exchange for Enhanced Healthcare Sharing
California has introduced a groundbreaking initiative with the enactment of AB 133, establishing the nation's first statewide bidirectional data exchange framework known as the California Health and Human Services Data Exchange Framework. Governed by a stakeholder advisory group, this initiative focuses on creating standardized policies, procedures, and a unified data-sharing agreement for real-time health information exchange among healthcare entities and government agencies in the state. Beyond enhancing healthcare data accessibility for key stakeholders, the law also emphasizes privacy and patients' control over their data. Starting in 2024, all health plans, hospitals, physician organizations, and clinical laboratories in the state will be mandated to participate in this innovative data exchange, a significant stride toward improving care coordination and providing patients with real-time access to treatment, payment, and operational information. Key provisions of AB 133 include patients' rights to access, correct, or delete their healthcare data, the option to opt out of third-party data sharing, and mandated measures for healthcare organizations to safeguard patient data against unauthorized access or disclosure.?Learn more?here.
Recovery Challenges for Health Sector Following Cyberattack on UnitedHealth Unit
Since the cyberattack?on Change Healthcare, a medical payment processing company acquired by UnitedHealth Group in 2023, healthcare providers across the United States, including in California, have faced significant challenges in electronically billing for their services. The company, which manages billions of clinical, financial, and operational transactions annually, suffered a ransomware attack on February 21, disrupting crucial billing processes. The American Hospital Association has labeled the attack as the most substantial incident of its kind in U.S. healthcare history, highlighting the broader vulnerability of the healthcare system to cyber threats. Despite efforts by UnitedHealth Group and the American Hospital Association to communicate about the incident, many providers remain uninformed about the attack's specifics, exacerbating the situation. In the long term, the cyberattack raises concerns about the resilience of the U.S. healthcare system against cyber threats and underscores the need for robust cybersecurity measures. With healthcare providers estimated to be losing up to $1 billion per day from the attack, the impact on California's providers is substantial, requiring additional resources to manage patient eligibility, claims filing, and administrative burdens. The incident underscores the urgent need for comprehensive cybersecurity strategies to safeguard the integrity and security of healthcare systems, both at the state and national levels.
Policies?Shaping the Future of California Healthcare
Navigating Medicaid Reforms for Incarcerated Individuals' Re-entry?
In April 2023, CMS urged states to explore a new Section 1115 demonstration, offering a platform to test transition-related strategies supporting the re-entry and care transitions of incarcerated individuals. Notably, California and Washington secured approval, while several other states have pending proposals for waivers to facilitate re-entry. This unique opportunity permits states to partially waive the Medicaid inmate exclusion policy, enabling Medicaid to cover services during incarceration. The integration of equity initiatives into these transitional strategies is crucial for addressing individuals' foundational health needs and enhancing their potential for success upon re-entry. ?
Health Related Social Needs
The Centers for Medicare & Medicaid Services (CMS) recently granted approval on?guidance that aligns with the Biden-Harris Administration's unveiling of the U.S. Playbook to Address Social Determinants of Health and Department of Health and Human Service's Call to Action to Address Health-Related Social Needs. As of January 2024,? Section 1115 demonstrations within the new HRSN 1115 framework now empower evidence-based Health-Related Social Needs (HRSN) services for targeted high-need populations in Arizona, Arkansas, California, Massachusetts, New Jersey, New York, Oregon, and Washington.
Absolutely love how HT4M champions healthcare innovation and equity, especially in a diverse landscape like California! ?? Reflecting on the power of community and innovation, a recent Forbes piece highlighted - Innovation flourishes not from solitary genius but through collective effort and diverse perspectives. It's a reminder that every step forward in healthcare is a leap towards inclusivity. #HealthcareInnovation #CommunityImpact