At Covered California’s latest April Board meeting, Executive Director Peter Lee declared: “We are raising the bar not just for California but for the nation.” Mr. Lee was referring to the bold initiatives adopted by the Covered California board that they expect will improve quality of care for Covered California enrollees, make advances in hospital safety, and promote primary prevention and wellness. The contracts will include 45 separate distinct requirements on plans focused on improving health outcomes for Covered California enrollees (See Attachment 7).
Starting in 2017, Covered California’s contracts will require health plans to demonstrate year-over-year reductions in health disparities in four targeted areas of chronic disease: diabetes, asthma, hypertension and behavioral health. In order to accurately measure disparities, health plans will be required to share quality and performance data for all their lines of business. Additionally, plans will be required to increase the percentage of self-reported demographic data for their Covered California enrollees with a goal of 80% of enrollees reporting by the end of 2019.
Communities of color are disproportionately impacted by chronic diseases, the leading cause of death in the United States and a significant contributor to health care costs. The California Department of Public Health in its report, Asthma in California: A Surveillance Report, found asthma hospitalization and emergency department visit rates are higher for African-Americans and Hispanics than for Whites, especially among children. With almost three in four California children from communities of color, this initiative will improve health outcomes and result in a healthier California for all of our children.
Many leading health advocates believe that the ground-breaking decision by Covered California will encourage alignment and spur innovation in other health care programs and delivery system reforms. This is especially important as families often move back and forth between employer sponsored coverage, the Covered California marketplace, and Medi-Cal. California’s diverse communities will benefit from these kinds of bold initiatives, and Covered California should continue to raise the bar by considering additional disparity reduction measures for other populations, including LGBTQ, children with special health care needs, individuals with disabilities, and families with Limited English Proficiency.