Health plan references innovation, four-decade history with forward leading, looking back theme
CenCal Health, the Medi-Cal Managed Care health plan for Santa Barbara and San Luis Obispo counties, has published its 2022-2023 Community Report. With this year’s theme of forward leading, looking back, the annual overview – available now to the public in English and Spanish – emphasizes both the organization’s 40-year history, and its future in delivering health services to one in four residents of Santa Barbara County and one in five residents of San Luis Obispo County. The digital report notes the ongoing collaboration CenCal Health has with its 1,500+ heath care providers and other community partners. It also outlines the agency’s local role in California’s ambitious, long-term commitment to transform Medi-Cal through the initiative known as CalAIM or California Advancing and Innovating Medi-Cal. Here are some of the key member and provider programs and achievements highlighted in this year’s community report.
First CalAIM initiatives launched on Central Coast
Developed by the California Department of Health Care Services (DHCS), the award-winning plan CalAIM goes beyond traditional medical care and provides expanded services to members, addressing social factors affecting people’s health, including homelessness, behavioral health, care of older adults, services for individuals transitioning from incarceration, and beyond. For 2022, CenCal Health launched two initiatives under the CalAIM framework: Enhanced Care Management – a comprehensive case management benefit; and Community Supports, which provides medically appropriate, cost-effective alternatives to traditional medical services or settings, such as medically tailored meals and recuperative care.
Providers offered support to address social determinants of health
CenCal Health’s Incentive Payment Program (IPP) makes funds available for community partners to build and increase capacity for Enhanced Care Management and Community Supports. Implemented in 2022 by DHCS, IPP ensures that CenCal Health and its CalAIM partners are poised to provide Medi-Cal members the tools and support needed to achieve optimal health outcomes. Funding may be used by Enhanced Care Management and Community Supports providers, including community-based organizations, county organizations, and traditional healthcare providers, toward activities including case management capabilities, staffing support; infrastructure or capital investment; data exchange/information technology development; staff training, and operations.
Incentives to primary care providers who deliver exceptional medical care
Also in 2022, CenCal Health launched the value-based Quality Care Incentive Program (QCIP). QCIP offers incentives to primary care providers who deliver exceptional medical care. The program emphasizes clinical priorities of significance to CenCal Health members, such as diabetes and asthma care, breast cancer and cervical cancer screenings, and child and adolescent well-care visits. Payments are also tied to the diversity of member patients managed by each physician; as such, incentives increase to reflect the proportion of members of greater clinical complexity, for example, the aged or those disabled. As of January 2023, QCIP has resulted in a distribution of over $11.1 million in payments.
High marks from both members and industry surveys for CenCal Health, providers
CenCal Health received high marks in two respected professional health care assessments– the national Healthcare Effectiveness Data and Information Set (HEDIS®), and the state-wide report on Consumer Assessment of Healthcare Providers and Systems (CAHPS®). With results released in 2022, the findings in both annual audits concluded that, in multiple categories, CenCal Health and its providers delivered exceptional care to child members, as well as members that are new mothers and members with diabetes.
Strategies for the future
With the shared vision to advance health equity so that community residents thrive and achieve optimal health, CenCal Health’s leadership and staff created the 2023-2025 Strategic Plan. Developed in 2022, the Strategic Plan is organized around CenCal Health’s four main goals – cultivate community partnerships; advance quality and health equity for all; expand its service role and reach; organize for impact and effectiveness. Tied to each goal are key objectives and multiple strategies to meet those objectives. One set of objectives and strategies is specifically directed at reducing health disparities in the local population.
“At CenCal Health, we value compassionate service, collaboration, integrity and improvement. I am pleased to present our 2022-2023 Community Report, which provides an opportunity to reflect back on achievements and share opportunities for the future,” said Marina Owen, CenCal Health CEO. “Through this report, we bring our values to life.” The public is invited to review the 2022-2023 Community Report at www.cencal2023.org
About CenCal Health
CenCal Health is the community-accountable health plan serving nearly 232,000 members in Santa Barbara and San Luis Obispo counties.
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Media Contact: Sheri Mobley 213 509-9816 sheri@seamlesspr.com
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