Only several weeks into the year and many of our systems’ leaders have already come together to share strategies, learn from experts and each other, and explore lessons learned to truly better patients’ lives in 2024.
Recently, 14 California public health care systems met to advance strategies that embed equity throughout their organizations as part of SNI’s Racial Equity Community of Practice (CoP). These members are participating in the second phase of the CoP, which will run for two years and builds on the first phase’s momentum. You can watch and read about how system leaders in phase one think about (and act on) racial equity, what advice they have for other systems around equity work, and more here.
On January 24, nearly 120 leaders from public health care systems and local Medi-Cal managed care plans gathered in Burbank as part of SNI’s collaboration to strengthen partnerships between systems and plans. This first convening, run in collaboration with the Local Health Plans of California (LHPC), focused on quality and equity.
Leaders from public health care systems and local Medi-Cal managed care plans gather at an SNI event in January 2024.
Speaking of collaboration, read below and here for a groundbreaking example of medical and social services integration on-site at Riverside University Health System’s (RUHS) Jurupa Valley Community Health Center. You’ll learn about why this new approach has been a hit with patients.
Lastly, as we move into the new year, systems continue their work in the Quality Incentive Pool (QIP), a pay-for-performance program that provides critical funding for public health care systems if they meet ambitious improvement targets on clinical measures. SNI convenes system leaders to share effective strategies to succeed in QIP, from improving cesarean birth rates to follow-up with patients after an ED visit for mental illness.
Patients’ Social Services Needs Met at Jurupa Valley Community Health Center
When you think of patients meeting with their primary care physicians at a community health clinic, you don’t usually think of them as leaving with completed applications for a Social Security number and legal documents appointing health care agents.
But at Jurupa Valley Community Health Center, part of RUHS, patients currently receive such help, and much more, thanks to the recent integration of social services into its physical and behavioral health care.
Staff from Riverside University Health System and the Safety Net Institute at RUHS’ Jurupa Valley Community Health Center.
“We pull on each other’s experience to make it happen for the patient,” said Shannon Bates, social services supervisor, Riverside County Department of Public Social Services. Part of this tight collaboration occurs during daily huddles when employees from the clinic, the newly built Family Resource Center, and on-site social services agencies (WIC, Office on Aging) gather to discuss and track their collective progress in meeting each patient’s needs.
So far, 100% of patients return for follow-up appointments with resource specialists and social workers. Read our blog about who and what is shaping this successful integrated care model, from social worker Rosalba Mejia-Torres to the whole person health score.
Winners of the Quality Leaders Awards and Their Work
At the CAPH/SNI annual conference last month, six public health care systems were recognized for their inspiring approaches to advancing equitable and high-quality care. The winners of the 2023 Quality Leaders Awards are:
Top Honor – UC San Diego Health
UC Health Milk Bank: Increasing Donor Milk Access in California
Despite strong evidence to support the use of pasteurized donor human milk (PDHM) for vulnerable infants, 20% of California NICUs do not have PDHM programs. This access disparity falls along racial and socioeconomic lines, leading to poorer health outcomes for infants of color. UC San Diego Health started the UC Health Milk Bank (UCHMB), to solve disparities in access to high-quality pasteurized donor human milk in NICUs. The program has since expanded donor milk access by opening the first accredited milk bank in Southern California under the Human Milk Banking Association of North America. In addition, UCSD Health worked with stakeholders to revise the 2022 Medi-Cal PDHM policy, making it easier for providers to prescribe PDHM when medically necessary, and established the Bridge Milk Fund to assist financially insecure families in accessing PDHM.
Equity – Zuckerberg San Francisco General
Behavioral Emergency Response Team: A Trauma-Informed Approach to Support Our Patients and Nonpsychiatric Medical Colleagues
Zuckerberg San Francisco General (ZSFG) established the Behavioral Emergency Response Team (BERT) program in 2018 with the goal of de-escalating behavioral health emergencies to create a safer and calmer environment for hospital patients and staff. BERT approaches these situations with trauma-informed care, focused on 24/7 support, verbal de-escalation, and patient engagement. BERT has played a vital role in reducing use-of-force incidences; 84% of BERT Activations were completed without law enforcement present. Due to the program’s success, it received permanent funding and expansion in 2022.
Care Redesign – Los Angeles County Department of Health Services
Advancing Equity and Reducing Disparities in Care by Expanding Access to Genetic and Genomic Testing in the Safety Net
Advanced genetic testing offers significant promise to improve care for many life-threatening diseases. However, inequities in access to genetic testing and counseling among racial and ethnic minorities threaten to exacerbate disparities in health care outcomes. To increase appropriate care delivery for genetic diseases, the Los Angeles Department of Health Services (DHS) has established a multidisciplinary genetics and genomics optimization program to develop and align best practices for screening, testing, and counseling of conditions with genetic basis of disease to improve outcomes and reduce care gaps. Since its creation, the program has improved on several of its goals, including improving clinical guidelines, hereditary cancer risk assessment and testing, and streamlined patient navigation.
Innovation – Santa Clara Valley Medical Center
Integrated Transitions of Care Model for Vulnerable Populations
Patients with cognitive impairments reentering communities after incarceration remain at high risk for poor health outcomes and often require extensive care coordination and support. The Integrated Care Team (ICT) program by Santa Clara Valley Medical Center provides complex care coordination to these patients post-custody release by establishing access to a medical home and addressing social determinants of health. By using a patient-centered approach, including case meetings and patient outreach, Santa Clara Valley Medical Center can better support the individual’s reintegration into the community. This program has resulted in increased primary care physician visits and court system compliance and decreased Emergency Department utilization and custody encounters for patients.
Population Health – UC Davis Health
Advance Care Planning and Mandatory Surprise Question
UC Davis Health initiated a comprehensive effort to enhance Advance Care Planning (ACP) in both inpatient and ambulatory settings by introducing their predictive Mandatory Surprise Question (MSQ) in January 2020. Admitting providers assessed whether they would be surprised by patients passing away in six months. “Not Surprised” patients exhibited a 6-fold higher mortality rate, more palliative/hospice referrals, longer stays, and increased ICU admissions. This predictive tool led to increased Advance Care Planning (ACP) rates, greater use of palliative care, and higher inpatient hospice enrollment. Overall, it has reduced unnecessary medical interventions and health care spending.
Honorable Mention – Kern Medical
Shelter Integrated Recuperative Care Facility
The Recuperative Care Facility program by Kern Medical was created to help alleviate the strain on the hospital caused by the rising homeless population. The facility provides non-acute care, including communal and isolation rooms, with the goal of lowering health care expenses, enhancing patient outcomes, and reducing the risks homeless patients face during their recovery. Kern Medical is also integrating medically assisted treatment for those in the homeless population who are willing to seek help. Since its official opening on July 1, 2023, the facility has been able to accept 20 referred patients who have stayed for a total of 235 bed days.
Webinar Series Recap on Meeting QIP Targets
In 2024, three Quality Incentive Pool measures moved to the priority measure set: the Cesarean Birth Measure; Follow-Up After ED Visit for Substance Use Measure; and Follow-Up After ED Visit for Mental Illness Measure. In the fall and winter of 2023, SNI’s three-part webinar series focused on helping members prepare for these new PY7 priority measures. In this webinar series recap, you can read about promising practices and strategies that San Joaquin General Hospital’s Family Maternity Center, Riverside University Health System, and UC San Francisco have implemented regarding these measures.
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LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE (NUBC)
These materials contain the NUBC Official UB-04 Specifications Manual and data codes (UB-04 Data), which are copyrighted 2022 by the American Hospital Association (AHA), Chicago, IL. Reproduced with permission. No portion of the AHA copyrighted materials may be copied without express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816.
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2. Any use not authorized herein is prohibited, including, by way of illustration and not by way of limitation, making copies of UB-04 Data for resale and/or license, transferring copies of UB-04 Data to any party not bound by this agreement, creating any modified or derivative work of UB-04 Data, or making any commercial use of UB-04 Data. License to use UB-04 Data for any use not authorized herein must be obtained through the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. Applications are available at the NUBC website, http://www.nubc.org/.
3. The UB-04 Data included in this product is commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
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This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the AMA, 330 Wabash Avenue, Chicago, IL 60611. The AMA does not agree to license CPT to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. The AMA reserves all rights to approve any license with any Federal agency.
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You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
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Applicable FARS\DFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the AMA, AMA Plaza, 330 Wabash Ave., Suite 39300, Chicago, IL, 60611- 5885. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Defense Department procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non- Department of Defense Federal procurements.
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LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE (NUBC)
These materials contain the NUBC Official UB-04 Specifications Manual and data codes (UB-04 Data), which are copyrighted 2022 by the American Hospital Association (AHA), Chicago, IL. Reproduced with permission. No portion of the AHA copyrighted materials may be copied without express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816.
Making copies or utilizing the content of the UB-04 Manual, including codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of the UB-04 Manual or any portion thereof, including the codes and/or descriptions is only authorized with an express license from the AHA.
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2. Any use not authorized herein is prohibited, including, by way of illustration and not by way of limitation, making copies of UB-04 Data for resale and/or license, transferring copies of UB-04 Data to any party not bound by this agreement, creating any modified or derivative work of UB-04 Data, or making any commercial use of UB-04 Data. License to use UB-04 Data for any use not authorized herein must be obtained through the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. Applications are available at the NUBC website, http://www.nubc.org/.
3. The UB-04 Data included in this product is commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
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UB-04 Data is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The sole responsibility for the software, including any UB-04 Data and other content contained therein, is with the Medicare/Medicaid Contractor or the CMS; and no endorsement by the AHA is intended or implied. The AHA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice to you if you violate the terms of this agreement. The AHA is a third-party beneficiary to this agreement.
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The scope of this license is determined by the AHA, the copyright holder. Any questions pertaining to the license or use of the UB-04 Data should be addressed to the AHA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USE OF THE UB-04 DATA. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMMISSIONS OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
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